Most Britons expect to have to pay for their healthcare due to NHS queues, report says

Groundbreaking new research has found that most people in the UK believe they have to pay out of pocket for private healthcare for routine care such as dentistry, physiotherapy and counselling, because they cannot get this care quickly through the NHS.

The Joseph Rowntree Foundation says its findings, based on extensive focus group analysis, are evidence that Britons have undergone a “critical shift in expectations” about the ability of the health service to meet their needs.

“This research shows that the public feel they can no longer rely on the NHS to provide a universal service that is 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 charity has updated its minimum income standard, which sets the basic amount that working-age adults would consider necessary to live a decent life in the UK. It includes £200 a year for private healthcare spending.

The charity commissioned focus groups for research carried out by Loughborough University as the basis for its study, following recent jumps in the use of private healthcare in the wake of the Covid pandemic. A record 898,000 people were admitted to private hospitals in 2023, according to figures from the Private Hospitals Information Network.

Record numbers of people are spending up to £3,200 on cataract removal and £15,075 on a hip replacement as frustration mounts over having to wait months or years for surgery performed on the NHS.

The focus groups found that people routinely felt that they needed to put money aside for private care. One woman in Sheffield said that a sum for private care was needed because “it’s meant for things that the NHS doesn’t cover, which is a lot now”.

A man in Norwich said: “Whether it’s mental or physical, you should have the choice not to go to the NHS and see yourself on a waiting list for years.

“You just want to get the help you need as quickly as possible. So you need a small budget to do that.”

Under the foundation’s minimum income standard, set by Loughborough University, a single person now needs an estimated £26,800 a year in income to ‘live in dignity’, while a couple with two children need to earn £66,200 between them.

In 2022, 272,000 people used their own money to cover the cost of an operation or diagnostic procedure at a private hospital. That was up from 262,000 the year before and a sharp increase from 199,000 in 2019, the year before the pandemic struck.

While all major parties went into July’s general election promising to keep the NHS “free at delivery”, there is growing awareness among staff and the public that the service cannot meet growing demand given budget constraints.

Waiting lists for hospital care in England rose again last month to 7.62 million.

Keir Starmer and Health Secretary Wes Streeting have pledged to end long waiting times and return to the targets set out in the NHS constitution. But they have insisted they have inherited an NHS that is “broken” after years of neglect by the Conservatives.

Private healthcare providers are experiencing a boom as more people take out private health insurance. Employers are offering private health insurance to circumvent NHS delays.

Hospitals, clinics and non-NHS diagnostic services are benefiting from significant increases in the number of scans, day case and overnight stays for major operations.

But campaigners warned that the charity’s findings underlined the damaging decline of the NHS after years of underinvestment in “a poor service”, rather than the universal, free-at-the-point-of-use service envisioned when it was founded in 1948. “It is shocking to see how politicians’ neglect of the service now means that those 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 further fuel this shift towards the NHS becoming a poor service.”

David Rowland, director of the Centre for Health and the Public Interest, a think tank that tracks the privatisation of the NHS, said: “The fact that households are budgeting for the cost of healthcare is another example of how the UK risks sliding into a two-tier care system, where the cost of healthcare is passed on to individuals and their families.

“This has happened insidiously over the past two decades, undermining the founding principle of the NHS, which is that healthcare should be available to all based on need, not ability to pay.

“Avoiding a two-tier system is the biggest political problem facing the new Labour government and this can only be avoided if the NHS is given the resources to provide timely access to good quality care for everyone,” he added.

But David Hare, director of the Independent Healthcare Providers Network, which represents many companies profiting from the rise in private healthcare, said people turning to non-NHS providers for basic healthcare needs was “becoming a new normal”, including GP care, diagnostic tests and surgery.

“The health of people and their families is their top priority, and it is therefore not surprising that more people are willing to fund their own treatment to ensure they get the prompt care they need,” he said.