Growing numbers of patients are paying for private treatment to beat rationing and delays for treatment imposed by the cash-strapped NHS.

People who do not have health insurance are increasingly paying up to £14,880 for operations such as a hip or knee replacement or cataract removal, a report reveals.

Profit-driven hospital firms are experiencing 15 to 25% year-on-year rises in the number of uninsured “self-payers”, with the increase mainly driven by long waiting times to undergo non-urgent surgery in NHS hospitals. Patients are using their savings or taking out loans to pay for their treatment.

The biggest increases have been in those paying for procedures to relieve disabling condition, interventions that are increasingly hard for people in England to obtain on the NHS without a long wait.

“There’s no doubt that NHS waiting lists are at the heart of this growth in self-pay,” said Keith Pollard, the chief executive of Intuition Communications, which undertook the research.

The report said: “Providers have noted a direct correlation at a local level between reported excessive waiting times for surgery and demand for self-pay surgery.”

The total number of patients in England waiting for planned hospital care within the maximum 18 weeks guaranteed under the Referral to Treatment scheme exceeded 4 million in July for the first time in decade, soon after NHS England and ministers controversially relaxed the target.

There has also been a rise in those paying for private cancer care in the wake of NHS England cutting the number of drugs it pays for under the Cancer Drugs Fund. “Widely publicised restrictions on NHS funding for cancer drugs is fuelling the growth in self-pay oncology,” notes the report, titled The Private Healthcare UK Self-Pay Market 2017.

The findings have sparked fresh concern about the state of an NHS struggling to cope with a rising demand for care caused by the ageing and growing population while it grapples with the longest budget squeeze in its history and deepening staff shortages.

One leading doctor, Dr Mark Holland, the president of the Society for Acute Medicine, said the growth in self-pay raised questions about whether the government’s long-term plan for the NHS was to hasten creeping privatisation or return it to its origins as a publicly-funded and provided service.

“[There are] mixed messages from government,” Holland said. “They reassure the public on one hand, but at the same time there is a clear move for services to be privatised. The public have a right to know what the government’s long-term strategy on healthcare really is. I fear we could make proper healthcare beyond the reach of those who are already disadvantaged.

“Selling off chunks of the NHS makes no sense. Assuming they want to make a profit, how can they maintain quality when services are already underfunded. My conclusion is that services and quality will be sacrificed for profit.

“[NHS creator, Aneurin] Bevan’s vision for the NHS should be revisited and updated as it approaches its 70th birthday,” he said. “What we must not allow is for the NHS to have its soul destroyed. If we are not careful the NHS will simply be a brand, lacking any substance and simply a limp apology by the government for a false promise. In every sense, this move will be tragic.”

The findings come as health service bosses gather in Manchester for the opening of NHS England’s annual two-day NHS Expo. Simon Stevens, the organisation’s chief executive, and the health secretary Jeremy Hunt, will outline their plans for the service in keynote speeches on Tuesday.

The shadow health secretary, Jon Ashworth, said: “This increase in patients paying for private treatment is because of the underfunding and neglect of the NHS under the Tories. It’s a sad indictment of how bad things really are.

“Given Theresa May has now abandoned the 18-week target for treatments like hip replacement and cataract operations, we fear this will drive even more vulnerable people into the hands of private healthcare some forced to pay as much as £14,880 for a hip replacement.”

A Competition and Markets Authority investigation has helped patients by making the cost of surgery more easily accessible and revealing that wide differentials exist across the UK, the researchers behind the report found. The cost of a private hip replacement , for example, varied from £8,945 to £14,880 and that of cataract surgery from £1,850 to £3,350.

The growth of private care is unsurprising given the pressures on the NHS, which needs more money, said Chris Hopson, the chief executive of NHS Providers, which represents hospitals.

“We must act to protect public confidence in our NHS,” he said. “That means acknowledging that more resources will be needed in order to maintain the services we have come to expect, or considering what may have to be dropped. As we approach the 70th anniversary of the NHS the need for that debate has never been more urgent.”



The Department of Health said: “The number of people with private medical insurance is lower now than it was eight years ago and the NHS continues to treat more than nine out of ten patients within 18 weeks.

“As expert analysis shows, spending on the NHS is in line with other European countries and once again our health service was independently judged to be the best and most efficient health system in the world.”