Almost two million people may have decided to pay for private healthcare – including so-called waiting list “fast passes” – during the pandemic rather than wait for NHS services, a think tank has said. The IPPR said a survey showed 31% of British adults found it difficult to access NHS services during the crisis – the equivalent of 16 million people.
Of these, 12% said they used some sort of private healthcare instead – an estimated two million adults, according to the poll of 3,466 British adults. And those who cannot afford to pay for private healthcare are at risk of being left to “put up or shut up”, the IPPR said.
The think tank said the UK risks embedding a two-tier health system whereby those who can afford to will supplement their access to NHS care with paid-for products, including private insurance, health tourism, direct payments and “waiting list fast passes”. The IPPR’s latest report states that the pandemic has “rapidly accelerated an existing trend of decline in access and outcomes” and warns that this is creating the conditions for an “opt-out by those who have the means – embedding a two-tier system”.
The authors wrote: “As access to, and quality of, care declines, more people are supplementing their entitlement to public health and care with paid-for products – private insurance, health tourism, direct payments and ‘waiting list fast passes’.” They added: “The risk is less a sudden privatisation, and more an emergence of something resembling the English education system – where the very best education is so often conditional on ability to pay (either private school fees, or via increased house prices).
“If this were to become the new normal after the pandemic (as it has in social care and dentistry), it would worsen overall health and widen inequality.” The think tank said investment is needed to ensure top quality and accessible NHS care for everyone, so no-one feels forced to go private.
Its survey also found that 17% of Britons said they would go private if they knew they needed to wait for longer than 18 weeks for pre-planned care. But 59% said they would not go private because they could not afford to.
The vast majority of those who participated in the poll said they support the NHS remaining free. The IPPR said that tackling long waiting times and poor outcomes is vital to ensuring the long-term survival of the NHS and avoiding a two-tier system.
Principal research fellow Chris Thomas said: “People aren’t opting out of the National Health Service because they’ve stopped believing in it as the best and fairest model of healthcare. Rather, those who can afford it are being forced to go private by the consequences of austerity and the pandemic on NHS access and quality – and those without the funds are left to ‘put up or shut up’.
“The risk is that, in the future, the idea you have to pay to get the best healthcare becomes normalised. This would erode public support and the electoral coalition that has underpinned the success and popularity of our NHS.
“In turn, this would further embed inequality, leave the NHS more liable to budget cuts, and to the poorly evidenced whims of politicians. Leaders should listen to what the public want and reinvigorate the NHS as a means to ‘universalise the best’ healthcare, for everyone, free at the point of delivery.”
An NHS spokesman, said: “The pandemic, including treating more than 600,000 people with Covid in hospital, has inevitably had an impact on routine services and we have seen fewer people coming forward for care during this time. But, despite pressures, NHS staff have continued to provide care to patients, with half a million people starting treatment for cancer, millions of routine GP appointments carried out and more people in touch with mental health services than ever – and it remains vitally important that, if you do have a health concern you come forward for care as soon as possible.”
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