Is private healthcare good value for money?

James Rowe: More people than ever are turning to the private sector for healthcare and more, too, are taking out private medical insurance to help cover the cost. Our research reveals which providers' customers rate highly. All this comes at a time when confidence in accessing NHS hospital services remains low. Let's discuss all this and more on this episode of Which? Money.

Hello, it's James in the Which? studio alongside senior writer in our money team, Matthew Jenkin. Matthew, hello.

Matthew Jenkin: Hi, good to be here.

James Rowe: And later on, we'll be joined by William Pett, who is the interim director of policy at Healthwatch. He'll be here to discuss what they call two-tier healthcare. But first, Matthew, do you want to give us some numbers on NHS waiting times and, I guess as a result, those turning to the private sector? What do we know?

Matthew Jenkin: Yeah, obviously we all love the NHS, but unfortunately, as most people who have sought a doctor's appointment, GP appointment or or need to see a consultant will have faced long waiting times. And according to official figures, there are around 2.7 million people in England waiting more than 18 weeks for non-urgent treatments. So that's a long time. And faced with very long delays, inevitably people are looking for ways to be seen sooner, and one option is to go private.

Healthwatch England ran a survey, and they found 16% of people had used the private sector in the past year. That's up from 9% in 2024. With more people looking to get seen privately, private medical insurance is one way that people can cover those costs. The latest figures from the Private Healthcare Information Network showed there's a record half a million PMI-funded admissions in the first nine months of 2025 alone. So it's something that's increasingly becoming popular with patients.

James Rowe: And when you say PMI, you mean private medical insurance.

Matthew Jenkin: Private medical insurance, yes. Or we could just call it private healthcare.

James Rowe: Exactly. And when you said before about 2.7 million people in England are waiting more than 18 weeks for non-urgent treatment, we mention that 18 weeks because for the NHS in England, that is the maximum wait time, that's the target for non-urgent consultant-led treatments, isn't it?

Matthew Jenkin: Yeah, that's right.

James Rowe: So should we talk about private healthcare then? Because as we say, there are more people going private for healthcare for a variety of reasons, and you've done some research with Which? members, which we'll be able to tell us why more people are going private. But when we talk about private healthcare, what are we talking about? How does that differ from the NHS?

Matthew Jenkin: You're going to see the same doctors as you might on the NHS – they also have private clinics – but the difference is you're going to be seen faster, you're going to get an appointment quicker, and you probably get a more comfortable experience. For example, you might have a private room, wider choice of food. But the quality of the procedures and appointments, it's likely to be much the same as the NHS. So, yeah, what you're paying for is you're paying for convenience and comfort, I would say.

James Rowe: And when we talk about the cost, without talking about insurance for a second, just the cost of upfront private healthcare, what are we talking? And I guess it's going to depend on kind of what service you're after, isn't it?

Matthew Jenkin: Yeah, so private healthcare isn't cheap. For example, if you want to see a GP privately, an appointment's going to set you back between £40 and £90. If you're going to see a consultant, it can cost you a couple hundred pounds just to be seen by a consultant. That's where private health insurance comes in. That's where health insurance comes in, because it can help you sort of avoid that shock bill – rather than having to pay out of your own pocket.

James Rowe: And it just works private medical insurance, it just works like any other kind of insurance policy one might have?

Matthew Jenkin: Yeah, that's right. Exactly. It's a very similar sort of concept. Yeah, you pay a monthly premium, and for that, you can claim the cost back. Or sometimes the insurer will actually settle the balance with the clinic directly for you, so you don't need to pay anything up front.

James Rowe: And as we know, more people are taking out private medical insurance than ever before. Do we know why?

Matthew Jenkin: Yes, the main draw is speed and choice. So we ran a survey, and we found that six in 10 customers – so 60% – were looking for shorter waiting times. That's probably not surprising, seeing as having to wait more, in many cases having to wait more than 18 weeks. Also, we found 59% only had to wait up to two weeks for treatment or a procedure. So you can see the attraction.

