One of the reasons ministers appear to have decided that they need the Department for Health and Social Care to take over complete control of the NHS and eliminate NHS England is, according to the Health Service Journal, because:
“the [Labour] team see more and more voters paying to go private, and honestly believe the universal service could lose widespread public support.”
However much Labour ministers may have convinced themselves of this defeatist view, the figures published by the private sector do not support it.
Record rises?
The most recent data from the Private Healthcare Information Network (PHIN) shows only a fractional increase in the number of treatments in UK private hospitals in Quarter 1 of 2025-26, which PHIN trumpets as a “Near record quarter”. The “near record” turns out to indicate only 8,000 extra cases over 3 months, of which half were privately insured patients.
Self-pay trends
The number of UK-wide self-pay patients (the most likely to be frustrated patients from NHS waiting lists, and who could not get private insurance because they already had a diagnosed pre-existing condition) rose by 4,000 (6%) – to 70,000 in Quarter 1 … but this increase just compensated for two much lower quarters in Quarters 3 and 4 of 2024.
Looking over the last few years, self-pay patients have been averaging a flatline 70,000 per quarter in the four years since numbers rose dramatically in Quarter 2 2021, after the peak of the Covid pandemic.
PHIN’s September private market update, showing the timeline of figures, and shorn of the triumphalist headline, notes that – far from booming – Quarter 1 of 2025 was 4% below Q1 2024:
“This is the first time there has been a decline in reported admissions for the first three months of a year since Q1 2021.”
Even numbers of insured patients seeking to escape waiting list delays have not been increasing as fast as England’s 7.4 million waiting list might suggest. PHIN comments:
“Reported admissions paid for with private medical insurance in Q1 2025 increased by less than half a percentage point compared to the same period in 2024. There were 730 more insured admissions than in Q1 2024 across the UK.”
The situation is not much brighter for self-pay:
“Self-pay admissions in Q1 2025 were down by 2,750 (-4%) compared to Q1 2024, which had the highest ever number of self-pay admissions (72,440).
“In Q1 2025, admissions financed by ‘self-pay’ fell in each of the devolved nations and every English region, except the West Midlands which increased by 6% compared to Q1 2024.”
Self-pay has fallen as a percentage of private hospitals’ workload from a peak of 34% in Q1 2022 to 29% in Q1 2025.
In addition, PHIN admits that the number of admissions has fallen across the board in Q1 2025 compared with Q1 2024, with only chemotherapy increasing admissions among the top ten procedures.
In other words, there is no sign of a stampede of patients “going private” either under their own steam or invoking private health insurance. This is consistent with the high costs and recent cost inflation in private health care (putting it financially out of reach of many) and with the complexity of many patients on waiting lists, making them unattractive to private providers with limited ITU facilities and no multidisciplinary teams.
Even the private sector itself is more realistic about its prospects than gullible Labour ministers, who are clearly pessimistic about delivering even their limited promises on the NHS.
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