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NHS costs squeeze means longer waiting lists – and growing numbers of patients opting to pay for operations, say private firms Private healthcare firms are experiencing an increase in business caused by the financial squeeze across the NHS in England, a new report on the sector shows. Independent providers are benefitting from the growing number of patients who are choosing to pay for their own care after having treatment delayed or denied altogether by an NHS primary care trust (PCT). In a survey of 101 influential industry figures – including chief executives, investors and advisers – 34% said budgetary pressure in the NHS had led to increased demand for private healthcare. While the reasons were not given, experts said the NHS’s need to cut costs was prompting patients to fund their own hip or knee replacement, hernia repair or cataract removal. “We are certainly picking up that some patients are being asked to wait longer than they would have expected and are therefore deciding to pay for themselves rather than wait,” said David Worskett, chief executive of the NHS Partners Network , which represents more than 30 firms – both for-profit and not-for-profit – that work with the NHS. Worskett said “misguided” decisions of many PCTs to force patients to wait many months for treatment, often until the next financial year, lay behind the growing trend. Many PCTs are rationing access to care as the NHS struggles to adjust to a 0.1% annual increase in its budget, after years of big rises, and the need to make £20bn of efficiency savings by 2015. The trend is a boost for a UK private health market which that was hit hard by the downturn in 2008 and for which recovery since has lagged behind that seen elsewhere in Europe, according to Credit Suisse. It is contained in HealthInvestor magazine’s annual study of the industry’s fortunes in conjunction with law firm Nabarro, called The Healthcare Industry Barometer 2011, which is published today. Mark Varian, of Ramsay Healthcare, which has more than 3,500 staff and runs 34 hospitals and treatment centres, said business was growing because of tighter NHS budgets. Hospital trusts unable to treat patients within the 18-week deadline set by the government have been paying Ramsay to treat NHS backlogs. “They are using us as an overflow. [NHS] Waiting lists are extending and of course some hospital trusts are talking to us about helping them achieve their 18-week target,” Varian said. All 34 of their facilities in England have signed contracts since June with hospital trusts, and growing numbers of trusts are doing the same in order to get people treated on time, he said. The expansion of patients’ right to choose where they are treated, between NHS and private centres, was another reason for Ramsay seeing more state-funded patients. Private firms receive only the same amount as an NHS hospital, called the “tariff”, when they reach such agreements, whereas usually prices in the commercial sector are higher. Private acute healthcare in the UK is worth an estimated £7.2bn, with independent hospitals contributing £5.1bn of that, said HealthInvestor’s editor-in-chief Vernon Baxter. But the survey also reveals that 76% of those questioned agreed or strongly agreed that “continued political uncertainty around the fate of [health secretary] Andrew Lansley’s reforms is now harming companies active in this sector. Over 80% believe the public and medical backlash against Lansley’s NHS shake-up has prompted many investors to leave the sector because of the risks involved. There is deep disappointment that the coalition’s NHS policies have not produced more opportunities for the sector. Only 22% of industry figures agree that “the coalition has supported the recovery of the UK independent healthcare market”, while 39% disagree. However, while 42% are not optimistic that the coalition will accelerate the private sector’s role in the NHS, 55% are quite or very optimistic. But 55% think that handing control of £60bn of the NHS budget to GP-led clinical commissioning groups in 2013 will ultimately produce a more plural and competitive market in healthcare. “The current lack of optimism in the healthcare industry is seen by some as a natural consequence of high expectations for rapid reform a year ago being dashed by current political uncertainty,” said Warren Taylor, head of healthcare at Nabarro. “However, for those taking a longer term view, there’s much to merit cautious optimism. The direction of NHS reforms under the coalition remains positive for the sector.” Healthcare industry NHS Health Denis Campbell guardian.co.uk