How NHS waiting lists could create a ‘two-tier’ system in healthcare

Patients in England on long NHS waiting lists paid thousands of pounds for treatment in the last three months of 2021, with just under 70,000 procedures being self-funded.

The figures indicate a 39% rise on the same period pre-pandemic, and experts have warned that it shows how “desperate” some patients have become, said the BBC. 

The broadcaster said it had seen evidence of patients taking out loans “and resorting to crowdfunding to pay for private treatment” for operations like hip and knee replacements, which can cost around £15,000. More than 6.6 million people in England are currently waiting for treatment.

Two-tier system

The NHS England data shows “a clear drop” in the number of people self-funding treatments when the pandemic began, said the BBC. Before this, around 50,000 people were paying for their healthcare treatments every three months. In April this year, that number rose to 70,000.

“Some of this is likely to be the system catching up”, but patient groups have said there’s a risk of a two-tier system being created, “with the poorest losing out”.

In its The state of health and care 2022 report published in March, the Institute for Public Policy Research (IPPR) think tank warned that without improvements, healthcare could become “comparable to dentistry in England, where poor NHS access for some, and superior but expensive access for many, has been gradually implemented and normalised since the 1950s”. 

The IPPR added that this would leave many people vulnerable “for no better reason than their ethnicity, postcode, income or occupation”. 

The British Journal of Nursing’s editor-in-chief Ian Peate said that the disparity between patients who can afford to supplement their healthcare and those who “risk being left out” is a “slippery slope to privatisation and the creation of a two-tier system”. “Avoiding” that scenario is “in all of our best interests”, he added.

If the trend continues, “it could threaten the deep and widespread support for the NHS among voters”, said The Guardian. 

Possible solutions

Tim Mitchell, a consultant and vice president of the Royal College of Surgeons (RCS), told BBC Radio 4’s Today programme that he was “very concerned to hear that people are using up their savings or getting into debt in order to fund their surgery privately”. “This really makes the priority to get the NHS back to providing timely surgery as soon as possible,” he added. 

A spokesperson for the Department of Health and Social Care said that the NHS recovery plan – a blueprint for addressing backlogs built up during the pandemic published on 8 February – “will reduce waiting times, give patients more control over their care, and harness technology to free up staff”.

But the RCS has urged the NHS to speed up the adoption of surgical hubs in every area of England in an attempt to deal with the backlog. “These are ring-fenced facilities available for surgery that mean that surgery can continue, even when there are the huge pressures for emergency care on hospitals as we’ve seen during the pandemic,” explained Mitchell on Today.

In a piece for The Times this month, the RCS’s president, Professor Neil Mortensen, said the organisation was “delighted” when former health secretary Sajid Javid “managed to squeeze extra cash from the Treasury to increase the number of surgical hubs” last October.

“But we need more of them and we need them in every part of the country,” he added. “It’s key to levelling up access to surgery.”

Article source: https://www.theweek.co.uk/news/science-health/957438/how-nhs-waiting-lists-could-create-two-tier-system-healthcare