This week, a relative went to a private hospital for a surgical procedure on his hand. For months, he had been dealing with a ganglion cyst, a harmless fluid-filled swelling that usually develops near a joint or tendon, which had eventually grown to the size of a golf ball. It had become so uncomfortable that instead of risking months languishing on an interminable NHS waiting list, he decided to go private. He had to wait ten days for his operation, practically a miracle in 21st century British healthcare provision, and a shorter timeframe than Matt Hancock’s recent stint in the Australian jungle (the procedure was probably less painful than eating camel’s testicles).
A growing number of Britons are taking out private medical insurance because they no longer trust the NHS to provide timely medical treatment. Anyone who uses the NHS will be impressed by the dedication of its staff, but it is clear the system is under immense pressure. There are now a record 7.1 million patients on the NHS waiting list for operations and in November, more than 11,000 ambulances per week were caught in queues of at least an hour outside A&E units in England, according to a BBC report. It is not surprising that one in ten Britons are choosing to go private.
The average premium for UK private health insurance is £1,435 per year, according to research conducted by finder.com. Even so, patients are increasingly willing to make this sacrifice in order to access a wider choice of treatments and sidestep NHS waiting times. Over half (53 per cent) of the UK population report that they would pay for private healthcare treatment.
The lazy response of Labour and too many Conservative MPs is to demand more funding for the NHS while shirking real reform. With another crisis in our health service looming this winter, it is easy to forget that the NHS’s budget increased from £123.7 billion before the pandemic to £151.8 billion in 2022-23. Rather than putting more money into the system, we need to introduce radical reforms and do something to alleviate the suffering of the millions of hapless people on NHS waiting lists.
The Government should consider ways to encourage people to provide for their own health care by restoring tax credits for those buying private health insurance. This would lead to a significant expansion of private services, in all areas of treatment, including counselling and therapy to deal with the explosion in demand for mental health services.
I recognise that many patients would neither want, nor be able to afford, private health insurance, but those who decide to opt in would be a major factor in reducing pressure on NHS trusts, to the benefit of all patients. It would take time for such measures to be implemented, and clearly it is easier to provide private care for elective operations. Chronic illnesses are more problematic as insurance companies will not always support treatment at a reasonable price, understandably because the costs are not quantifiable.
It is important to stress however that this has been done before. Conservatives introduced a relief scheme, confined to the basic rate, for patients aged 60 or over who were at risk of losing their health insurance upon retirement in 1990. It was axed by Gordon Brown in his first Budget after the Labour Party’s victory in the 1997 general election. Some Conservative MPs have determined that reviving tax reliefs for patients is an approach the Party should once again welcome. In February 2022, during a debate about the perilous post-pandemic state of the NHS, the Conservative MP Sir Edward Leigh suggested restoring tax relief on private health insurance for older patients who might otherwise be made to wait years for an operation.
Opening up choices for patients would be an opportunity for the Conservatives to prove they have distinctive electoral offering and show voters that a diversity of choice is a better way to drive up standards and improve outcomes.
This would be in stark contrast to Labour’s outlook, demonstrated this week by their plan to scrap the charitable status of private schools. This would have the unintended result of making independent schools even more exclusive and further out of the reach of hard-working middle-income families who already struggle to pay the average independent day fee of £14,000. Independent schools facing the loss of charitable status will cut the amount of bursarial funding which they allocate to families unable to pay the fees and social mobility will go into reverse.
As with the NHS, we would be better off providing tax breaks for those able to send their children to private schools, thereby freeing up resources for the state sector. This is not particularly novel or radical. In Germany, if you send your children to a private school instead of a free state school, you can claim 30% of the tuition fees, capped at €5,000 per annum, per child as a tax deduction. In Australia tax breaks for private schools are even more generous. The Australian Education Tax Refund scheme provides up to 50% back on a range of children’s education expenses.
Tax relief would not entirely resolve the problem of health funding for our ageing population, but it would generate healthy competition which could be replicated in other sectors, such as education.
We cannot simply continue throwing more long-suffering taxpayers’ money into the NHS blackhole. It is time our political leaders planned for a post-pandemic world in which citizens are empowered to make their own choices rather than being permanently infantilised and bamboozled by slogans which are not rooted in economic reality.
There is a Conservative way to relieve pressure on our stretched public services this winter, but it will require courageous politicians to carry out the necessary reforms. The 2021 Census showed that 50% of the U.K. population profess to be Christian, but 100 per cent of politicians kneel at the altar of the NHS. Why can’t we accept polytheism and view the NHS as part of a smorgasbord of options on the health menu?
