The facts are startling: seven million people on NHS waiting lists, patients having to wait three months to start cancer treatment or up to two years for non-emergency surgeries, such as knee and hip replacements - and that’s before the spate of NHS strikes meaning things can get a lot worse.
It’s unsurprising then, that the numbers choosing to self-fund private treatment has risen by more than a third since the pandemic, according to figures published in the BMJ.
For instance, figures from the Private Health Information Network show that self-funded hip replacements have increased by 184 per cent and knee replacements have risen by 153 per cent between 2019 and 2022.
“People are wanting to take control of where and when they have their operations,” says Alistair Moses, a spokesperson for the PHIN. “It’s not just that the waiting list exists, it’s the fact that it’s not clear how long the waiting list is going to be, so the uncertainty means people choose to [go private].”
1. Hip and knee replacements
Ultimately, the decision to turn to private healthcare depends not only on personal circumstances but on how much of an impact a condition has on your quality of life. It is fairly self-explanatory why joint operations and other elective procedures like cataract operations make up almost all of the top ten self-funded procedures, according to data from the PHIN.
The pain and restricted movement from needing a joint replacement can have a severe impact on livelihood. “People are looking at it and realising it’s worth the investment, because you’ll be able to go back to work faster,” says Moses.
Elective operations currently come with a very long waiting list on the NHS: some patients are reportedly waiting over 1,000 days [roughly two years and seven months] for knee and hip replacements.
According to the PHIN's website, the typical fee for an initial consultation for a knee replacement is £180 to £250; the cost of the procedure itself can range from £950 to £2,500; and follow-up appointments cost between £100-150. However, other sources report that the 'package cost' of a knee replacement is much higher: between £12-15,000, according to the market data company Go Private.
2. Hernia repair
Another common non-emergency procedure that has slid down the list of priorities on the NHS is hernia repair. In some areas, you can only have an operation if your hernia is growing or at risk of strangulation (becoming cut off from your blood supply). In the private sector, many hospitals can offer rapid access.
Inguinal hernia repair treatment (for the most common type of hernia, found in the groin) is the third most commonly self-funded operation. The PHIN says a typical fee for an initial consultation is £150 to £233; the fee for the procedure itself ranges from £300-800. Go Private says private hernia repair costs between £2,500-4,000.
3. Cataract surgery
Surgery for cataracts is usually offered on the NHS if your cataracts are seriously impacting your eyesight. But, as with joint replacements, there can be a lengthy wait, even though it’s a straightforward procedure that takes just half an hour. Data from NHS hospitals, in London and Bedfordshire, showed an average nine-month wait in 2021.
Longer waiting lists can pose a threat to health; it leaves patients more susceptible to accidents due to poor vision and means the operation can be more difficult to carry out.
It’s no surprise, then, that it’s the largest self-funded private surgery by volume - over 11,000 procedures were carried out in the independent sector between April and June last year. However, it’s not cheap; self-funding private cataract surgery costs between £838 and £2,445, depending on where you are in the UK (and that excludes consultants fees).
4. Endoscopies and colonoscopies
Diagnostic endoscopies and colonoscopies are also in the top ten self-funded procedures, up by 16 per cent and 11 per cent respectively. The main reason for this is waiting times - more people are going private to circumvent lengthy NHS queues for testing and results. Any patient with potential cancer symptoms should be seen within two weeks, but figures from last October show that seven in 10 NHS trusts are failing to meet this target.
This pushes people to go private. “We all know that the uncertainty can be really difficult,” says David Furness, policy director for the Independent Healthcare Providers Network. “A diagnostic test can give you that peace of mind or help you understand what the next steps will be.” In the private sector, you would be looking at maximum wait of weeks rather than months, claims Furness.
5. Urgent GP appointments
Private GPs are also becoming increasingly popular, with private clinics and remote services appearing everywhere to cope with demand. Private GPs are often available on the same or next day, whereas on the NHS in October last year, nearly two million people had to wait more than 28 days for an appointment.
Appointments start from £40 with some providers. Bupa charges £79 for a 15-minute face-to-face appointment, but a video consultation is slightly cheaper via providers such as Babylon Health, who charge £49 for a first one-off consultation (or £149 for an annual subscription).
How do you pay?
Almost all private hospitals and insurers require a referral. “Lots of journeys in the private sector start with an NHS GP referral, and then people can take that referral and contact a private hospital. What you then have is an initial consultation with a specialist on what needs to happen next,” says Furness.
A typical fee ranges from £175 to £250, according to the PHIN’s data, which is based on over 8,000 UK consultants, although this varies by specialism. A consultant will also charge for the procedure itself and for aftercare or follow-up consultations - either as part of a “package fee” or through separate invoices. They are required by law to outline the expected cost of treatment, but this can be subject to change if you experience complications.