The number of British people choosing to pay for private hospital surgery has soared with the total amount spent doubling in six years to £1.1bn.

Widespread NHS rationing of treatments and record waiting lists have helped deliver a 7.4 per cent real-terms growth in self-paying patients between 2014 and 2018, according to market analysts LaingBuisson.

Its latest report forecasts the market will continue to grow to £1.3bn by 2021.

It also found NHS hospitals were increasingly profiting from the treatment of private patients, with total revenue from NHS-run private units up 3.2 per cent to £677m in 2018-19, with particular growth in obstetrics and cardiology.

There are more than 4.4 million patients now on the NHS waiting list for surgery, the highest number since 2007.

LaingBuisson said there was evidence NHS waits for diagnostic scans such as MRI, CT and ultrasound were also driving people to pay for the tests themselves with MRI scans now available for just hundreds of pounds.

At the end of September more than 38,000 patients had waited six weeks or more for one of 15 key NHS diagnostic tests. This was the worst performance since February 2008.

LaingBuisson said NHS waits were a “key driver”, pointing out that more than 660,000 patients had waited beyond the health service’s 18-week waiting time target.

UK news in pictures Show all 50 1 /50 UK news in pictures UK news in pictures 15 September 2020 People enjoying the autumn sunshine as they punt along the River Cam in Cambridge PA UK news in pictures 14 September 2020 Early morning light bathes the skyscrapers of the City of London, at the start of a week in which the UK is expected to bask in temperatures of more than 30 degrees PA UK news in pictures 13 September 2020 England celebrate after they dismissed Australia's Alex Carey to win the second ODI match of the series at Emirates Old Trafford, Manchester PA UK news in pictures 12 September 2020 Protesters outside BBC Broadcasting House in central London, as marches and rallies form across the country calling for a 15% pay rise for NHS workers and an increase in NHS funding PA UK news in pictures 11 September 2020 An empty migrant dinghy floats off the beach at St Margaret's Bay after the occupants landed from France in Dover Getty UK news in pictures 10 September 2020 A view of small boats thought to be used in migrant crossings across the Channel at a storage facility in Dover, Kent PA UK news in pictures 9 September 2020 EU's chief negotiator Michel Barnier, left, arriving from the Eurostar with EU Ambassador to the UK, Portuguese diplomat Joao Vale de Almeida at St Pancras International railway station, London, for the latest round of the negotiations on a free trade deal between the EU and the UK PA UK news in pictures 8 September 2020 Dawn over Coquet Island, a small island off Amble on the Northumberland coast PA UK news in pictures 7 September 2020 A hovercraft arrives to Southsea, Hampshire from the Isle of Wight PA UK news in pictures 6 September 2020 Forensics officers near the scene of multiple reported stabbings in Birmingham Reuters UK news in pictures 5 September 2020 Anti-migrant protesters demonstrate in Dover against immigration and the journeys made by refugees crossing the Channel to Kent PA UK news in pictures 4 September 2020 Activists take part in a demonstration against the HS2 hi-speed rail line outside the Department of Transport AFP via Getty UK news in pictures 3 September 2020 Peter Baker, who plays Trigger in the musical version of Only Fools and Horses, sweeps the stage of the Theatre Royal Haymarket in London, after observing a 15 minute silence to show solidarity with those in the theatre industry that have lost their jobs due to the coronavirus pandemic PA UK news in pictures 2 September 2020 Kadie Lane, right, 11, and Brooke Howourth, 11, hug on their walk to Marden Bridge Middle School in Whitley Bay, Tyne and Wear, for their first day of term, as schools in England reopen to pupils following the coronavirus lockdown PA UK news in pictures 1 September 2020 Extinction Rebellion protesters sitting outside The Houses of Parliament in Westminster, London PA UK news in pictures 31 August Surfers at Long Sands Beach, Tynemouth PA UK news in pictures 30 August Black Lives Matter protesters march through Notting Hill in London in the first Million People March EPA UK news in pictures 29 August A protester reacts as she demonstrates against the lockdown and use of face masks, amid the coronavirus disease outbreak, outside Downing Street in London Reuters UK news in pictures 28 August Caribbean soca dancers display their costumes as they promote the first ever digital Notting Hill Carnival, following the cancellation of the normal Carnival festivities due to the continued spread of the coronavirus disease, in London Reuters UK news in pictures 27 August Father and son team Chris and Sam Milford from historic building conservation specialists WallWalkers begin restoration work on the spire of Norwich Cathedral, which stands at over 312ft high. The first known spire was completed in 1297 PA UK news in pictures 26 August Giant waves at Seaham in County Durham, as the bad weather continues PA UK news in pictures 25 August An assistant at the Wallace Monument cleans the case which houses the William Wallace sword in the Hall of Arms room at the monument near Stirling as they prepare to re-open PA UK news in pictures 24 August Restored World War Two landing craft LCT 7074 is transported from from the Naval Base in Portsmouth to its final resting place at the D-Day