James Rowe: It's a huge difference compared to the target wait time for NHS, isn't it, of 18 weeks?

Matthew Jenkin: Yes, that's right, exactly. Access to treatment, greater choice are also a big part of the appeal. 42% and 41% named that as the main reason for buying cover.

James Rowe: So, Matthew, as part of this research you did with our members, obviously you were trying to find out what they thought of the insurance providers. Do you want to just take us through some of that research and I guess some of the results as well? Which providers did well and not so well?

Matthew Jenkin: Yeah, so on the plus side, on the positive side, most of the customers that we surveyed, they said their cover actually offers good value for money, which is really positive. And the results of our survey, our member survey, based on the results of the feedback that respondents gave, we were able to name one of our one insurer, WPA, as a Which? Recommended Provider. They got a customer score of 86%, which was which was the highest score, and customers were really impressed.

James Rowe: So just the one WRP, Which? Recommended Provider, for WPA. The other six that were that we managed to rate and review thanks to our members, none of the others hit the mark for an endorsement. How come?

Matthew Jenkin: Yeah, that's right. I mean, they all scored above 70%. However, what let others down was the clarity of their terms and conditions, as well as waiting times between initial referral and treatment. So those were the the main aspects that let the other insurers down.

James Rowe: Is it fair to say maybe it's a bit of an elephant in the room about the the cost of private medical insurance, because it can be a sizeable payout every every month to get that cover? What are we talking for the cost? It's going to differ widely depending on your age, isn't it?

Matthew Jenkin: Yeah, that's right. I mean, health insurance premiums, they can take a big bite out of your budget. They're not cheap. But it will also depend on the level of coverage that you want and your your own personal circumstances. You mentioned your age, but also medical history, where you live.

So our survey showed just how sharply cost can rise the older you get. People aged 30 to 49, for example, they pay £50 a month on average, or £600 a year. But that rises to £149 a month, or £1,788 annually, for someone who's 60 to 69. And it gets it's even higher if you're 70 to 89 – premiums jump to around £300 a month, and that's a pretty hefty £3,600 a year. So that's six times more than someone in their 30s or 40s.

James Rowe: Yeah, it's crazy that difference, I guess. And I guess we see it in different sectors as well – with car insurance, perhaps it's the reverse, where younger people pay a bit more compared to to older people.

Matthew Jenkin: Yeah, I mean, it stands to reason the older you get, the more health problems that that you have. And so insurers factor in that extra risk risk factor.

James Rowe: Another stat I pulled out from the piece you wrote for Which? Money magazine was that 77% of customers said the amount they pay for private medical insurance had increased in the past year; 22% said it increased a lot. I guess that just comes back to what we've just said about age. The older you get, naturally the premium is going to go up.

Matthew Jenkin: Yeah, that's right. There's no two ways about it – the older you get, it's going to go taking out private health insurance is going to cost more.

James Rowe: And I guess this goes for all insurance, but for private medical insurance, people will naturally want to cut the cost they're paying, cut the cost of the premium every month. Is it possible to get it to come down? Is it to do with what we would talk about for other insurance, like excess or or trying to haggle the price down?

Matthew Jenkin: It comes down to how much cover you want and what you can afford. So that's what, you need to focus on what really matters to you. For example, you could cut outpatient cover, you could limit hospital choice, or you could even opt for NHS bank treatment, and that can lower premiums as well. You could also consider how quickly you want specialist care, whether you want pre-existing conditions to be covered.

Another one of the biggest levers is your excess, and that's common across all types of insurance. That's agreeing to pay more when you claim can significantly cut your your monthly premium – something 18% of customers we surveyed have actually done.

Another option is co-payments. This is where you can set a set percentage of each claim, usually capped, and this can help lower your premiums without exposing you to unlimited bills.

