Private healthcare surge sparks 'two-tier' health system fears

 A patient watchdog has issued a stark warning about the emergence of a "two-tier" healthcare system in England, as a growing number of people are forced to turn to private treatment amid concerns over lengthy NHS waiting lists.

Healthwatch England revealed that the proportion of individuals opting for private healthcare has "increased significantly" over the past two years, creating a system where those who can afford it bypass public queues.

New figures from Healthwatch England highlight a notable shift in public attitudes towards NHS care.

A comparison of responses from 1,758 people in September 2023 and a new poll of 2,593 adults at the end of last year, both conducted by Savanta, showed a marked rise in private healthcare use.

In 2023, nine per cent of those surveyed reported accessing private healthcare within the preceding year, a figure that climbed to 16 per cent by 2025. The report also indicated that individuals earning over £80,000 were more likely to have paid for private treatment.

The primary driver for this shift appears to be the perceived length of NHS waiting times. In 2025, 39 per cent of respondents cited "NHS waiting time was too long" as their reason for using private care, up from 34 per cent in 2023.

Additionally, convenience played a larger role, with 30 per cent in 2025 choosing private options for this reason, compared to 14 per cent in 2023. Healthwatch noted that this move towards private healthcare coincides with "confidence in NHS hospital services remains low".

These findings emerge despite recent NHS figures indicating a fall in the overall waiting list for treatment. The list in England has decreased for the third consecutive month, with an estimated 7.25 million treatments awaiting completion at the end of January, affecting 6.13 million patients.

This marks a reduction from 7.29 million treatments and 6.17 million patients at the end of December, reaching its lowest level since February 2023, when it stood at 7.22 million. The waiting list had peaked at a record high in September 2023, with 7.77 million treatments and 6.50 million patients.

Chris McCann, acting chief executive at Healthwatch England, commented on the survey: "The NHS 10-Year Plan aims to tackle long waits for elective care, however, this work needs to move faster if we want to boost patient confidence, stop the move towards two-tier healthcare, and restore the NHS as a truly universal service for all."

He stressed the importance of consistent service and communication for all patients, regardless of location or hospital.

"This includes timely confirmation that their referral has been received and accepted – not lost in an administrative black hole – and information on managing their symptoms while they wait," he added, urging hospitals to provide regular updates and sufficient notice for cancellations.

The human impact of these delays is evident in patient testimonies. Andrew Howe, a 67-year-old professional photographer from Leicestershire, was referred to a neurologist in August for debilitating symptoms including fatigue, weakness, and brain fog.

"I’ve got a letter confirming that I’m on a waiting list, but when I ring them for an update, there’s no word about when I might actually get an appointment," he said. "I’ll be honest, it’s scaring me to death. My symptoms are getting worse. I’m eager just to have a diagnosis and to know what’s causing my problems so I can get treated."

Similarly, Stephen Whitley, 62, from Skegness, is awaiting an urgent appointment after seeking help in September for inflammatory bowel disease symptoms. He discovered a nine-month wait for an urgent appointment when he contacted his hospital.

"I think that because I’m waiting for my condition to be formally diagnosed, I’m stuck with a long wait," he explained. "If I already had a diagnosis, I might be seen quicker, but now I’m worried that it could become more serious, just because I have to wait to even get an appointment to confirm I even have this condition."

David Hare, chief executive of the Independent Healthcare Providers Network, acknowledged the trend: "This latest research reflects the growing numbers of people from all across the country who are now accessing private healthcare services, either alongside or instead of NHS care, in what is becoming a ‘new normal’."

He noted that this encompasses a wide range of treatments, from GP services to surgery.

"People’s health and the health of their family is their number one priority and so it is not surprising that more people are willing to fund their own treatment – or use private medical insurance provided by their employer – to ensure that they receive the swift, high-quality care they need at their convenience."

In response, an NHS England spokesperson stated: "The NHS delivered record numbers of appointments, tests and scans in 2025, reducing the waiting list to its lowest level in three years and cutting 18-week waits to levels last seen in 2022."

They highlighted that GP teams provide over a million appointments daily and expanded services like Pharmacy First are improving access to care.

A Department of Health and Social Care spokesperson affirmed: "We will end the unacceptable, two-tier, healthcare system we inherited that leaves patients feeling they have no choice but to go private."

They pointed to significant progress, including NHS waiting lists at their lowest in three years, improved A&E performance, rising GP satisfaction, and 1.8 million more dentist treatments.

"Our extra investment and modernisation is beginning to turn the tide, but we know there’s a long way to go," the spokesperson concluded.