Is it worth paying for private healthcare?

Rob Lilley-Jones: Private healthcare has become more and more mainstream since the COVID-19 pandemic. But is it really worth paying extra to skip the NHS queues? Welcome to this podcast from Which?

Hello, I’m Rob Lilley-Jones, here to give you expert advice and recommendations to help you live your best life every day. To help us this week, I’m joined by two expert guests: Megan Thomas is a senior researcher from our health team here at Which? Hello, Megan.

Megan Thomas: Hi, Rob.

Rob Lilley-Jones: It’s lovely to have you here. And also, we are joined by Oscar Duke, doctor and broadcaster. Oscar, welcome.

Oscar Duke: Pleasure to be here. Thanks for having me.

Rob Lilley-Jones: It’s brilliant to have you both here. Megan, the basics: what do we mean when we talk about private GP appointments?

Megan Thomas: A private GP appointment won’t look really that different from a regular NHS appointment, but you get a bit more control over how long you wait. That’s a lot of the reason people go for a private appointment — it's because you can cut down on those wait times that people have been struggling with lately.

Rob Lilley-Jones: And then if we talk about how many people are choosing to go private, do we have those figures?

Megan Thomas: Market research LangBuisson has estimated that 13% of GP consultations were private in 2024, which is up from 3% two decades ago.

Rob Lilley-Jones: So it’s a big rise. Oscar, why do you think more people are choosing to go private? Is it those long waiting times, do we think?

Oscar Duke: I’m sure it inevitably is. The National Health Service is under so much pressure. GP time is under so much pressure. We’ve got an ageing population; we’ve got growth in that population. So there are lots of reasons that people find it very difficult to get in to see their GPs. GPs have to do a lot of paperwork; there’s a lot of administration that comes with being a GP. There can be a perception that the GPs aren’t there or aren’t seeing so many people — that isn’t true in my experience of any of the GPs I know or work with. People are working very, very hard, but there is a huge demand.

Rob Lilley-Jones: And talking of that demand, of course, we know that more and more people want to see a doctor, hence why more people are choosing to go private. Oscar, if we talk about the NHS specifically, why are those services so stretched? Why are those waiting times so long?

Oscar Duke: In the NHS, we’ve obviously still got a backlog from the COVID pandemic, so that’s had an impact. In general practice, we’ve changed the way that we do a lot of consulting. Some of that for the better — we do a lot of telephone consultations. If you look in the media, you see a lot of negativity towards "oh, I could only speak to my GP on the phone." Actually, when I speak to patients on the phone, and I know a lot of my colleagues get the same response, a lot of people find that really helpful if they’re at work or they can just pop out into a meeting. They don’t have to take the whole morning off to go and sit in a waiting room; they’re not exposing themselves to other bugs while they’re waiting there.

There have been a lot of pros and a lot of things that we can sort on the telephone, and then that means that we also have availability to bring people in who need to come in. So I think there has been actually a lot of progress in terms of how we are able to look after patients. In a way, we’ve learned a lot from the pandemic, but of course there is that backlog. There’s an element of COVID still lingering on, so patients struggling with things like long COVID.

Also, for the most part, people are using resources very appropriately, but then there are always patients who say "actually, perhaps this could have been better solved by going to see your pharmacist or finding another route, perhaps through the 111 website, to getting that help," and that you didn't need to wait for that appointment. There are lots of different ways to access healthcare professionals within the NHS if you need that advice.

Rob Lilley-Jones: Just going back to something you just touched on there, which was the fact that you’re doing a lot more work on the phone now, having those initial consultations with patients. Does that mean that you are able to see more patients than you would have been otherwise?

Oscar Duke: I don’t think it means more necessarily, because you still have to have that time. You’ve still got to go through the patient’s history, the story of what’s happened, why they’re there. So I would say the timing is fairly similar, actually. Yes, okay, you can’t examine somebody over the phone, but then there’s the time where you’ve got to download the photos and they’ve got to send in a photo and all the extra admin maybe that goes on with being on the phone.

