In the United Kingdom the historic premise behind the National Health Service (NHS) has always been medical care free to the user at the point of delivery. It should of course never be forgotten that the NHS is anything but ‘free’ being funded in its entirety as a public sector organization paid for by central government.

However, since the formation the NHS in 1948 it has become increasingly apparent that all care cannot be ‘free’ and indeed in the 21st century we live in an era of both austerity in the economy generally but in particular one of a ‘post code lottery’ for NHS treatment, one only has to consider biological and hormonal therapies for cancer or infertility treatment (a topic I discussed obliquely in a previous post) to see that where you live can materially affect what treatment you receive and for how long. The issue of the cost and funding of the NHS is further exacerbated by the rising age of the population and advances in medical science that enable people to live longer but of course : older means by definition in most instances ‘sicker’ and older people are and will continue to be a big call on NHS funds.

The capability of the NHS to both cope with and provide for an adequate ongoing service to its user base – the UK population, us. It is an enormous debate that is played out both politically and in the media on a regular basis, again a topic covered in other posts. From some of these previous blog posts on Talk Health you’ll know that I have worked in both the National Health Service and the private medical sector in the last 25 years and it is not for me (or indeed a suitable discussion for this forum) to sell my readers private medical insurance. Indeed, medical insurance is not necessarily the ‘answer’ to the problems that may be perceived to exist within the NHS. In fact it would be true to say that in my experience it (medical insurance) is a complimentary rather than a competing effect.

My view is that that purchasers of medical insurance may be exhibiting a reaction to the above issues within the NHS and the very existence of a medical insurance is a symptom of the state of the healthcare market in the UK rather than the cause or the need for a competing private service.

Those people that take the decision to buy insurance of this kind are doing so for a number of reasons :

Some want peace of mind that they have extra cover in place. That might be due to personal experience (often a negative one) of the NHS. For some medical insurance is a lifestyle choice – to plan for elective, acute treatment, buying choice and freedom away from the limitations inherent in the NHS and of course, although waiting lists are less of a problem now than historically but there is still an issue in some specialties and geographic areas. Medical insurance is often at its best when solving this kind of postcode and waiting list lottery. Of course many people receive medical insurance cover as an employee benefit as a ‘perk’ of their jobs so for them medical insurance is not a choice particularly influenced by the NHS just an acknowledgement by their employer that an alternative to the NHS is useful for their business or demanded by employees.

In the context of the discussion above I wanted to end this article with a simple question. Is it worthwhile financially to buy medical insurance, regardless of the motivating factor for the purchase ? In the end I think it really depends on personal experience but it isn’t right for everyone and one has to bear in mind all the factors above and of course that for all its shortcomings, each and everyone of us that is a UK tax payer is already paying for NHS treatment anyway.

One needs to bear in mind that medical insurance does not replace the NHS – chronic (uncurable) and pre-existing conditions are not covered, nor is primary care (GP and other community based medical services) nor is accident and emergency treatment typically. Whilst medical insurance cover does not replicate the NHS it does provide input into the NHS system. Many insurers offer access to their policy holders to NHS pay facilities and although it is difficult to estimate the direct financial benefits (probably hundreds of thousands of pounds or more) it is certain that indirectly the private sector saves the NHS tens of millions of pounds in providing elective treatment for policyholders and self paying private clients who otherwise would be forced to use the NHS. It is also worth considering that to fulfil waiting list targets the NHS regularly takes spare capacity in the private sector (especially for common procedures like hip or knee replacements or cataract replacement where lower set procedure costs can be negotiated in advance in return for bulk contracting).

Regardless of ones political persuasion or view on the fairness of private medical insurance it is true to say that the private and public sectors are inextricably linked. The decision therefore to elect to purchase medical insurance isn’t then as simple as opting out of the NHS, rather it is case of weighing the factors discussed above whilst bearing in mind that one still funds the costs for the UK national health system via your tax and taking the decision to pay twice can be worthwhile if your personal requirements are to be fulfilled.


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Phil Knight started work in the National Health Service in Leeds in 1989 before going to Hull University to read American Studies and then moved into private medical sales and marketing in 1994. He now owns two business focused in the private medical sector and works with senior clinicians and healthcare providers on a daily basis advising on a variety of healthcare issues. He is also a Member of the Leeds Teaching Hospitals NHS Trust. He is interested in all aspects of healthcare and regularly blogs on related medical, business and technology issues and also hosts the only podcast in the country focusing on private medical insurance. He is lives in Leeds, West Yorkshire but has clients across the UK and internationally. He is married to Hazel, a Senior HR Manager with two children : Megan aged 13 and Ryan, 7. His interests include technology, podcasting, science fiction and martial arts - he is a Second Dan Black Belt in Tai Sabaki Do Karate and 2nd Kyu Brown Belt in Shukokai Karate so health and fitness dominate both his business and personal life. Read his blog at and visit his websites : and

2 Responses to Do people buy ‘go private’ because the NHS is bad ?

  1. Thank you for the article.

    on August 4, 2018 at 7:09 am Glenn Wolfe

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