Another option, another way you can cut the costs, is you can also you can opt for an NHS wait option. This is where private treatment is covered only if the NHS can't treat you within a set time frame, and that's often set at six weeks.

And of course, switching is also a very good way to keep costs down. Have a look around, shop around, switch to another insurer that can maybe offer you better value. Despite that being a great way across all types of insurance of of getting a better deal, only 4% of of survey respondents told us they've done this.

But one thing to say is, while a cheaper deal elsewhere might be tempting, you've also got to check what you're getting before making the move. For example, this could it can be an issue if you have pre-existing conditions; some insurers won't cover it. So you could actually lose protection you already have. So saving on premiums may leave you facing bigger bills later if your cover no longer meets your needs.

James Rowe: So plenty to think about there. You can, of course, read all of the reviews of the seven providers on our website, and if you're a Which? Money member, you can you can read Matthew's full piece in the latest issue of Which? Money magazine. But for now, Matthew, thanks very much for your time.

Matthew Jenkin: Thank you very much.

James Rowe: And joining us now, we've got William Pett, who is the interim director of policy and external affairs at Healthwatch. William, hello.

William Pett: Hello, thank you for having me.

James Rowe: Nice to have you here. Do you want to just first of all, do you want to just give us a quick top line about what Healthwatch is and what you do there?

William Pett: Yes, so Healthwatch England is the national statutory body representing users of health and care services across England. So we analyse about 10,000 pieces of feedback that we hear each month from members of the public about what's working and what isn't working about health and care.

James Rowe: And we've just been chatting to Matthew from our team about private medical insurance, and I think at the start we mentioned a stat of yours: 16% of people have used private services. Can we just dig in on those numbers a little bit more? Why do you think that number is growing? Because it is growing, isn't it?

William Pett: Yes, well, I think it's worth starting by saying that private healthcare can mean different things. So there's data out there showing an increase in private medical insurance, an increase in people going to hospitals privately for operations. But it might also mean someone seeing a private GP because they want a quicker appointment, or downloading an app to pay privately for mental health support.

So we wanted to find out what proportion of the public were using any form of private healthcare. So last year, we commissioned a national poll of over 2,500 adults across England. And, yes, you're right, we found that about 16% of people said they'd used private healthcare in the previous 12 months, and that's almost double the proportion that we found when we did the polling in 2023. So we are seeing quite a significant increase in terms of people self-reporting private healthcare use.

Now, you asked about why, and interestingly, people's reasons for seeking private healthcare have shifted, and there's three points that I'd like to make on this.
So, firstly, in 2023, the most common reason why people were going private was because they felt they'd have a better quality of care. But by last year, that had shifted, and now the number one reason is that waiting times for NHS care were too long. So long NHS waits are now the primary driver of private demand.

Secondly, we've seen some other reasons really shoot up in terms of prevalence. So, for example, in 2023, we found that 14% of people sought private care because it was simply more convenient for them. Now, that reason has doubled to over 30% last year. We know from our research that administration of care in the NHS causes people huge problems. I'm talking things like clunky appointment booking systems, phone numbers that go nowhere, late appointment letters – the list goes on. Often private providers offer patients a better customer service. So this needs a bit more exploration, but that seems to be an increasing driver is convenience.

And thirdly and finally, we know that patients are being forced into private care when there is simply no NHS provision in their area. We see that very strongly in an area like dentistry, where there are now parts of the country that we call dental deserts – whole areas where dental practices are not accepting any new NHS patients. So in that situation, patients have a choice of going private or nothing. And so we've seen that reflected in our data: private dentistry use has increased from 22% in 2023 to 32% last year. So sometimes going private – you think of it as a free choice; often it's not. It's a forced choice for people.

James Rowe: So for some people, in a lot of different areas – so it could be dentistry or it could be mental health, as you mentioned at the top – it almost becomes a necessity for some people. And I guess for some people, not affordable. So these two don't necessarily go hand in hand, do they?

