Going private: should you pay to skip NHS queues?

One month after she found out she had cataracts, Marion Trew couldn't see well enough to drive properly. After six weeks on the NHS waitlist, she received a letter confirming her operation, but with no timeline given. 

Faced with an unspecified wait, she explored her options. 

'I'm 75,' she told us. 'I'll probably be dead in 10 years. If I can't do things and I lose a year, that's 10% of the life I have left.' 

So she went private, seeing a consultant in less than two weeks. She had both of her operations within a month at a cost of £5,000 (£2,500 per eye). 

Marion is grateful she was able to have private surgery, but she's conflicted. 

'I was beset with guilt because I could afford it, but I have an acquaintance who couldn't. It's not very fair.'

Post-pandemic, there's been a jump in patients turning to the private sector in the wake of long NHS waiting times. According to the Private Healthcare Information Network (PHIN), 272,000 UK patients self-funded private care in 2022 - a 37% increase on pre-pandemic levels.

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The self-pay private health boom

A few decades ago, Marion's story was relatively unusual. But it's getting more common. 

More people are paying for one-off treatments, such as private surgery, rather than signing up to private medical insurance (PMI). 

'It does seem that it's self-pay, rather than PMI, that's taking off since the pandemic,' says Siva Anandaciva, chief analyst at health charity The King's Fund. 

'People who have the means to do so don't opt out of the NHS completely, but for episodes of care they go around the NHS.' 

There are certain demographics who are more likely (and able) to take this route. Self-paying patients tend to be retirees who can fund care with life savings, a pension pot or wealth gained through downsizing. 

What's driving private patients? 

You won't be surprised to learn that the biggest motivator behind the growth in the self-pay health market is the time it takes to access NHS care. 

We surveyed 14,821 Which? members in June 2023 about whether they'd self-funded healthcare in the past two years, and one in five said they had. 

Appointments with consultants were the most common, followed by diagnostic procedures (such as X-rays), operations and private GP appointments. The majority said that long NHS wait times were their primary motivation.

This was the case for Mary James, who waited two years for an NHS hip replacement at a Derby hospital. 

By the time the wait was over, life had moved on, and Mary had moved hundreds of miles across the country to Cornwall. 

To have the operation locally, she'd have to rejoin the waiting list, and possibly endure another two or three years of considerable pain and reduced mobility. 

She told us: 'At 78, I couldn't contemplate waiting any longer. I'd had enough of the pain. No more messing about, let's just get on with our lives.'

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How does 'going private' work?

So what does 'going private' actually look like? A lot depends on the treatment you're paying for. 

Hip replacements, knee operations and cataract surgery are among the most popular self-funded operations, but you can also pay privately for one-off GP appointments and tests. 

For something that requires a hospital visit, you have a few options to start the process. 

You could ask your GP if there's someone they'd recommend for what you need, or you could ask an NHS consultant you're already seeing if you could book with them privately. 

You can also search for nearby private hospitals online, where consultants, prices and terms and conditions should be listed. 

The independent Private Healthcare Information Network (PHIN), has a 'find a consultant or hospital' search tool you can use, and you can also read the NHS guide to using private care.

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Private health costs can vary significantly

Hospital procedures are typically priced as packages, which include fees for the staff involved and peripherals such as food.

A lifetime of NHS care can leave us blind to the high price of everyday health procedures: costs can add up quickly, particularly if you need multiple investigations. 

Prices can vary substantially, both regionally and by patient. Standalone procedures are more of a known entity, so it's worth doing your homework and comparing what's included.

The average hip replacement costs just over £13,000, and cataract surgery will set you back around £2,800 per eye, but again prices can fluctuate by thousands of pounds depending on the provider.

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Need a GP? There's an app for that

It seems like companies offering speedy access to virtual private GP appointments have been popping up everywhere recently.

Most big high street pharmacy chains, such as Boots, Superdrug and Lloyds, offer some version of these services, which typically promise easy and quick access to an appointment, something that past research has shown is a top frustration amongst patients. 

But naturally, this comes at a price. 

Appointments range from around £40 to £100 or more for an appointment that could be just 10 minutes, or up to an hour. 

With your consent, some providers can access your NHS records for a fuller picture of your health. However, keep in mind that you'll typically have to pay extra for any follow-ups such as blood tests or other diagnostic procedures. 

Also factor in the cost of required prescriptions - which won't be capped at the £9.65 NHS price. 

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Is it worth paying for private care?

Private patients we heard from in our survey were generally very happy with their care. 

Since you'll often be seeing a doctor who also works for the NHS, in some cases the treatment itself might be exactly the same. 

What's likely to be better are the things surrounding the treatment - including private rooms and better food. 

The biggest driver though is how quickly you'll be seen and treated.

What's the long-term impact of self-funded private healthcare?

Some fear the rise in self-pay care lays the groundwork for a two-tier system, where wealthy patients are fast-tracked while poorer patients wait. 

At the moment, private healthcare in the UK tends to focus on elective surgery, rather than a 'full suite' of healthcare services. 

Most private hospitals don't have a full A&E service, and most experts still consider the NHS better equipped to handle urgent care and terminal illnesses. 

The typical self-paying patient only turns to the private sector because they feel they have little choice - and have the funds available. The picture could start to look more worrying if there's a rise in people taking on debt to fund care. 

'The public's belief in the NHS is pretty rock solid, even as satisfaction falls,' says Siva Anandaciva. That's evident from the patients we've heard from, the vast majority of whom express a sadness that they couldn't get NHS treatment as quickly as they'd like. 

In July this year, three major health thinktanks warned of successive governments’ ‘addiction to short-termism’ when it comes to NHS reform. 

That's something Marion Trew, the ex-NHS nurse we spoke to, agreed with. When she cleared out her desk at the end of her NHS career, she found several papers outlining reform plans, each just a few years apart. ‘They never gave anything a chance to work,’ she says.

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