But for convenience for a lot of people, it works really well. If it’s a simple piece of advice that people want, then they can normally get that over the phone. If they need to come in to have a lump looked at, or whatever it might be, then we often have slots available, often even the same day, to be able to do that. Different people do have different experiences. Different practices have different demands, different populations. There are hugely varied experiences when you talk to patients about how easily they can access their GP through the NHS across the country. What might be one person’s experience may sadly not be another’s.

Rob Lilley-Jones: You said there you’re not necessarily seeing more patients, but it’s just about seeing them in a different way, and it might still be able to resolve an issue or maybe they will still have to come in. How much of your time and your GP colleagues' time is actually spent seeing patients, and how much of it is spent on the other stuff that isn’t necessarily why you got into medicine in the first place?

Oscar Duke: It’s hard because all of it is related to patients. If you’re not seeing a patient, then you’re perhaps looking at their blood results that have come in, or you’re following up the letter from their consultant that they’ve seen at the hospital. I suppose it is all patient care, albeit that it might not be direct person-to-person care with someone sat in front of you. It’s hard to give you an exact figure as to how much of that day, but there always feels like there’s more admin to be done than there’s ever really time for. That’s why it’s a long day for most GPs in the NHS.

Rob Lilley-Jones: If we switch back then to private healthcare, Megan, who is offering these private GP services? Are they names that we’d recognise?

Megan Thomas: Some of them you might recognise, so Bupa you might know — they’ve got dentists, they’ve got private healthcare as well. They’re quite a big provider. There are a lot of online-only providers as well, and there are some regional-specific providers like Spire. There’s a lot to look at.

One thing you can look at is because you might not have heard of some of these providers, you might not know whether they’re legitimate. It’s easy to pay for an ad on Google; it’s not necessarily the best option for you. But you can check that they’re properly registered. All private GP practices must be registered with the Care Quality Commission, so the CQC, and should display the logo and their latest rating. You can check that it’s a legitimate enterprise.

Rob Lilley-Jones: Oscar, are we seeing some GPs moving across to private healthcare? Would it be fair to say that the NHS are losing some doctors, some practitioners, because they’re going over to private?

Oscar Duke: Across the board, GPs and hospital consultants as well. There’s long been a model in the UK where we have the main provision of healthcare through the NHS, but a lot of consultants have worked privately alongside that. That’s been less so with GPs, but I think you’re seeing more of that developing as well.

For me, what’s lovely is that in the UK we have this structure of having the NHS. I think it’s an amazing service in so many ways. But in terms of the way that it provides education and that initial training for almost all doctors — almost every doctor who’s trained in the UK will have worked in the NHS at some point. We, even whether that’s in the private sector or in the NHS, benefit so much from that because people have started their training at least in a world where finance and profit — perhaps if it’s a for-profit organisation — are not foremost in their minds.

When I was training as a doctor, you're very much about the patient: what’s the right treatment, what’s the evidence-based treatment for that? Then, when those doctors go off into private practice, hopefully they’re working to the same models, but yes, perhaps being able to see somebody slightly quicker or offer them a treatment that maybe they wouldn’t be able to fund through the NHS. So they’re opening up other options, but hopefully the moral essence of healthcare in the UK is stronger as a result of having that NHS at the core.

Rob Lilley-Jones: Megan, for these private services — private appointments, for example — what’s the price point that we’re talking about here? How much might people have to pay?

Megan Thomas: It will vary between providers. What I’ve found looking into it is that you’re looking at sort of between £40 and £90 for what is generally a 15-minute appointment. You can pay a bit extra if you want to stay longer. But one thing that I think is worth keeping an eye out for is this won’t cover everything that you might encounter in a private appointment. It’s worth checking the Ts and Cs because often it might say prescription writing is an extra charge, as well as the prescriptions themselves. Then that’s also just really for online appointments. You’ll usually pay extra for face-to-face, if that’s one of the reasons that you wanted to go private — if you really cared about face-to-face, you would likely pay extra.