Story at Southsea PA UK news in pictures 23 August Jenny Nguyen and Tony Cao, from Vietnam, pose for wedding photos on Tower Bridge in London, as it remains closed to vehicles after it was stuck open on Saturday due to a "mechanical fault". The landmark's Twitter account confirmed only pedestrians and cyclists could use it on Sunday morning PA UK news in pictures 22 August England's Zak Crawley hit 267, joining the exclusive Double Hundred club, on day two of the Third Test match against Pakistan at the Ageas Bowl, Southampton PA UK news in pictures 21 August Harri Teale gathers lavender during the annual harvest on the Wolds Way Lavender farm near Malton in North Yorkshire PA UK news in pictures 20 August Parents and a student react after checking GCSE results at Ark Academy in London Reuters UK news in pictures 19 August Tate Modern workers hold a strike outside the gallery in London, to protest the institution's announcement that it would cut more than 300 jobs from its commercial arm, Tate Enterprises PA UK news in pictures 18 August Two rescued brown bear cubs, Mish (left) and Lucy, cool off in a pool after arriving at their new home with the wildlife conservation charity Wildwood Trust in Herne Bay, Kent. The orphaned pair, who have been living in a temporary home in Belgium since they were found abandoned and alone in a snowdrift in the Albanian mountains, will be acclimatised to their new life in the country before moving to a permanent home PA UK news in pictures 17 August A level students celebrate outside the Department for Education in London after it was confirmed that candidates in England will be given grades estimated by their teachers, rather than by an algorithm. The government U-turn comes just days after Education Secretary Gavin Williamson vowed there would be "no U-turn, no change. PA UK news in pictures 16 August Wasp players take a knee as Northampton Saints stand prior to kick-off in their Premiership match at Franklin's Gardens PA UK news in pictures 15 August Piper Colour Sergeant Lil Bahadur Gurung attends the VJ Day National Remembrance event, held at the National Memorial Arboretum in Staffordshire, Britain Reuters UK news in pictures 14 August People including students hold placards on Whitehall outside Downing Street as they protest against the downgrading of A-level results. The government faced criticism after education officials downgraded more than a third of pupils' final grades in a system devised after the coronavirus pandemic led to cancelled exams yes AFP via Getty UK news in pictures 13 August Benita Stipp (centre) and Mimi Ferguson (left) react as students at Norwich School receive their A-Level results PA UK news in pictures 12 August 2020 A train derailment near Stonehaven has left three people dead. Driver Brett McCullough, conductor Donald Dinnie, and a passenger were killed when the 6.38am Aberdeen to Glasgow Queen Street service crashed amid heavy rain and flooding BBC UK news in pictures 11 August 2020 A woman hydrates in the sun after open water swimming at the West Reservoir Centre in north London Tolga Akmen/AFP via Getty UK news in pictures 10 August 2020 Prime Minister Boris Johnson takes part in an archery session as he visits Premier Education Summer Camp at Sacred Heart of Mary Girls' in Upminster Reuters UK news in pictures 9 August 2020 People cycle through Cambridge as the heatwave continues in Britain EPA UK news in pictures 8 August 2020 Healthcare workers take part in a protest in London over pay conditions in the NHS Getty UK news in pictures 7 August 2020 Emergency services make their way along the seafront on Bournemouth beach in Dorset on one of the hottest days of the year PA UK news in pictures 6 August 2020 Alison Murphy poses for a picture by husband Peter as she walks through a field of sunflowers in Altrincham, Cheshire PA UK news in pictures 5 August 2020 Pakistan's Abid Ali being bowled by England's Jofra Archer during day one of the First Test match at the Emirates Old Trafford, Manchester PA UK news in pictures 4 August 2020 The 'Timbuktu tumblers' from Kenya perform their balancing act on the Southsea waterfront as Zippos Circus reopens in Portsmouth Rex UK news in pictures 3 August 2020 Pelicans interact with a visitor in St James's Park in London PA UK news in pictures 2 August 2020 Lewis Hamilton drives with a puncture towards the finish line to win the Formula One British Grand Prix at Silverstone POOL/AFP via Getty UK news in pictures 1 August 2020 Arsenal's Pierre-Emerick Aubameyang celebrates with the trophy and teammates after winning the FA Cup, as play resumes behind closed doors following the outbreak of the coronavirus disease Pool via Reuters UK news in pictures 31 July 2020 People enjoy the sunny weather at a Bournemouth Beach Reuters UK news in pictures 30 July 2020 An artist puts the finishing touches to a wax figure of Prime Minister Boris Johnson, in the entrance line at Madame Tussaud's in London, as the attraction prepares to reopen to the public following the easing of lockdown restrictions in England PA UK news in pictures 29 July 2020 A member of staff stands on Ai Weiwei's 'History of Bombs' during a photocall for the Chinese artist's new work on display at the Imperial War Museum in London PA UK news in pictures 28 July 2020 Stuart Broad celebrates after taking the wicket of West Indies batsman Kraigg Brathwaite. It was a milestone wicket in his career, reaching his 500th Test Wicket for England. They went on to beat the West Indies in Manchester and therefore win the series 2-1 Getty/ECB

