Survey shows people are ‘going private’ more and NHS staff are advising them to

A survey of nearly 7,000 members of the public and over 500 NHS staff has shown an alarming increase in the number of people opting to pay for private treatment rather than face longer waits – and in many cases, NHS staff have advised them to in the face of unprecedented demand, mounting staff shortages and cuts to NHS services.

The survey, by Open Democracy, paints a grim picture of the realities facing the NHS post-pandemic, pre-dated by years of under-investment, with demoralised and exhausted NHS staff feeling they had little choice but to advise their patients to pay privately – if they could, and where treatment options were on offer by the private sector. The survey showed:

  • Forty per cent of people who replied to the survey were told that the NHS simply can’t offer them the treatment they need. Half of these – one in five of the total – said an NHS worker then told them they would instead have to pay privately for the treatment they needed.
  • Most of the NHS staff responding (68%) said the problem had got worse in the past decade. Only 12% blamed the pandemic.
  • Nearly all frontline NHS staff – 98% – said they had felt worried that a patient’s health was going to deteriorate due to the length of time they would have to wait for an NHS treatment.
  • Nearly two in five respondents (38%) said that an NHS worker had told them they’d get seen more quickly if they accepted an NHS referral to a private hospital or clinic. Nearly three in five frontline NHS workers replying said they’d had to refer patients to an NHS-funded private provider. Of those who did so, the majority (70%) had misgivings about this approach, but many said they felt they had little choice.

Far from showing the NHS is ‘unfit’ and in need of yet another massive reorganisation, this demonstrates the critical need to invest in the NHS quickly and redress problems over staffing which in many cases have been building for years, and will take years to resolve. People should not have to face paying for their own treatment because they will otherwise have to endure waits of months to years – or can no longer get treatment from the NHS because it has been cut. Privatisation is not as a rule happening on a large contractual basis, through competition by private companies for service contracts, at least not yet. It’s happening one worried person at a time, those who can afford to pay or increasingly who can put themselves into debt. The drift to private treatment and cutting of NHS services also adversely affects training.

Mr Colin Hutchinson, Chair of DFNHS and a retired Consultant Ophthalmic Surgeon, said:

‘In my field alone, eye surgery, there has been a massive increase in the proportion of cataract surgery that is being transferred to the private sector, which is now the setting for half of all cataract operations.  This is making it increasingly difficult for eye surgeons in training to receive sufficient experience to become fully competent in dealing with both straightforward and complex cases and, particularly, to develop the skills they will need to train surgeons themselves, once they become consultants.

‘They are getting so little surgery that they are having to extend their training period, exacerbating the workforce shortage that this government showed itself unwilling to address, by voting down the amendment tabled by former Health Secretary, Jeremy Hunt, in Parliament earlier this week [24 November]. Private hospitals are almost entirely dependent on the skills of doctors trained in the NHS, at public expense, and yet they are extremely reluctant to put in place the arrangements for eye surgeons in training to develop that practical expertise.’


But in many other disciplines, more and more treatment options are being withdrawn as staff shortages and financial pressures continue to mount: and more NHS staff are advising people to pay rather than see them suffer. Which in many cases they simply cannot afford to do. This is no way to run a National Health Service.

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