Due to the tight restrictions being placed on GP referrals as well as cuts in the availability of certain procedures on the NHS, more and more individuals are forced to pay for private healthcare.

Pulse, a UK medical journal read widely by GPs (general practitioners, primary care physicians), approached three leading private healthcare companies who reported an increase in the number of “self-pay” procedures, as a result of patients without medical insurance choosing private healthcare in order to avoid from blocks placed on GP referrals.

Spire Healthcare, one of the three leading private healthcare companies that operates 37 private hospitals throughout the UK, reported a 10% year-on-year increase in the number of self-pay “clinically necessary procedures” conducted in October. Furthermore, the number of enquires Spire Healthcare received between August and November regarding self-pay procedures significantly increased by 33%.

In addition, Nuffield Health, which runs 30 private hospitals across the UK, reported a rise in self-pay procedures in 2011, especially for orthopedics and plastic surgery, two areas that have been the subject of rationing and tough referral management.

BMI Healthcare, which describes itself as “Britain’s leading provider of independent healthcare” explained that there has been a “continued and steady” rise in the number of self-pay treatments.

The increases have raised concerns from GP leaders that the rising use of referral management centers, as well as additional referral restrictions, together with rationing of “low clinical priority” treatments is challenging the NHS.

The concerns come as Pulse’s “A right to refer” campaign calls for a Secretary of State guarantee of GPs’ right to refer. In addition, the campaign demands clinical commissioning groups to put all referral management centers to a voting of practices.

Dr Jean-Jacques de Gorter, clinical services director at Spire Healthcare, explained:

“The increase in enquiries about private treatment is largely the result of changes we’re seeing in the UK healthcare system. NHS funding can only stretch so far.”

A survey of 1,000 GPs by Spire discovered that 32% of GPs expected to make more referrals in 2012 to private hospitals than in 2011, with only 5% expecting to make fewer referrals.

A spokesperson for Nuffield Health stated:

“We can see a trend that self-pay has gone up. The key areas are plastics and orthopedics.”

Dr Clare Gerada, chair of the Royal College of GPs, cautioned that there was a risk individuals would increasingly observe the NHS as providing “sub-optimum” healthcare:

“GPs are being restricted in what and who they can refer, you have referral management systems putting barriers between the GP, patient and specialist, a limited budget for commissioning and the squeeze in hospitals. If people want to go privately that’s fine, but I don’t want a health service that is sub-optimum compared with what you can get privately.”

Richard Hoey, editor of Pulse, explained:

“GPs are reporting restrictions in access to a whole range of treatments, from hip and knee replacements to IVF, and their referrals are being routinely screen in many places, which injects delays and uncertainty into the process.

It’s maybe not surprising that these developments appear to be undermining faith in the NHS, and that increasing numbers of uninsured patients are choosing to pay to have procedures done privately rather than wait to see if the NHS can find the cash. But we must remember – the more people who can afford to go privately, the less willing they are likely to be to pay towards a national healthcare system that everyone can access.”

Written by Grace Rattue