2022 in review: Private firms prey on NHS waiting lists

Remember the heady days of 2020, when NHS workers were clapped on the doorstep, rather than demonised in the media and by politicians for wanting to work decent hours and fair pay? And remember when patients were acutely aware of the deluge being faced by the NHS due to the novel Covid virus, and seemed willing to accept that care might be delayed?

Two years on, waiting lists are worse than ever – and this is as much due to years of underfunding from the Government as to the impact of Covid. 

The NHS waiting list hit seven million patients for the first time in October, with median waiting times reaching 13.8 months, and things have been getting worse since.

But one group has seen some potential in these waiting lists: private health companies. A Pulse investigation at the start of the year revealed that their profits were soaring, partly as a result of designing their marketing around long NHS waiting lists. 

‘The overall positive dynamics in our market…have not changed – especially with lengthening waiting lists and significant demand in both the NHS and private sector resulting from the postponement of elective procedures,’ read the 2020 report from private provider Spire Healthcare. Meanwhile, a report published by health data firm LaingBuisson in April 2021 found NHS waiting times are having a direct impact on the demand for self-pay in a way ‘that hasn’t been seen in recent years’, with ‘numerous providers’ commenting that this would form a ‘significant part’ of their marketing messages in early 2021.

But patients aren’t just been directed to these firms by marketing messages. One thing that has become more significant is that GPs themselves are advising patients to go private if they can afford it.

And this is having an effect on GP workload. GPs told us of how patients are attending private health services, paying for one or two appointments, and returning to their GP to continue their care. This is especially true of conditions such as ADHD in adults, where waiting lists for assessment on the NHS exceed two years, or musculoskeletal imaging. But this often leaves GPs left picking up investigations, follow-up and test chasing – and most worryingly, managing conditions they are not trained to manage. 

Private firms are not just capitalising on the long waiting lists by targeting patients. NHS England’s ‘Increasing Capacity Framework (ICF)’ is an agreement that could see the NHS spend up to £10bn on private providers over the next four years to ‘support the contracting authorities’ ability to manage [and] reduce waiting lists’. A change of government won’t change this – shadow health secretary Wes Streeting has made clear his intention to use private companies more to help manager NHS contracts.

While the NHS is deteriorating constantly, the private health sector continues to thrive.

A report on the first quarter of 2022 shows there were 200,000 private patient admissions, an increase of 1% from pre-pandemic figures and the second highest rate in the past three and a half years. But over the period the number of private operations funded by health insurance has fallen while self-funded admissions have increased by 36%, the market update report suggests – meaning that the increase is fuelled by self-paying patients.

And among their number is the one person who can do more than anything to reverse the tide – Prime Minister Rishi Sunak. But it probably shouldn’t come as any surprise that a man worth an estimated £750m, and who has showed little indication to invest in the NHS, is happy to rely on the private sector. Unfortunately, not all his fellow citizens have such an option.