Rob Lilley-Jones: One thing that was really interesting that you’ve actually both touched on there is how much of a postcode lottery it is sometimes, whether it’s with the NHS or private. Is it possible to say where you are best off living to get the best possible medical treatment, if that makes sense? Obviously, if you live in London, for example, that’s a lot of people in a very small area, but does that necessarily then equate to worse healthcare as a result?

Oscar Duke: It’s really tricky. The thing for me that makes life easiest as a doctor, and I think therefore makes for the best patient experience, is the continuity of care. It depends on how different practices are set up as to what enables that. In private healthcare, it's not necessarily the same either if you’re calling up a big organisation to speak to a doctor.

What I think is so important, and studies have shown that people live longer if they have a doctor who gets to know them, because you can then cut through so much of that time. Time is so pressured in these interactions. If you think of the average NHS GP appointment, face-to-face probably about 10 minutes, some slightly longer, maybe some a little bit less, especially if it’s a busy afternoon or an urgent clinic for some general practices. A lot of that time is spent catching up, reading through the notes, trying to see where you’re at. If you know that patient or have looked after them for many years, then you’re leagues ahead.

The patient themselves — perhaps even more importantly — feels comfortable with that person, feels that they’re able to share the problem, maybe is able to be very direct with what it is they’ve come about rather than telling about something else before you’ve actually find out that they’ve got a lump here that they’re worried about or the cough’s actually they've been coughing up some blood and that’s why they’re really worried. Sometimes it takes time, and building that rapport and the bedside manner and all of that stuff is really important in trying to make a patient feel comfortable. Where is incredibly variable. You might have a lovely local village GP who’s known your family for a long time, and that is a fantastic context. Equally, you could find that in the heart of a city as well. Finding a right practice which is a nice fit from the NHS side is really important if you’ve got options where you live.

Rob Lilley-Jones: And how do you find something that is the right fit for you? What are the things you should be looking for? You’ve said there you might not have many options because say you live in a small village with not much around, so therefore your options are limited. But if you do have a bit of choice — maybe you’ve moved to a new area and you’re trying to work out where you could register and they’re accepting NHS patients — what are the things you could look for?

Oscar Duke: First, I’d have a look on the NHS website. You can actually go, pop in your postcode, and it will show you the practices that are near you and how far from you they are. Also there are ratings there, people’s reviews you can find on either there or search engines. You can have a look at that. Be a bit mindful with reviews sometimes that, as with any review, it might be that people who are either really happy or really not happy — and a lot of people will go for their appointment and not leave a review.

There’s something called the friends and family test that you might be able to find on the practice’s website, so we ask patients to give a kind of happy or unhappy face — it’s quite a simple test, but gives an idea of the thumbs up or thumbs down as to what people think about the practice. I think word of mouth is really good as well.

But also, you’ve got to remember that different people will have bad days. Sometimes you might meet a doctor in a practice and you don’t think you’ve had a great rapport with them — they might have had a particularly bad day, their child might be sick at school. Doctors are human as well. Sometimes it’s about giving people a second chance, seeing if they were having a bad day, or get onto another appointment and see how that goes. Often in practices nowadays there are lots of different GPs, so if you find that you’re not a great fit with someone, it doesn't mean they're a bad doctor; it might not be right for you. Then maybe try switching to another doctor. Sometimes I think the receptionists are good to ask: "who would be good for me to see?" They might often be good matchmakers in finding the right doctor-patient combo.

Rob Lilley-Jones: That is a good tip. I like it. Megan, if we talk about private healthcare providers then, is that similar in terms of how you would try and find the right provider for you? Are you looking for similar things, or are there other things you could look for when you’re trying to identify the right private healthcare provider?

