Demand and willingness to pay for private healthcare are growing rapidly in the UK as short-term pressures combined with a long-term decline in NHS funding has begun to show on the public service.
The findings came from a report by the Institute for Public Policy Research (IPPR) think tank which noted the UK had seen the sharpest rise in paying for private healthcare than any other G7 nation since the 1970s.
It also found that with backlogs and waiting lists mounting following the pressures of multiple Covid waves, people were increasingly keen to pay for private treatment.
A YouGov poll of 3,466 adults in November for the IPPR found 31% had struggled to access the care they needed during the pandemic.
Of these, 12% then used some form of paid-for alternative with 25% considering doing so, with this proportion rising for wealthier and older people.
The IPPR also asked people if they would hypothetically go private if they faced waiting more than 18 weeks to start treatment – the maximum limit recommended for NHS care.
It found 17% would definitely arrange private care with a further 59% wishing to do so but not expecting to be able to afford it. Only 10% rejected the option because they did not approve of private healthcare.
“It implies that these trends, if continued, would lead to the creation of a two-tier health system,” the IPPR said.
“Those people who could not afford to opt-out would find themselves unable to access the best and latest care and treatment.”
Fastest rising private payers in G7
This changing approach to private healthcare was backed up by wider UK data over the last fifty years, according to the IPPR.
Out-of-pocket expenditure in the UK has risen faster than any other G7 nation since the 1970s – more than trebling as a proportion of GDP from around 0.5% to around 1.75%.
And healthcare spend through all voluntary schemes was 0.54% of GDP in 1970 and 0.45% in 1975, but increased five-fold by 2020 to 2.33% – the fastest rise of any G7 nation in the period.
Meanwhile, spending on the NHS has only doubled from around 3.5% of GDP in 1970/71 to around 7.2% in 2018/19 pre-pandemic.
This lack of investment has become particularly pronounced over the last decade with Conservative-led governments stagnating or cutting NHS funding as a percentage of GDP.
‘Trend of people supplementing tax-funded care’
“Our overall conclusion is that a long-term decline in NHS access and quality, rapidly accelerated by the pandemic, has begun to catalyse a trend of people supplementing their tax-funded public entitlement to healthcare with private products,” the IPPR said.
“These include insurance products, direct payment for procedures, or waiting list fast passes that provide quicker access to a GP, physio or therapist.”
In its hope to avoid a two-tier system, the IPPR said the more optimistic conclusion “is that this trend is not yet so advanced as to be irreversible”.
It continued: “The model of dentistry or eyecare has not yet spread to the whole National Health Service, even though the trajectory towards that is clear.
“There is still time for decisive policy action, to revitalise health and care for the 21st century.”