Private health and protection insurance expert and editor
Private healthcare can offer an alternative to the NHS, but what does it involve, and how does it work? This guide explains what private healthcare offers and how you can access it.
Private healthcare is broadly any medical service that requires payment for treatment, unlike the NHS, which is mostly free at the point of use.
There are many types of private healthcare providers, from GPs, physiotherapists, and dentists to surgeons, psychiatrists, private hospitals, and clinics.
You can pay for private healthcare in several ways:
Many specialists and consultants in the private sector also work in the NHS, so there often isn't a difference in the skills or experience of those looking after you. It'll usually be quicker to go private, and of course, it will cost you money in one way or another.
It wasn't that long ago that private medical care and private health insurance were seen as a luxury for only the rich; however, following COVID-19, Brexit, and numerous doctor strikes, NHS waiting lists have spiralled to record lengths. In April 2024, The ONS (Office for National Statistics) released stark survey findings showing that almost 10 million people could be waiting for an NHS appointment or treatment, far higher than the NHS' waiting list data.
Issues accessing NHS dentists, GPs, and hospital treatment have all fueled growth in the number of people turning to the private sector either as "self-pay" patients or via insurance. The PHIN (Private Health Information Network) reported that self-pay admissions to private hospitals in 2023 were 32% above pre-pandemic levels, with record numbers of people taking out private health insurance too.
While Spring and Summer are nearly upon us, and there's the possibility of a change in government later in the year, resolving the issues in the NHS will take time, so the more significant role private healthcare plays will likely remain for the foreseeable future.
Private healthcare is any medical appointment or treatment you pay for rather than those from the NHS, which is funded by taxes and free at the point of use.
Later in this article, we explain how you can pay for private healthcare, but primarily, you can choose between paying yourself or, if you already have health insurance, it may cover some or all of the costs.
You can access several different types of private medical services, from primary care to surgery, at your convenience. Here, we explain how each treatment type works.
If your doctor has told you that you need a particular type of surgery, you can choose to have it privately if you can cover the cost. For example, you may have been told that you need a hip replacement that requires an overnight stay in hospital, but the waiting list via the NHS is lengthy, and therefore, you look at whether it can be done privately.
Many NHS consultants also work privately in a private hospital or a separate unit in an NHS hospital, and you can often ask if this option is available. Otherwise, you can choose one of the private hospitals in your area or further afield if that's your preference.
When you contact your chosen hospital, you'll need a private referral letter from your consultant confirming that you need the surgery.
Private hospitals often have hotel-style facilities, and you'll usually have a private room with a private bathroom and a choice of meals. You can choose your hospital based on the consultants you want to treat you, the facilities or whether it's close to home.
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There is a vast range of out-patient treatments that you can access privately in various ways.
For example, you may have a GP referral to see a consultant but have waited a long time for an NHS appointment. You can pay for a private consultation and diagnostic tests to confirm what treatment you need. That may be surgery or another type of treatment, such as physiotherapy.
Some types of surgery, such as a knee replacement, involve a hospital admission, but many don't. Hospitals often carry out cataract surgery or tonsillectomies as out-patient procedures, and you can have treatment privately in the same way as you would with in-patient surgery.
Alternatively, your doctor may recommend physiotherapy to relieve your symptoms. You can wait for NHS treatment or choose a local provider, such as a specialist clinic. Mental health treatment is also available in a similar way, with private practitioners operating from local treatment centres.
Patients in England report that making a GP appointment has become increasingly challenging. NHS GPs typically work office hours, but there's greater demand for appointments outside those times so we can balance our healthcare needs with other commitments.
Many private healthcare providers offer private GP consultations online, over the phone or face-to-face. If you have private health insurance, it will typically include virtual GP appointments via video or telephone call, and many offer a limited number of face-to-face appointments for an additional charge.
However, you can still pay for a private GP appointment if you don't have private health insurance. You can find a local clinic online and call or complete a form to book. A private GP can offer general health advice, a private GP referral or a private prescription.
It's worth remembering that private prescriptions typically cost more than NHS ones. Some services are only available to patients over 16 or 18, so they may not be suitable for you if you want private healthcare for your child.
Most private health insurance policies cover cancer care as part of their standard coverage. Depending on your policy, you can access private consultations and diagnostic tests. Policies typically include surgery, chemotherapy, and radiotherapy as standard. Your health insurance policy may also provide other treatments and services such as stem cell therapy, nutritional advice, and help accessing wigs or prosthetics if needed.
One of the benefits of private cancer care is that private healthcare providers often invest in cutting-edge treatments or drugs not yet available via the NHS. Even if these treatments aren't needed, you'll receive your care in a private hospital with high-quality facilities.
One of the main drawbacks of private cancer treatment can be the cost. If you don't have private health insurance, you must self-fund. Cancer is unpredictable, and the cost of treatment can quickly mount, running to hundreds of thousands of pounds, which is unaffordable for most people.
In the UK, you can receive free dental care and eye tests if you meet the relevant age criteria or receive certain benefits. Some people also qualify for free eye tests based on their medical history, for example, if they have diabetes or glaucoma or are at increased risk of certain eye conditions. Qualifying patients typically also receive vouchers towards the cost of glasses or contact lenses if needed.
