Most people in the UK now believe they will have to spend their own money on private healthcare for routine services such as dentistry, physiotherapy and counselling because they won’t be able to get them quickly on the NHS, pioneering new research has found.
The Joseph Rowntree Foundation says its findings, based on extensive focus group analysis, is evidence that Britons have undergone a “critical shift in expectations” about the health service’s capacity to meet their needs.
“This research shows that the public feel they can no longer count on the NHS to provide a universal service that’s free at the point of delivery because some NHS services are now so difficult to access”, said Peter Matejic, the thinktank’s chief analyst.
For the first time, the foundation has adjusted its minimum income standard, which sets out what working-age adults believe is the base level of money they need to live a decent life in the UK, to include £200 a year for spending on private health care.
The foundation commissioned focus groups for research conducted by Loughborough University as the basis for its study, following recent jumps in use of private healthcare after the Covid pandemic. A record 898,000 people were admitted to private hospitals in 2023, according to figures from the Private Healthcare Information Network.
Record numbers are also spending up to £3,200 on having a cataract removed and £15,075 on a new hip as frustration grows at having to wait months or years for an operation on the NHS.
The focus groups found people routinely taking the view that they should set aside money for private care. One woman in Sheffield said that a sum of money for private healthcare was necessary because “it is for things that the NHS don’t cover, which is a lot now”.
A man in Norwich said: “Whether it is mental or physical, you need to be able to have the choice to not go with the NHS and see yourself on a waiting list for years and years.
“You want to just be able to get the help that you need as soon as possible. So you need the little budget to put towards that.”
According to the foundation’s minimum income standard, drawn up by Loughborough University, a single person is now estimated to need £26,800 a year in earnings in order to “live with dignity”, while a couple with two children must bring in £66,200 between them.
In 2022, 272,000 people used their own funds to cover the cost of having an operation or diagnostic procedure at a private hospital. That was up from 262,000 the year before and a sharp rise on the 199,000 in 2019, the year before the pandemic struck.
While all the main parties went into July’s general election promising to keep the NHS “free at the point of delivery”, there is a growing recognition among its staff and the public that it can’t cope with growing demand, given budget constraints.
Waiting lists for hospital care in England went up again last month to 7.62 million.
Keir Starmer and health secretary Wes Streeting have pledged to end long waits and once again meet targets enshrined in the NHS constitution. But they have stressed that they inherited an NHS “broken” after years of neglect by the Conservatives.
Private health operators are experiencing an uplift resulting from more people using private health insurance as employers offer private health cover to circumvent NHS delays.
Non-NHS hospitals, clinics and diagnosis services are benefiting from significant rises in the numbers having scans, day-case procedures or overnight stays for bigger operations.
But campaigners warned that the foundation’s findings underlined the NHS’s damaging descent after years of under-investment into “a poor service for poor people”, rather than the universal, free-at-the-point-of-use service conceived at its creation in 1948. “It is shocking to see how neglect of the service by politicians now means that those people who can afford it feel they have no option but to turn to private providers”, said Dr John Puntis, co-chair of Keep Our NHS Public. “Labour’s plans for greater reliance on the private sector are likely to drive this shift further towards the NHS becoming a poor service for poor people.”
David Rowland, director of the Centre for Health and the Public Interest, a thinktank that tracks NHS privatisation, said: “The fact that households are budgeting for healthcare costs is yet another example of how the UK risks drifting towards a two-tier healthcare system where the costs of healthcare are being pushed back on to individuals and their families.
“This has happened by stealth over the past two decades, undermining the founding principle of the NHS, which is that healthcare should be available to all on the basis of need, not ability to pay.
“Avoiding a two-tier system is the biggest political issue facing the new Labour government and it can only be avoided if the NHS is given the resources to provide timely access to good quality care for all”, he added.
But David Hare, chief executive of the Independent Healthcare Providers Network, which represents many firms profiting from the surge in private healthcare, said people turning to non-NHS providers for basic health needs was “becoming a new normal”, including for GP services, diagnostic tests and surgery.
“People’s health and the health of their family is their number one priority, and so it is not surprising that more people are willing to fund their own treatment to ensure they receive the swift care they need,” he said.
• This article was amended on 2 September 2024 because an earlier version misnamed the Private Healthcare Hospitals Information Network as the Private Hospitals Information Network.
