Waiting lists initiatives have not diminished the demand for private medicine

March 30, 2000

Private funding of elective hospital treatment in England and Wales, 1997-8: national survey

The demand for privately funded surgery has remained high despite years of effort to reduce NHS waiting lists, suggests research from the University of Nottingham in this week's BMJ.

Williams and colleagues assessed the proportion of scheduled admissions to all NHS hospitals and to 215 of the 221 independent hospitals for non-psychiatric and non-maternity care for the financial year 1997-8 in England and Wales which were funded privately, and compared the findings with those of three similar surveys in the previous 20 years.

The results showed that 14.5 per cent of patients had been privately funded, including 13.5 per cent of surgical patients. These figures have remained constant for the past 20 years. One in 10 private patients had been treated in NHS hospitals, compared with 1 per cent of NHS patients in private facilities, but it is unlikely that all the surgery carried out privately would have been done in the NHS, say the authors.

The data show that a higher than average proportion of patients pay for surgery to relieve severe disability and discomfort, such as hip replacement and cataract removal, and to delay the risk of death, such as coronary artery surgery. But there were also a higher than average proportion of procedures for cosmetic surgery and gender reassignment, considered low priority in the NHS, and of some procedures, such as middle ear drainage with grommets and varicose vein stripping, whose effectiveness is, in some cases, questioned, say the authors.

Professor Brian Williams, School of Community Health Sciences, University of Nottingham Email: b.t.williams@nottingham.ac.uk


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