The NHS waiting list for treatment now exceeds six million people with more than 300,000 having waited more than a year to start.
Earlier this month the Westminster government unveiled its plan to drive wait times down, but it is clear some frustrated patients are choosing to pay for their own treatment and private hospitals are increasing capacity to cope with increased demand.
Advisers are taking different approaches to handling this demand and enquiries from people, including when and where they refer them to other services.
But as self pay clearly is not an affordable option for everyone, are there signs the self pay clients of today could become the private medical insurance customers of tomorrow?
Rapid increase in self pay
Unprecedented pressure on the NHS caused by the pandemic has led growing numbers of patients to consider private healthcare.
Research from the Independent Healthcare Providers Network (IHPN) in December 2021 revealed almost one in three people (30%) were now more likely to pay for private healthcare compared to before the pandemic
This was a 40% rise from December 2020 where just over two fifths (22%) said they would be more likely to consider private treatment.
The research also revealed rising waiting times and difficulty in accessing NHS care was the key factor in driving this demand, with 42% of people polled saying this was the key reason for considering private treatment.
IHPN chief executive David Hare said the data was unsurprising with NHS wait times at record levels and government indicating these would continue to increase for at least a further two years.
KIMS Hospital is one private hospital group that has noticed an increase in the number of patients it treats through self-pay and private medical insurance (PMI) patients.
“Over the last few years we have seen a significant growth in the number of patients who choose to self-pay for their healthcare, enabling them to get fast access to diagnosis and treatment,” the group said.
“Although PMI patients will continue to make up a significant proportion of our private patients, we expect the share of patients who self-pay for their treatment to continue to increase over the next few years.
“The growth in self-pay is particularly noticeable in treatments where there may unfortunately be long NHS waiting lists, such as orthopaedics, or for where there may be pre-emptive barriers to getting treatment on the NHS, such as ophthalmology.
“With an increasingly ageing population and the knock-on effects this has on demand for healthcare, along with growing consumer expectations for the latest technology and medicines, we believe that the trend of more customers choosing to self-pay for their treatment will continue to grow.”
Growing demand is also leading private healthcare providers to increase capacity.
Circle Health Group revealed to meet increased patient numbers nationally, it has stepped up its investment programme, enhancing facilities and services.
“So far £100m has been spent on mobile MRI and CT scanners to meet local demand, in addition to 15 new operating theatres across our network of 52 hospitals nationwide,” the group told Health & Protection.
Self pay not always affordable
However, advisers say self pay is not an affordable option for everyone.
Paul Nugent, CEO of the Santé Group, told Health & Protection: “Self pay trends show that more and more people are paying for their own healthcare, but with medical inflation on the rise this is simply not a viable option for many individuals as it becomes unaffordable.
“Knee replacements can cost more than £13,000, slipped disc removals more than £7,000, shoulder replacements more than £11,000 and then the more complex treatments such as heart surgery and cancer treatment can reach six figures.”
Insurance Boutique owner Penny Jackson, agreed adding that a heart operation could cost between £40,000 and £60,000, while cancer treatment can cost in excess of £300,000.
Referring and supporting self-pay clients
When it comes to referring clients with pre-existing conditions who feel their only option is to self pay to private hospitals, Jackson added she does not get involved with this as most of her customers either have PMI or want it.
However, Isaac Feiner, owner of Lifepoint Healthcare, told Health & Protection while he does not have any formal referral agreements in place with private hospitals, he has referred clients to private healthcare doctors in some instances.
“I haven’t put in place anything to be honest. But it is actually a great idea. Maybe it’s something I should look at,” he said
“But I do refer clients to the right people in my network who I know can help them and they have to deal with it themselves.
“I don’t take money for that sort of thing. I haven’t taken any commission for it. I just do it as a kindness. I send them to the right doctor and let them sort it out themselves.”
But Feiner added he has seen an uptick in enquiries from patients looking to put in place policies to cover existing conditions.
“We have to let them down gently that the policies generally will not cover pre-existing conditions,” he continued.
“As a result clients have resorted to the self-pay market. Examples are hip, knee operations and things like cataracts.”
Cover for pre-existing conditions
According to Richard Charlton, director at Phoenix Health & Protection, as pre-existing medical conditions do not tend to be covered, those who have experienced delays with the NHS have had no choice but to self pay.
“We have had an increase in clients who have paid thousands for treatment and now want to have medical insurance in place for any future conditions,” he said.
“This includes those that cancelled cover during Covid only to have needed to pay for expensive treatment and are now coming back to us.”
Charlton adds that it is only after discussing the costs of some potential treatments, some of which cost tens of thousands of pounds, that alternative compromises to fully self-funding are recommended.
“Removing outpatient cover for example, to create an inpatient only plan can be cost effective, and some of our clients are happy with this level of self-funding where they pick up the costs of diagnostic tests and consultations but the big stuff like cancer treatment and hip and knee replacements are still covered in full,” he added.
And ultimately, it appears despite increased demand for self pay, it will continue to coexist with PMI, according to Claire Ginnelly, executive committee member of the Association of Medical Insurers and Intermediaries (AMII).
“While private medical insurance and self pay have always competed with one another, one could also argue someone who wants to self pay is not necessarily interested in buying PMI,” she said.
“I do not hear anything from insurers to suggest the self pay market is having a detrimental impact on access to private treatment for insured people.
“I believe the two will continue to exist alongside each other as they always have done,” she added.