The rules mean that most adults in the UK now pay for private healthcare in the form of dental or optical treatment. Some dentists and opticians offer payment plans that let you spread the cost of your routine appointments and receive discounts on treatment and glasses or contact lenses. If you use display screen equipment at work, your employer has a legal duty to pay for your eye tests and glasses if you need them for work.
You can also buy private health insurance with optical and dental coverage as an optional extra or a standalone policy. Cash plans are a cheaper alternative to private health insurance and pay cashback on routine healthcare costs such as eye tests, dental check-ups and physiotherapy appointments.
You can combine private healthcare with NHS care, but only in certain circumstances, so it's wise to proceed carefully.
NHS waiting lists include patients waiting for a diagnosis or a specialist opinion on the type of treatment they need and those who need a specific treatment such as surgery or physiotherapy. Choosing private healthcare can help you avoid all or part of that waiting time. For example, you can ask your GP for an open referral to a specialist and pay for a private consultation, tests and scans if needed. The private hospital can often give you a fixed fee quote if you need surgery. You can accept this or return to the NHS for your treatment.
Equally, you can receive a diagnosis via the NHS and ask for a referral so you can have private surgery.
Mixing private healthcare and NHS treatment can be complex. The NHS website states that there must be a clear separation between private healthcare and NHS treatment. You can't mix private and NHS care as part of the same treatment, but you can pay for additional private services, such as cancer drugs. It's wise to speak with your doctor to make an informed decision about your healthcare.
Arranging private care is usually straightforward, but it depends on the type of treatment you need and how you plan to pay for it.
Your insurance provider will tell you how to claim if you have health insurance. Many provide an online platform or app, or you can call them to arrange your treatment.
You can also get in touch with a private hospital or treatment centre directly to make an appointment or ask for a quote. If you want to arrange surgery, you'll usually need to send a copy of the referral letter confirming your diagnosis and the required treatment.
Other treatment providers, such as physiotherapists, counsellors, or alternative practitioners, vary in their practices. Many will let you book an appointment and carry out an assessment as part of your initial consultation. Others request a referral from your GP as part of their triage process.
You'll usually need to pay for an initial consultation when you book or pay a deposit for surgery to confirm your appointment. It's a good idea to check your chosen treatment centre's website for details of their process and any information they need before seeing you.
The most significant difference between private and NHS treatment is how much it costs. While NHS treatment is free of charge, private care can come with a hefty price tag. Before choosing private care, you must consider how you'll pay for your treatment.
There are three main options.
Private health insurance ranges from basic policies to comprehensive healthcare coverage. Basic policies typically fund in-patient hospital treatment, cancer treatment and services, including virtual GP appointments and telephone helplines. Comprehensive health insurance policies offer full out-patient coverage and enhanced mental health treatment. Most insurance providers offer a basic policy, which you can enhance by adding optional extras to meet your needs and budget. The more coverage your policy includes, the higher your premium.
The hospitals your health insurance covers are set out on a hospital list. You can choose a standard list or an extended one that covers areas where healthcare prices are higher, such as central London and other major cities.
Many businesses offer health insurance as an employee benefit, so it's worth checking whether your employer already covers you.
It's worth remembering that medical insurance doesn't include chronic conditions such as asthma or diabetes. If you have seen your doctor for treatment for a condition in the five years before taking out the policy, your insurers will exclude this for the first two years.
If you don't have insurance, you can still get private care by paying for your treatment directly. As mentioned, you can book a private appointment or arrange treatment at most hospitals. You'll need to pay a booking fee or deposit depending on the type of appointment you need.
While health insurers will only pay for treatment at hospitals on their hospital list, when you pay for yourself, you have a completely free choice. If you've already seen an NHS specialist, you can ask whether they offer private care. You can also seek hospital recommendations from friends or family members who've had the same surgery as you or read reviews to discover what other patients say about the hospitals in your area. The Care Quality Commission website provides information about UK hospitals based on their regular inspections.
Self-pay is ideal if you have savings set aside for a rainy day. You can also use it to pay for your healthcare if you have medical insurance that doesn't include the private care you need, for example, because it doesn't include the appropriate coverage or because of a policy exclusion.
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Perhaps you don't have medical insurance or a nest egg set aside so you can pay for your healthcare. In that case, medical loans can allow you to pay for your private care in instalments rather than in one lump sum.
Many hospitals have private finance partnerships with loan companies. Loans vary, but most offer an interest-free period of between nine and twelve months. If you can pay off the loan in full within that time, you won't pay anything extra in interest.
Medical loans follow the same basic process as other loans. The finance company will check your credit rating and assess whether you can afford the repayments before agreeing to lend you the money. You should also check whether a medical loan is the most affordable way to pay for your care. Look at other loans or private credit and consider how much you'll pay overall based on the repayment period and interest rates before you decide whether to choose a medical loan.
MyTribe guides help you understand your private healthcare options so you can make an informed choice. If you want to find out more about whether private health insurance is right for you, speaking with a broker is the best way to explore your options. Contact us for a comparison quote, and we'll connect you with a regulated broker for advice tailored to your circumstances.
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.
