Private health and protection insurance expert and editor
The NHS has been providing healthcare that's free at the point of use since 1948. At the same time, the popularity of private healthcare has increased, with 1.7million of us now having private medical insurance. In this post, we explain the key differences between private healthcare and the NHS.
When you're making a comparison of the NHS vs private healthcare providers, there are several factors to consider. The type of care you need, how long you can wait, and your budget will all impact the type of care that's right for you. Here's our round-up of the key points of difference between the National Health Service and private healthcare.
When you see your GP and are referred to a consultant, your NHS treatment should start within 18 weeks of the hospital receiving the referral letter, according to Government guidelines. However, there's a growing backlog in NHS waiting lists, which has worsened since the COVID-19 pandemic.
The most recent statistics found that only 61.7% of patients were being seen within the 18-week deadline, whereas the target is for 92% of people to be seen by that stage. The British Medical Association assessed the figures and found that there were several reasons for this, including a lack of qualified staff and reduced capacity during the pandemic. They also suggest there is a hidden backlog caused by patients' reluctance to 'bother' their GP with non-urgent but nonetheless debilitating symptoms.
By contrast, private health care providers set their own standards but are typically able to provide treatment much more quickly. The process will vary depending on whether your treatment costs are funded by private medical insurance or whether you opt to pay them yourself. You may still need to see your GP for a referral; however, you're likely to be seen by a consultant much more quickly and will often be able to book a consultation appointment with a medical professional direct. If you need surgery, this may be able to take place within a few days or a couple of weeks of your appointment.
NHS hospitals' facilities include some private rooms, although you're more likely to be in a mixed ward with other patients who are having similar treatment to you. This can mean you have to deal with more noise from your fellow patients. NHS hospitals mitigate this by limiting visiting hours to allow you to rest outside those hours. There are ongoing efforts to improve the quality of the food available to NHS patients. Your dietary requirements will be catered for, but you may not be offered many choices.
Private healthcare facilities offer hotel-like facilities, so you'll have a private room with a TV, telephone, WiFi and an ensuite bathroom. One of the benefits of this is that you'll be able to welcome visitors at a time to suit you as they won't disturb other patients. A private hospital has higher funding than an NHS hospital, meaning they have more to invest in providing comfortable surroundings.
Many private hospitals also have professional chefs so that you can choose your meals from an a la carte menu. Some hospitals will also let you invite your visitors to stay for dinner. If you're looking for a lower-cost option, look for a private medical facility in an NHS hospital where you can still benefit from a private room.
The NHS has stringent guidelines to follow when they make prescribing decisions about new drugs and treatments. There's a cost-benefit analysis as they're using public money, so they need to ensure that the drugs and treatments have a measurable benefit in terms of the increased life expectancy or quality of life of the NHS patients who receive them.
Both NHS and private healthcare professionals need to consider whether a course of treatment or medication is in the best interests of their patients. However, if you opt for private medical treatment, a wider range of specialist drugs and treatments will be available, simply because of the difference in NHS vs private healthcare budgets. As a private patient, you can also ask for a particular treatment that may not be licensed in the NHS, and your medical professional will assess it based on clinical need.
NHS healthcare is funded in a very different way from private providers. In the UK, the NHS provides free medical care to the whole population and receives funding via National Insurance contributions. By contrast, private care is provided by private companies financed by their investors and the payments received from their patients.
The way the NHS is funded means that every UK citizen receives free healthcare at the point of use. You'll be able to access free NHS healthcare whether you have a minor injury or illness or need ongoing care for a chronic condition.
By contrast, if you opt to receive private care, there will be restrictions on the type of care you can receive, and you'll also need to pay for it. The direct cost of your treatment will be higher as it will come straight out of your pocket rather than being a number on your tax bill or payslip.
Payments for private health care can be made in two different ways.
Private health insurance allows you to access private healthcare when and where you need it. Health insurance policies are designed to pay for the treatment of acute conditions. For example, it will pay for routine procedures such as cataract removal, more serious operations like hip or knee replacements and even cancer treatment. Depending on your health insurance, you can also get cover for mental health treatment or long-term dental care. You can contact your insurer to make a claim and arrange private treatment when you need care. Health insurance is an ongoing cost as you'll need to pay a monthly premium to keep your cover.
You don't need to have private medical insurance to have private treatment. If you have savings, you can also opt to pay your healthcare provider directly. If you've been diagnosed with a medical condition that can be resolved by surgery, your NHS GP can provide you with a referral letter, or you can choose to pay for a private GP or consultant appointment. Your chosen hospital will provide you with a fixed price quote and issue an invoice for payment. Medical loans are also available if you'd prefer to pay in instalments.
It's a common misconception that private healthcare is of a higher standard than NHS services. Whilst private facilities are often more comfortable than an NHS hospital, the quality of care is usually very similar. Many doctors work for the NHS and private hospitals and have the same duty of care in both settings.