Self-paying patients, who fund the care themselves rather than using the NHS or insurance providers, made up just over a fifth of total private hospital revenues in 2018.

Although this has risen since 2010 it remains lower than the peak of 28 per cent in 1981 when NHS surgery waits were measured in years.

Report author Liz Heath said: “At that time it was not unusual to have someone on a waiting list for two or three years.

“There is some correlation between self-pay and NHS performance but it’s not a single factor. There are other things going on that influence people, for example if you’re self-employed and don’t want to risk a cancellation or the move from inpatient care to ambulatory or [same day surgery] care which is now much more affordable than it was.”

She added that the relative cost of private surgery had also become more affordable which has meant people have not renewed their health insurance and instead opted for a “mix and match” approach with private healthcare now a “considered one-off purchase” like a car or a family holiday.

Other incentives include zero-interest financing for some surgeries while companies are actively using affordability and rising NHS waiting times in their marketing material.

According to LaingBuisson’s analysis, the total revenue for private hospitals in the UK in 2018 was more than £5bn, of which around £1.6bn was for treating NHS patients.

People who pay for their own healthcare, without insurance, generated 21 per cent of private sector hospital revenues in 2018.

LaingBuisson found significant variation in the price patients paid with the quoted guide price for a knee replacement varying from £8,110 to £15,160 across 171 hospitals.

The UK private acute medical care market has five large providers – BMI Healthcare, HCA, Nuffield Health, Ramsay Health Care and Spire Healthcare.

Their combined share of UK private hospital care was estimated at 60 per cent for 2018. Spire Healthcare, BMI Healthcare and HCA had the largest shares of this market.