(p. 4) For David Haselgrove, it was a battle each day to get out of bed, then another struggle to put on his socks. Stairs were often impossible, and the pain made him tetchy and difficult to live with.
But when he sought medical help for his arthritis, Mr. Haselgrove was told the wait for a specialist consultation was more than two years. It might be another two years before surgery.
“If I wasn’t the person I am, I would have been losing the will to live because the pain takes over your life,” said Mr. Haselgrove, 71, who is now fully mobile after a successful hip replacement.
His recovery has nothing to do with Britain’s National Health Service.
Instead, Mr. Haselgrove, who ran several small businesses during his working life, flew to a clinic in Lithuania to have surgery, becoming one of a growing number of Britons who have dipped into their own pockets to pay for procedures to which they are entitled free on the N.H.S.
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Investment in buildings and equipment, including in vital diagnostic tools such as CT and M.R.I. scanners, has significantly lagged medical systems in other advanced economies, according to the King’s Fund, a health-focused think tank.
That contributed to a backlog of 4.6 million procedures even before the pandemic, a number that swelled to six million as planned procedures made way for emergency care during the Covid crisis. The line for treatment has only grown since. It is now about 7.7 million procedures, representing about a 10th of the population. Thousands have waited more than two years, often in pain.
Little wonder, then, that many Britons who can afford to pay to cut the line are doing so, while some of more limited means are dipping into savings or taking on debt. Yet that trend, some critics say, could undermine a health care system that has been a bedrock of British life for three-quarters of a century.
Private medical insurance is costly in Britain, and taxable when offered as a benefit by employers, so the shift is most visible when people pay for operations and other medical help out of pocket.
According to the Private Healthcare Information Network, which publishes data on the sector, there were about 50,000 “self-pay” medical admissions in a typical quarter before the pandemic. That figure is now steadily substantially higher; in the first quarter of this year, it was 71,000, close to a record.
That does not include patients who go overseas, like Mr. Haselgrove. At 7,000 euros, about $7,500, a hip replacement at the Nord Clinic in Lithuania was significantly cheaper than it would have been in a private hospital in Britain.
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Britain is chronically short of health workers, with over 100,000 N.H.S. positions vacant.
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. . . the deepest risk of the rise in self-pay patients, according to Chris Thomas, principal health fellow at the Institute for Public Policy Research, a progressive think tank, is not to the health service’s operations, but to its political underpinnings.
The British health system, he said, is built around the idea of “universalizing the best” — creating a system “as good for a rich person” as for a poor one, Mr. Thomas said.
If wealthier people increasingly opt out, Mr. Thomas said, the N.H.S. will become a second-class system for those who cannot afford to do so, resulting in “a slow erosion of support.”
(Note: the online version of the story has the date Dec. 9, 2023, and has the title “Britons Love the N.H.S. Some Will Also Pay to Avoid It.”)
