Why is demand for private treatment rising in Scotland as admissions hit record high?

Scotland’s private healthcare sector has soared to record levels amidst an ongoing crisis in the NHS - with top medics warning a “two-tier healthcare system” is forming “which threatens the founding principles of the NHS”.

Compared to 2022, in 2023 the total number of Scottish patients skipping NHS waiting lists and instead being admitted to a private hospitals was up 11 per cent, with self-pay admissions up eight per cent - the highest level ever.

According to research conducted by the Private Healthcare Information Network (PHIN) – an independent, not-for-profit, government mandated organisation - the number of admissions funded by private healthcare insurance was up 13 per cent.

In total, there were 46,000 private hospital admissions in Scotland in 2023.

Dr Iain Kennedy, chair of the BMA’s Scottish Council, said Scotland needs to have “an urgent discussion” on the future of health and social care services.

“Patients are facing unacceptably long waiting times and a two-tier system of healthcare is rapidly developing where only those who can afford it are able to access timely treatment,” Dr Kennedy said.

“This is unacceptable and threatens the founding principles of our NHS.

“Indeed, the starting point for any discussion must be that our health service should remain free at the point of need, but we need to examine how this can be achieved for both now and the future.”

The latest shows 2023 was the third year in a row that private admissions were above pre-pandemic levels, and marked the first time insured admissions have been higher than pre-pandemic levels.

Colin Poolman, the Scotland executive director at the Royal College of Nursing (RCN), said:

“The fact that an increasing number of patients are turning to private treatment is not a surprise, given the serious backlog on NHS waiting lists.

“The bottom line is that patient demand across all services is severely outstripping workforce supply, with nursing staff leaving in their droves because of unsustainable pressures.

“Attempts to tackle waiting lists will not be successful without investment in the nursing workforce – including fair pay – to achieve a sustainable nursing workforce.

“Only then can we ensure patients get the care they deserve.”

Dr Ian Gargan, PHIN’s chief executive, said: “With NHS waiting lists at record levels, a growing number of people are looking for alternatives and choosing to use the private sector rather than risk prolonged waits and potentially seeing their health deteriorate.

“The number of people using private medical insurance, or opting to ‘self-pay’ for their procedure, has increased despite the difficult economic conditions over the past few years, demonstrating the importance people place on their health.

Dr Gargan added that the majority of the private sector carries out “the most easily-arranged and most common procedures”, such as cataract surgery, hip replacements and knee replacements.

“The NHS can then concentrate on the more complex conditions and chronically ill patients,” he said.