Bespoke Healthcare

Bespoke Healthcare

We take a look at the growing trend for choosing your own healthcare, picking from an array of private services as the need arises

The healthcare culture in the UK is shifting. Typically, it used to be the case that when you were ill, there was either the NHS, or private, paid for by a company or individual under an insurance policy. Now, self-pay, where you choose to fund tests, treatments and consultations as and when you need them, is on the rise, with people choosing from a range of services to meet their needs.

The Internet has increased awareness of what is available, and there is a growing confidence in taking charge of your own healthcare. Private services run from a GP appointment and a blood test, right through to major surgery, with some private hospitals also offering intensive care and cardiac units.

Notes Desiree Gaze, business development manager at Spire Healthcare, which runs 39 private hospitals across England, Wales and Scotland. “People are increasingly setting aside money so that they can fund their own healthcare. They want to be in the driving seat and be able to make their own decisions. They want to choose where and when to have a procedure and who will carry it out. That kind of choice just isn’t available within the NHS.”

But Desiree, who is based at Spire’s St Anthony’s Hospital in Sutton, stresses that private healthcare is always complementary to what the NHS offers. “We are not competing but supplementing what is available.” This might entail a patient paying privately for fast access to a consultation and tests and then going back into the NHS for treatment, or being diagnosed via the NHS and then opting for a procedure privately to avoid having to wait.

While self-pay is currently only a small part of the private healthcare market, accounting for 18-20%, its popularity is growing, and in the last five years, the market has increased by 40%. Says New Victoria Hospital’s marketing manager Sally Dobinson: “The reasons include waiting times on the NHS, NHS restriction on funding for certain procedures, and the rising cost of private medical insurance.”

Indeed, the private medical insurance market has been broadly flat in terms of numbers in recent years. Adds Desiree: “Private medical insurance has grown in some areas but declined elsewhere such as personal insurance as people either wait for the NHS or use self-pay options, which also come with flexible payment plans in some instances.”

As to the typical self-pay consumer, Sally notes that they tended to be over 40 years of age, but this is shifting due to the increasing awareness of self-pay options and the increasing number of treatments only available on the NHS under very strict guidelines. Abbad Toma, an ENT consultant at New Victoria Hospital gives several examples: “Children and adults are no longer allowed to have their tonsils removed unless they have seven or more documented attacks of tonsillitis per year. Similar restrictions are in place for children with hearing loss from glue ear or adults with blocked noses caused by polyps or a deviated septum. These procedures can all be provided to self-pay patients once they have been assessed by a consultant ENT surgeon. Another is prominent ears which has practically been stopped in the NHS except for extreme cases. This can have a devastating effect on the child’s psychology.”

Desiree adds: “We see parents opting for self-pay for their children – they just want them to get back to normal as quickly as possible, and they like to be able to schedule an operation when it might be more convenient such as school holidays. Other typical self-pay patients are those in pain, won’t die from their condition, but the impact on their life is huge. A hip operation might be an example of that. We are also seeing a large number of self-employed people pay for their own procedures – they need to get back to work quickly and can’t afford to wait.”

Private GP surgeries are also increasing in popularity as part of the self-pay boom. Says Desiree: “Culturally in the UK it isn’t the norm to have a private GP unless you are particularly well-off but with the strain on the NHS people are looking for fast access, and out-of-hours access, to a GP. NHS practices are trying to address this but there is a place for the private GP surgery.”

Of course, it all comes at a price. A private GP consultation can cost around £100 – that said, you can get a comprehensive 20 to 30 minute appointment to ensure that the GP has all the background information, a hip replacement can cost £10k to £14k, and blood tests £50 to £800 depending on what you want to screen for. Fixed price surgery schemes and finance plans are opening up the market, and making self-pay more accessible and transparent.

Clearly the demand is there, and choice and awareness can only be a good thing for everyone’s health.

Pick and Mix

The NHS recently announced 17 operations that it will not routinely fund including Carpal tunnel syndrome release and breast reductions. There is also the variation between local Clinical Commissioning Groups as to what criteria needs to be met before a procedure is funded. Self-pay can provide an alternative pathway.

Varicose Veins

It may be possible to get varicose vein treatment on the NHS where skin damage, clots or bleeding have already occurred. However, for those bothered by aching, swelling or more cosmetic aspects it is usually appropriate to seek private treatment, notes says Sudip Ray from Parkside Hospital. “We offer assessment by ultrasound and then a choice of “keyhole” treatments such as sclerotherapy, microwave or superglue closure. Recovery from these is rapid and the vast majority of patients are highly satisfied with the result. Having a choice of specialist, hospital and timing makes vein improvement one of the most popular procedures in the private sector.”

Private Dentistry

“While NHS treatment is widely available for children, going privately may be the preferred option for areas such as braces. Invisalign, for example, is a neater and quicker solution rather than standard metal braces – which can often be daunting for the selfconscious teenager,” says Dr Anand Patel of Infinitidental Clinic in Wimbledon.


There are any number of private tests you can opt for – blood tests for tropical travel screening, hereditary cancer genes, full body scan. The list is endless. But testing should always be done in conjunction with advice from a medical professional. A barrage of testing may put minds at rest but they can also do the exact opposite.