Matter for Discussion: Private health care

Private health care typically refers to services which an individual pays for directly, whereas independent services usually refer to contracts funded publicly and delivered by private companies. In recent years there has been growth of the private sector in providing health or health-adjacent services in the UK, either self-funded directly or through public contracts.

The COVID-19 pandemic, heavily affected access to public funded elective health care across the UK. This prompted some concern about a two-tier health system in the UK, in which those who can access private health care, whether self-funded or via a private insurance scheme, are able to access care more quickly.

Research by the Institute for Public Policy Research (IPPR) think tank found that the long-term decline in NHS access and quality was compounded by COVID-19, prompting more people to purchase private health insurance or pay for treatment. In November 2021, a IPPR/YouGov poll conducted across Great Britain asked all who said they found it difficult to access NHS services what they did next. 12% of people, having not been able to get the care they needed, used a private alternative. Those most likely to access private health care were people living in London (18%), people in social grade ABC1 (16% – twice as many as in social grades C2DE), and people aged 65 years old or over (15%) (Thomas et al., 2022).

In some UK countries, publicly funded contracts can be awarded to private companies to deliver NHS services. For example, in England, around 22% of health spending goes to non-statutory bodies, including GPs, dentists and pharmacists (Buckingham and Dayan, 2019). Expenditure on private companies received particular negative publicity in the awarding of PPE contracts in England during the early COVID-19 pandemic. Regardless of whether a service is delivered by a public or private organisation, all of them are regulated to the same independent standards. In the NHS, patients have the right to choose which hospital or service they go to, including both the NHS and private service providers.

With growing waiting lists and times in the public sector increasing the appeal of private health care for those who can afford it, where does it leave those who cannot, and what does it mean for the health system as a whole? 

Reading list for this debate available at rcn.libguides.com/congress2023.
 
References

Thomas C, Poku-Amanfo E and Patel P (2022) The State of Health and Care 2022. Institute for Public Policy Research. Available at: www.ippr.org/research/publications/state-of-health-and-care-2022 (Accessed 13 March 2023).

Buckingham H and Dayan M (2019) Privatisation in the English NHS: fact or fiction? Nuffield Trust, 15 November. Available at: www.nuffieldtrust.org.uk/news-item/privatisation-in-the-english-nhs-fact-or-fiction (Accessed 13 March 2023).