Private hospitals take advantage of NHS waiting lists as people without insurance pay | Private medical care

When Fabien had to have a decayed tooth removed in May, his dentist told him he would have to wait up to three years for it to be done on the NHS. Incredulous, the 27-year-old from Edinburgh called 50 dental offices, but was unsuccessful. He had no choice but to go private. Having lost his job during the pandemic, he was on universal credit and had to borrow the £ 600 from his family.

Fabien is one of the growing number of people without health insurance who pay for their medical care out of pocket. Waiting lists at NHS hospitals in England have reached record highs, reaching 5.6 million this summer, as doctors struggle to clear a growing backlog caused by Covid-19. People with modest incomes, and even those seeking benefits, turn to private providers for knee or hip replacements, cataract removal or even expensive cancer treatment.

This week, a survey of 4,000 adults commissioned by the charity Engage Britain found more than a fifth had become deprived because they could not get the treatment they needed. While support for the NHS remains high, a quarter said that waiting for treatment for themselves or a loved one has had a serious impact on their mental health.

About 13% of the UK population has some sort of health insurance, mainly through their employers. Others face a difficult choice: wait months, if not years, for much-needed treatment, or save money to skip the line.

“The pandemic will have a lasting impact on the self-payment market,” said Vernon Baxter, managing director of HealthInvestor UK magazine. “With the NHS under pressure for the foreseeable future, the concept of paying out of pocket to speed up treatment will be increasingly common – for those who can afford it. “

Health data company LaingBuisson has valued the annual self-pay market worth at £ 1.1bn, including cosmetic surgery, and says it grew 7.1% between 2010 and 2019. That year, private hospital groups drew just over 20% of their income from patients who pay themselves. With private hospitals closed to non-NHS patients during the pandemic, statistics were not collected last year, but all indications are that they will have increased significantly.

Medical students chat with each other and their manager after a shift in the wards of a hospital in Speyer. Photograph: sturti / Getty Images

Last week, Spire Healthcare revealed a 47% increase in semi-annual self-paying patient revenue to a record £ 130million, which took overall revenue to nearly 40% from prior levels. the pandemic at £ 558million.

The UK’s second-largest private hospital group, with 39 hospitals and eight clinics, Spire says the majority of paying patients are aged 35 or over and most have a combined family income of over £ 50,000 . As CEO Justin Ash says, “They’re by no means the wealthiest. David Hare, CEO of Independent Healthcare Providers Network, the industry body, says many people have accumulated savings over the past 18 months. , not having been able to travel or dine outside, and “some people want to spend this money to regain full mobility” by having knee or hip surgery. “People also pay for cancer treatments,” he says.

A similar picture emerges among Speyer rivals. The UK branch of HCA Healthcare, listed in the US, which dominates the London market, saw a 25% increase in self-paid hip and knee replacements and other orthopedic procedures, a 20% increase in cardiothoracic operations such as aortic valve replacement and repair, and a 30% increase in neuroscience treatments, such as injections in the joints to treat back, head, neck, shoulder, groin or leg pain. People are coming to the HCA’s six London hospitals from further afield than usual, particularly from the south and southwest of England where it has seen 25-35% more paying patients.

Britain’s largest private hospital chain, BMI Healthcare, has refused a request to share numbers for its own hospitals. He is part of the BMI Circle group, which now operates 53 hospitals in the UK, and is owned by Centene Corporation, a listed US healthcare giant.

Documents filed by the company show that at BMI the highest paid director, believed to be Karen Prins, the managing director, received nearly £ 1.6million for the year through March 31 2020. The company did not pay a dividend, but the previous year it paid £ 1.1 billion to its then parent company, GHG.

Baxter says the UK private healthcare sector is “really at a crossroads”. Operators decide to position themselves as an NHS partner or as a competitor.

David Rowland, director of the Center for Health and the Public Interest think tank, said: ‘There is a great risk that unless the government provides adequate funding for the NHS, more and more people will be forced to pay privately, which in turn will undermine the middle-class support for a tax-funded NHS.

“We are unlikely to end up with an American style insurance system. But a two-tier system, where the NHS is a residual service for those who cannot afford to pay is a possibility – at the end of the day, these are political choices. “

Rowland says private operators were already trying to “create a new kind of healthcare consumer” who pays for their own treatment before the pandemic, through television and social media campaigns. They have sought to make self-payment more attractive by offering fixed-price packages and some hospital groups, such as Nuffield Health, offer zero-interest financing. They also embarked on lucrative cancer treatments, which became the main source of income for private hospitals in London in 2019, when the Cleveland Clinic and other American brands entered the UK.

Public support for the NHS remains high after the pandemic. But the government has imposed a hike in national insurance to lower waiting lists. With many now paying twice for care – first through their taxes, then out of their own pockets – this goodwill cannot be taken for granted.

“I don’t know if I’m angry or annoyed,” says Fabien, who is still in debt to his family. “I feel like it’s really unfair to have to pay for treatment.

The cost of typical operations

  • Knee – over £ 9,000

  • Hip – from £ 12,060

  • Cataract – from £ 2,040

  • Hernia – £ 3,077

  • Slipped Disc – £ 6,525

* Prices vary – examples given by Spire Healthcare

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Robert Young

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