Private Business Intermediaries

Private vs. NHS Funding and Treatment options

Private vs NHS Funding & Treatment Signpost
Our customer service teams are finding more and more people confused about the public and private health care choices available to them. Here at Freedom Health, we are passionate about patient choice and want to help to guide patients through the NHS and Private Hospital maze.

NHS vs Private

NHSNHS: Once upon a time, your GP who worked for the NHS, put you on a list to see an NHS consultant (often with a delay of weeks or worst case, months). The speed of tests such as MRI and CT scans would be carried out on the basis of urgency; so patients may have been seen the same day or, if the case was thought to be less urgent, after a considerable wait.  In general, any treatment in an NHS hospital, usually had a delay of at least few days or weeks following your consultation after any required tests.
The quality of care was, and in most cases still is, excellent. Wait times varied by speciality and region, and whilst the Government set targets to shorten these, the system still struggled to cope, especially for routine procedures such as hip replacements. However, in the most, the NHS usually provided timely and world class interventions for life critical issues such as cardiac bypasses.

Recently however, there has been much news of NHS trusts ‘rationing’ patient care and simply closing lists so they are not fined for having people waiting too long. Many patients decide to use private care instead of the NHS.

You see your NHS GP (very few people have access to private GPs except some of our policyholders)  who may refer you to see a consultant. In many cases, the consultant may be an NHS doctor who works at a private clinic in the evenings. There are a few subtle yet key differences between seeing a private and NHS consultant:  
  • In the NHS the procedure is carried out by a member of the consultant’s team versus the consultant themselves.
  • In private care you are usually seen within a week or so of your GP requesting a referral and tests are arranged within a few days.
  • In private hospitals your treatment is usually in a private room which has hotel type services such as TV, menu choices etc., at a time to suit you. 
Private Hospital
However, things are no longer so simple anymore, as the boundary between NHS and private care is now blurring. You will find that NHS hospitals often have private units now. Some of the world class NHS hospitals use their private units/ wards as key sources of income to support their NHS work.  So you may well be a private patient, yet choose to be treated in the private wing of an NHS hospital. 

Common examples of this cross pollination between NHS and private sector include: 
  • NHS specialist hospitals usually have excellent  intensive care (ITU) facilities, and whilst these should not be needed for routine procedures, some patients like to have peace of mind.  Although there are some larger specialist private hospitals in London, even these often lack 24x7 ITU. It's a little known fact that if you become critically unwell in many private hospitals, you are likely to be transferred back to the NHS for emergency care. The NHS has many specialist hospitals that are world leaders in areas such as cancer, cardiac and pediatric care. People fly in from all over the world to be treated at these centres of excellence, yet they are often overlooked by the UK private parent.  Your small local private hospital may not always be the best place to be.  
  • The NHS private wards are there to make money for the hospital/ NHS, but they are not ‘profit making’ in the true sense. Thus NHS private units/ wards can often offer treatment at a lower cost than a private hospital; using NHS operating theatres and staff, while at the same time allowing you the benefit of consultant-led healthcare and a private room.  More innovative private insurance plans now offer incentives to patients that keep their treatment costs lower, for example Freedom Essentials plan pays a cash sum for you to use for your healthcare in any way you like, so you can keep any surplus or top up as required. 
  • NHS patients can often now request treatment in a Private Hospital. Patient Choices was introduced by the government to increase the competition and choices available. The old boy’s network still exists to a degree, and your GP may simply refer you to a consultant they know in the NHS. However, it is currently your right to choose where you are treated, and many find that by asking a few questions they can receive an NHS funded operation in a private hospital. In theory, this could be in a shared room, but in practice the experience is often identical to the private patient, except a few menu choices and perhaps a fee to use the TV.  

As GPs take greater control of their budgets and as budgets get stretched, it is difficult to know where this will all end up. Whilst the private sector can provide services at a lower cost than the NHS, there is an argument that this will continue. NHS hospital bosses argue that taking all of the easy and profitable work out of the NHS simply leaves the NHS with the complex and expensive treatment without the ‘income’ from the routine procedures.  You can understand why health economics is a speciality in its own right and why the USA has got into such a mess.

NHS hospitals can now be run by the private sector. The private sector has been building and providing support services under the Public Private Partnerships, yet we are now seeing private health corporations running hospitals for the NHS, either as new facilities or where an NHS trust has been ‘failing’. An example of this is the Circle group who now run two NHS hospitals on a partnership basis, similar to John Lewis where the staff own the business.

Private care coopted to the NHS

If you require a complex cardiac scan or other specialist procedure your private hospital may refer you to an NHS facility for that test or procedure. So what does these all mean?  

We all need to be clued up about the state of the NHS, the private sector and our options. Whilst many may not be surprised by this finding from a health insurer, we believe that the reality may well be that some sort of insurance safety net  would be a good idea for many to protect you from the aches and pains of the NHS as it adopts to a difficult economic picture, rising costs for new interventions and an aging population. Whereas conventional private medical  insurance has served the middle and upper income bands well,  new and innovative insurance products that work well in this new world, alongside the NHS are essential. For that reason we created Freedom Essentials which puts you, the patient in greater control of what and how you spend your money.