Megan Thomas: Because the care should be really similar — the level of care to what you get on the NHS — I think those principles definitely would apply. The only thing that’s going to be different is any fees that you might not expect. As I mentioned, it’s checking what is actually included in the cost that you know you’re paying up front. What extra might you have to pay? Are you willing to pay it? But otherwise, all the principles of care should be the same for both.

Oscar Duke: From the medical side, I think that’s important as well because sometimes as a doctor it’s very difficult to make a full assessment without some of those tests. There’s that balance of feeling "am I being sold something?" But also actually we may well need some of those blood tests to be able to give you that answer. If you’re having to have further tests or scans, then that can be where there’s a lot of cost associated as well.

Rob Lilley-Jones: Now, let’s get back to costs, because they really could start to rack up if you require follow-up appointments, Megan, couldn’t they?

Megan Thomas: Yes. Every aspect of healthcare when it’s private will incur extra fees. As we talked about, diagnostic tests — you won’t pay NHS prescriptions, whether that’s £9.90 or free if you’re in Scotland or you meet various criteria. They can really mount up. I think it’s worth, before going in, thinking about whether that’s something you’re willing to do. Looking at other private services and therapies — something like a physiotherapist will cost extra. Something like a surgery will be a huge expense. You don’t need to commit obviously to all of that privately after one appointment, but it's all things to think about if you’re wanting to go down the private route.

Rob Lilley-Jones: And Oscar, are there some things that a private healthcare provider might be able to offer that the NHS simply wouldn’t? Or is it that the NHS will offer that treatment but you may just have to wait a lot longer?

Oscar Duke: Broadly, in terms of treatment, it’s going to be pretty similar. There are sometimes things that might be — particularly within specialties — certain cancer treatments, certain very expensive treatments that maybe haven’t yet been funded by the NHS might be available. That said, often some of the newer treatments are coming through trials, and if you’re exposed to trials, that's often being run through the NHS. So I would say not always.

It’s more about the experience that you’re able to get, so that speed of being seen, perhaps having that continuity of care there, and time. I think a lot of patients miss out because they feel they don’t have enough time in their appointments, and actually if someone had longer to explain what was happening, they might feel a little bit more heard or that their symptoms had been better understood.

Rob Lilley-Jones: One thing that it would be really useful to talk about is how the NHS and these private healthcare providers sort of interact with one another. We’ve seen that if people choose to go back to the NHS — maybe if they have gone with a private provider and they’ve not necessarily been unhappy with the treatment, but they’ve decided they no longer want to pay for that treatment — you could face delays, couldn’t you, trying to integrate back into the NHS? There’s a secondary issue, isn’t there, of the NHS doctor may have to do what they can to agree with or identify whether the private doctor’s recommendations were the right thing for you?

Oscar Duke: There’s always a sensitivity from the doctor’s side about what you’re recommending if you’re a private doctor going back into the NHS. Hopefully people will have an awareness. As I say, most likely in this country they would have been trained within the NHS. Hopefully they have an awareness of what might be available and give those signposts to a patient.

Yes, there can be some difficulties. Most private doctors won’t be able to refer directly to see an NHS specialist. But then equally, if say you have a health insurance policy and private medical insurance through your work, then seeing a private doctor might be a good route in to activating that, and then you might find that things are picked up through your private insurance provider. For a lot of patients, seeing a private GP can be a gateway to triggering that when the general practice, the primary care element of it, is not covered by most insurance policies. The interaction between the two is important, and private doctors would normally be updating the NHS GP about treatments that they’ve been given, obviously with that patient’s permission.

Rob Lilley-Jones: It’s really interesting that you mentioned there private medical insurance, because that is something that we were really keen to talk about today. If you have it already, private medical insurance, you should have access to GP services through that, is that correct?

Oscar Duke: I believe that a lot of private medical providers will offer at least a telephone or video GP service as part of that service. Because for the most part, if you want to go and have further tests or you need to have scans or see a specialist, then you’ll need a referral from a private GP to enable you to do that. There's a filtering system for the insurance company.

