As more people opt for private healthcare in the UK, what is causing this surge in popularity? And what does this mean for the NHS in the coming years?

5 minute read

Since its birth in 1948, the NHS has been the bedrock of healthcare in the UK, providing free-at-the-point-of-use care from the cradle to the grave. However, in recent years, there has been a dramatic rise in the number of people opting to pay privately for medical treatment.

So what is causing this surge in popularity? Is private healthcare only for the wealthy? And what does this mean for the NHS?

What percentage of the UK population have private healthcare?

According to the Statista’s Consumer Insights, the number of adults using health insurance has almost doubled in recent years. Since 2019, the number of adults with private healthcare was steady at around 12%. By the end of December 2022, this had increased to 22%.

Last year, 272,000 people in the UK paid privately for surgery or a diagnostic procedure, an increase from 262,000 from the previous year. In 2019, before the pandemic hit, this figure was considerably less, at just under 200,000. Most people opted for private treatment for non-urgent or “elective” procedures for which waiting lists can be several months, or even as long as a year.

The top ten procedures carried out in private hospitals last year were:

1. Cataract surgery (76,000)

2. Chemotherapy (66,000)

3. Diagnostic endoscopy (38,000)

4. Diagnostic colonoscopy (31,000)

5. Hip replacement surgery (30,000)

6. Knee arthroscopy (21,000)

7. Epidural (19,000)

8. Knee replacement surgery (19,000)

9. Inguinal hernia repair surgery (14,000)

10. Diagnostic cystoscopy (12,000)

Why is private healthcare gaining popularity in the UK?

The rise in the number of people turning to private health care appears to be due to a perfect storm of the pandemic, an aging population, chronic staff shortages, recent strike action, and years of underfunding. These have all increased strain on an already struggling NHS in recent years.

In May 2023, the waiting list for non-urgent hospital treatment rose to a record of nearly 7.5 million. More than half of those on the list had been waiting up to 18 weeks and about 400,000 patients had been waiting more than a year. Non-urgent treatments may include diagnostic tests like endoscopy, colonoscopy, hip and knee replacements, some cancer treatments, heart, and brain surgery.

The 18-week treatment target set by the government has not been met since 2016.

With waiting lists at an all-time high, many people are opting to pay privately to ensure they receive fast, high-quality care. In addition to this, more employers than ever are taking out private health insurance policies for their employees.

In a recent survey, participants were asked how likely they would be to pay for private healthcare if they needed it. 23% of those questioned said they would be likely to pay, while 47% said they would be unlikely to pay for private treatment.

Is private healthcare available to all?

Private healthcare in the UK has long been viewed as a luxury only the wealthy can afford. However, in recent years, many people who would never ordinarily go private are paying for medical treatment either directly, or through health insurance.

For some people, paying for treatment may make more financial sense than losing income from taking time off work. Record waiting times and more employees on long-term sick leave has also meant that more employers now offer health insurance as an employee benefit.

Around one in five UK employers are considering offering private health insurance to their employees in the coming year, and this number is expected to rise.

What is the cost of private healthcare in the UK?

According to research conducted by myTribe insurance, the average cost of private health insurance in the UK is £86.07 per month, or £1,032.84 per year.

The price you pay for health insurance varies according to several factors, including:

• Your age - insurance premiums increase with age from an average of £36.19 per month for a 20-year-old to around £179.21 a month for a 70 year old.

• Where you live - insurance companies take into account factors such as the cost of private medical treatment in your area, how affluent the area is, how many policyholders are in your area and the claim rate for that area. London is the most expensive place to buy health insurance, with premiums an average 25.55% higher than the national average, followed by Manchester at 12.60% higher. Edinburgh is the cheapest, at 15.74% below the national average.

• Whether or not you smoke - if you smoke in any capacity, you can expect to pay a higher premium than a non-smoker.

• Pre-existing medical conditions - chronic or pre-existing medical conditions may not be covered by your insurance policy, or you may need to pay a higher premium.

• Guided or unguided consultant access - guided access means you have to choose a consultant on the insurance company’s “approved” list, whereas unguided consultant access means you can choose any consultant. Unguided consultant access increases your premium by an average of 20%.

• Type of coverage - treatments such as outpatient care, physiotherapy, acupuncture, homeopathy, mental health treatment, dental and optical care may or may not be included in your policy depending on the level and type of coverage you have.

An alternative to taking out health insurance is paying directly for treatment as you need it. Prices for private surgery vary depending on your provider. But, on average, cataract surgery in the UK costs between £3,000 and £4,000 per eye, while a hip replacement will set you back between £10,000 and £15,000.

Who are the main providers of private healthcare in the UK?

According to Which?, the top providers of private healthcare in the UK are:

WPA

WPA, or Western Province Association’s main policy, is called Complete Health and provides three levels of cover; core, mid-range and comprehensive.

The basic “core” level covers inpatient and day-patient treatment, a remote GP service, and cash back for time spent in an NHS hospital.

Mid-range and comprehensive policies include additional outpatient cover, cancer cover, and extras such as overseas cover and mental health treatment.

Aviva

Aviva offers two main health insurance policies; Healthier Solutions and Speedy Diagnostics.

Healthier Solutions is available as two levels of cover, “Limited” and “Full”. The “Limited” version doesn’t include outpatient consultations, diagnostic tests, therapies, non-surgical treatments, and outpatient mental health treatment, which are all included in the “Full” version.

However, it is possible to customise your policy and increase or reduce your cover with either version, as well as add extra non-standard cover like inpatient mental health and alternative treatments and therapies.

Speedy diagnostics covers rapid access to tests, scans, and hospital charges while your condition is being investigated. It does not cover treatment once your condition is diagnosed.

AXA Health

AXA’s Personal Health policy covers inpatient treatment, cancer care, outpatient surgery and diagnostic tests and scans. The policy can be customised to add extras like mental health cover, therapies, travel insurance and help with dental and optical costs.

Bupa

Bupa is the largest private health insurance company in the UK and provides two options for cover; Treatment and Care and Comprehensive. The main difference between the two is that the Comprehensive option covers a wider range of outpatient treatments.

Both policies can be customised to increase or decrease your level of cover and tailor your policy to your needs.

Saga

Saga specialises in providing health insurance to people over 50. There are three main plans, offering varying levels of cover; Super, Saver and Support.

All three policies cover inpatient and outpatient treatment and cancer cover, but vary in their coverage of scans, tests, consultations, and therapies.

Vitality Health

Vitality Health offers an Active Rewards Scheme, which encourages members to adopt healthy lifestyle habits. Members of the scheme receive points for logging healthy activities such as walking, exercise or working out, which can then be used to receive discounts on products and perks with partner companies.

Vitality Health insurance provides full inpatient cover, cancer care and outpatient surgical procedures, and can be customised to add extras like mental health cover and travel insurance.

Looking to the Future

With the unprecedented demands on the NHS showing no signs of easing, the rise of the private healthcare sector in the UK seems set to continue in the coming years. But what does this mean for the UK as a whole, and is this the beginning of the end for the NHS?

The rise in popularity of private healthcare has caused concern among some that we are heading towards a two-tier healthcare system, with the wealthy having access to fast, high-quality care, while those on lower incomes are forced to wait for treatment. This could widen the inequality gap between rich and poor, and lead to worsening health for millions.

On a more positive note, private healthcare for those that can afford it relieves pressure on the NHS and may allow it the breathing space it needs to regain its original purpose — universal, comprehensive, and free healthcare for all.