The main differences between NHS and private care are in respect of the facilities, waiting times and the availability of specific drugs and treatments. The knowledge and expertise of the doctors treating you are the same.
Private hospitals provide a range of treatments from surgery to rehabilitation therapies on a private basis. Their services are built around providing treatment for acute conditions which can be resolved by surgery or a course of treatment. This covers a wide range of services, including treatments that aren't routinely available on the NHS, such as acupuncture, homoeopathy and cutting-edge therapies. However, there are services which private hospitals don't provide.
If you need to go to A&E, you won't find it at a private hospital as most private hospitals don't offer emergency care. Some provide a private urgent care service which will allow you to be seen and treated on the same day, but you need to make an appointment. They will still tell you to go to A&E if you've been in a serious accident, have severe bleeding or think you're having a heart attack or stroke. Receiving NHS care in an emergency means you'll have access to specialist doctors who can manage your treatment after you've received emergency care.
If you have a chronic condition such as asthma or diabetes, you'll need ongoing health monitoring and management. That falls within the NHS' remit, mainly because health insurance doesn't cover chronic conditions. With NHS care, you'll benefit from an ongoing relationship with your GP, who'll get to know you and provide you with the care that's tailored to your needs.
Yes, you can. You might receive most of your healthcare from the NHS but then opt to have surgery in a private hospital because it means you can be seen and treated more quickly. Private hospitals will sometimes carry out the surgery but discharge you back to the care of your GP so that they can monitor your progress or arrange for any rehabilitation you might need.
If you have health insurance but have either a chronic condition or a pre-existing condition that's excluded, you can access private healthcare for the things that are covered and NHS treatment for everything else. Many health insurance policies also have a cash benefit which pays a fixed amount if you're treated in an NHS hospital.
Medical mistakes can happen wherever you're being treated. The rules of medical negligence are the same wherever you're treated; if the standard of care you received falls below the expected standard and you suffered harm as a result, you may be able to make a claim. In the NHS, this can simply be directed to the hospital trust where you were treated, but in the private sector, this can be more complex.
Pursuing medical negligence claims against private hospitals can sometimes be difficult because several companies can be involved. The hospital you're treated in could belong to an organisation with a private rental agreement allowing other healthcare providers to use their facilities. Your surgeon or other healthcare workers may not be employed by the company you paid for your treatment; they'll have their own insurance and, potentially, their own legal representation if you make a claim, which can make things more complicated.
Whether you opt to be treated in a private hospital or the NHS, the quality of care you'll receive is the same. However, each type of treatment has its advantages.
When you choose private healthcare, you'll benefit from shorter waiting times, a more comprehensive range of drugs and treatments and better facilities. A private hospital is often closer to a boutique hotel, so you'll have your own bathroom, TV and telephone. Visiting hours are also more relaxed.
Private hospitals often have professional chefs, so you can choose restaurant-quality meals from a menu and even invite your visitors to eat with you.
If you need urgent care, you need the NHS as private hospitals don't have A&E departments. They also don't have intensive care units. If something goes wrong when you're being treated privately, you'll probably be transferred to an NHS hospital where you'll benefit from specialised, multi-disciplinary care.
While you're more likely to see the same consultant throughout your hospital treatment when you opt for private healthcare, your long-term health needs can only be managed by the NHS. GP services may be under pressure, but you're more likely to build a lasting relationship with your family GP. They have the opportunity to get to know your history and offer medical advice based on that knowledge. If you have a chronic condition such as diabetes or asthma, the NHS provides continuity of care which private healthcare doesn't.
If the NHS has always looked after you, but you'd like to explore the possibility of having private health insurance as another option, you can get free advice from a broker regulated and authorised by the Financial Conduct Authority.
Speaking to an FCA-regulated broker gives you access to advice tailored to your circumstances. A broker can give you expert advice as they know all the features of each health insurance policy on the market. They can also help you find the right policy for your needs and budget.
Disclaimer: This information is general and what is best for you will depend on your personal circumstances. Please speak with a financial adviser or do your own research before making a decision.
Chris Steele is myTribe’s resident expert in private health insurance and healthcare, with over a decade of experience in the field. As a Chartered Insurance Institute (CII) qualified professional, he has helped countless consumers navigate private medical insurance. Regularly quoted by national media, Chris is a trusted voice in the UK insurance industry, with his insights featured in leading consumer finance publications.
The NHS has stringent guidelines to follow when they make prescribing decisions about new drugs and treatments. There's a cost-benefit analysis as they're using public money, so they need to ensure that the drugs and treatments have a measurable benefit in terms of the increased life expectancy or quality of life of the NHS patients who receive them.
NHS hospitals' facilities include some private rooms, although you're more likely to be in a mixed ward with other patients who are having similar treatment to you. This can mean you have to deal with more noise from your fellow patients. NHS hospitals mitigate this by limiting visiting hours to allow you to rest outside those hours. There are ongoing efforts to improve the quality of the food available to NHS patients. Your dietary requirements will be catered for, but you may not be offered many choices.
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