Rob Lilley-Jones: And it might be the case that this is being offered through your employer, right Megan? This is something you should look into.

Megan Thomas: Yes, your employer might offer it. It might be you individually paying in monthly. It is worth noting one thing that we mentioned already, which is it does not apply to chronic conditions or pre-existing conditions. So you shouldn’t look to private medical insurance if you’re already experiencing some sort of medical issue. It won’t be able to help you.

Oscar Duke: And I think it's important as well to say that your NHS GP can also do a referral for you which you could take to a private doctor, a private consultant, or to your insurance if you wanted to. You don’t have to see a private GP first in order to activate your medical insurance if you have it.

Rob Lilley-Jones: So if you do decide that private healthcare is for you in some form or another, Oscar, how quickly can that happen?

Oscar Duke: If you wanted to see a private GP, then normally you’d be able to register and do that the same day. If you want to see a private specialist, then some will accept direct referrals — normally they’ll want you to have seen a GP or have a letter of referral for you from your GP. Certainly for most private health insurance policies, if you’re going to see a specialist, they will have expected you to have a referral from a GP as well.

Rob Lilley-Jones: The flip side then: if you’ve had a listen to this and you think "actually, maybe going private isn’t for me, I’m going to stick with the NHS," how do you make the most of an NHS appointment? This is really interesting, Oscar, from your side obviously being a doctor. What are the things that you really want your patients to come with that will make your job easier?

Oscar Duke: First you’ve got to build that rapport, and everyone’s got to work towards that. The doctor’s trying to do that all the time — that’s part of our role. You can help with that as well. If you can come in and try and give the exact reason that you’re there, what it is you’d like from the consultation, really try and lay that out. Some people find that easier to do than others.

Complaining about how long you’ve been waiting for the first five minutes — whilst that might well be a valid thing — is not necessarily the best use of your 10 minutes of time. I would be mindful of that and maybe save that for a discussion with the practice manager or something at a separate time. When you’re there, try and be really focused in a positive way on giving the information. Be very clear with exactly what it is that you’d like to happen as a result, and ask questions if you don’t understand. Just say "I’m sorry, I don’t understand that." We wouldn’t as doctors expect you to be healthcare professionals unless you are one. Even then, if I go to the doctor, I want someone to just explain it to me in human English because it’s about me. I think you just be very clear and direct with your doctors in a nice, engaging way and then hopefully everybody gets on. Even if you’re not a perfect match for that doctor, you should hopefully have a really satisfactory consultation.

Rob Lilley-Jones: It’s real interesting having listened to what you’ve both been saying today in this episode is that it’s not necessarily a one-size-fits-all approach for anyone. You have to find what’s right for you. Are there any final words you’d like to leave anyone listening to this episode with, whether they are considering going private or they’re wondering what is best for them when it comes to their health?

Megan Thomas: I would just say: I think don’t necessarily let all this talk about how hard it is to get a GP appointment make you not even try. Because you might actually find that at your local GP you don’t necessarily run into an issue. You might hear "oh, you’re not going to get an appointment, you’re not going to get an appointment, I’ll just make a private one." But you don’t necessarily need to. Don’t rush into it because you feel like you have to without trying, would be my thought.

Oscar Duke: I’d say find a doctor that you feel comfortable talking to, because then you’re going to get the best care that you possibly can. You don’t need the greatest Einstein, but you need somebody who you feel relaxed around and that you are able to share your problems with, and actually that will see you and stand you in the best stead.

Rob Lilley-Jones: Guys, thank you so much for joining us today. Megan, thank you very much for joining us today.

Megan Thomas: Thank you for having me.

Rob Lilley-Jones: And Dr Oscar Duke, Oscar, thank you so much. Really, really appreciate you finding time in your very busy schedule to join us.

Oscar Duke: It's a pleasure. Thanks for having me.