The three top UK hospital groups are all reducing their involvement in, and marketing to, the NHS. They are all refocusing on attracting private patients, either self-pay or insured.
Spire, Britain’s second largest private hospital group, says NHS work is no longer core to strategy. The company had invested heavily in adapting its business model to take on NHS patients. It will offer spare capacity to the NHS when it suits. But Spire is refocusing on the private patients who make up 90 per cent of its business and it now expects no more than 10% of its business to come from NHS patients.
Nuffield Hospitals, which had also invested heavily in NHS work, says there is now a limit to how much effort they put into this, as NHS work will no longer be a major part of business. Nuffield also expects only some 10% of its work to come from the NHS.
BMI, Britain’s largest private hospital group, has never seen the NHS market as vitally important, and will continue to focus on private patients.
Three or four years ago most hospital groups saw a very significant opportunity. There were projections that NHS patients would make up almost half of private hospital admissions within a few years, and private patient numbers were projected to fall by 15 per cent.
NHS waiting times have reduced sharply. How much of this is due to massaged waiting lists is debatable. For example, if a patient refuses an appointment they are often sent to the back of the queue. If a patient refuses a second appointment – even if offered so near time that other commitments mean they cannot go – government guidelines dictate that they get thrown off the waiting list and their GP or dentist has to crawl to the NHS to plead for them to get back on the list. Basically, the waiting list system works if you are retired or at school, but of you have to work or care for children, there is no guarantee that the NHS will offer a convenient time, and if you refuse an offer you may be off the list. This may explain why private patient numbers have not fallen, as the reality of the NHS for individuals gets further apart from what the politicians claim.
Only about 5 per cent of NHS waiting list operations are currently carried out in the private sector – against projections of up to 15% a few years ago.