William Pett: Absolutely. We've unfortunately seen some of the biggest increases in private healthcare and private dentistry among people who tell us that they are financially struggling. And so this is a real concern, because you often associate private healthcare with the well-off, but that's not proving to be the case.

James Rowe: Can you tell us about somebody called Chloe? Because Chloe's got a really interesting story, which sort of comes off the back of us chatting just there about people going private as a necessity, not necessarily out of choice.

William Pett: Yes, so we heard from Chloe Lackey. She's 51 and from Buckinghamshire, and she said that she was effectively pushed into private healthcare after being unable to access the treatment that she needed on the NHS.

So Chloe was first referred for an emergency hysterectomy following a severe episode of sepsis, and that was back in 2023. However, the hospital declined to carry out that operation; they described it as too complex. Chloe was then referred into the Oxford Endometriosis Clinic, where she was told that she would need physiotherapy before surgery could go ahead. Nearly two years later, she's still waiting for that physiotherapy, and she's told us, really heartbreakingly, that she's been left disabled by the lack of treatment.
With no progress on the NHS, Chloe eventually underwent the hysterectomy privately. And this was only an option because her husband's employer had recently expanded health insurance to include pre-existing conditions. So she explained to us that she went private because she had no other option. But she also told us that the insurance doesn't cover many of the costs, like the cost for ongoing investigations or further monitoring. Now Chloe is back on NHS waiting lists. She's awaiting an MRI scan to investigate some bowel issues, and she is still waiting to see that physiotherapy team. So stories like this are concerning, but unfortunately, they're not uncommon.

James Rowe: And that's probably just one story of many that you hear. And there's a lot of people who weren't exactly or aren't exactly confident in getting timely hospital outpatient treatment as well. Is the number 32% of people said that?

William Pett: Yeah, so we are actually starting to see early signs – really early signs – that confidence in accessing timely NHS care is starting to increase, albeit from a very low base. So to take your example, yes, we asked about confidence in being able to get a hospital outpatient appointment when you need one, and that's risen slightly from 28% confidence in 2023 to 32% last year.

But this represents really slow progress in restoring confidence in the NHS, reflecting the fact that waiting times have seen relatively slow improvement. It's encouraging that the waiting list has fallen slightly over the past couple of years. But if we compare waiting times, let's say pre- and post-pandemic, you can see why confidence has been impacted. The median waiting time for elective care before the pandemic was 7.5 weeks; currently, it's over 13 weeks.

So the longer long waits continue, the more people are affected and the more people potentially lose confidence in NHS provision.

James Rowe: And just on on waiting times and waiting targets, I was reading on your website back in March, you were urging the government and I guess the NHS to to hit that target of 65% of patients being seen and treated within 18 weeks of referral. As you mentioned, that target was hit, and you mentioned you, you know, you were pleased. That isn't far enough, though, is it, just to sort of hit that? Because it was an interim target as well, wasn't it?

William Pett: Yeah, so, look, I mean, I think the government does deserve some credit for making some progress on improving 18-week waiting times. Most of all, it's NHS staff who deserve credit for the amazing work they've done to deliver the best possible care for patients, particularly those who've done additional work during periods of industrial action.

But you're right, it's worth remembering that the 65% target is a just a temporary progress measure. The constitutional 18-week target is 92%. So we have some way to go to get back to this standard, and really we won't be able to judge the government on progress until its aim is to hit that target by 2029. So that's when we'll really know how much progress has been made.

There's also been some concern about the way in which waiting lists have been tackled. The government uses a technique called waiting list validation to remove patients from lists who either don't need care anymore or who have received the care they need already. As well as the risk of people being incorrectly removed from waiting lists, the concern is that it's been this, rather than increased activity, that has driven reductions in the waiting list over recent months. And looking ahead, there's only so many times that you can clean waiting lists. Really, what has to drive future progress is significantly increased activity.

James Rowe: So with that in mind, then, what can – is it more on the government rather than just the the NHS as we call it – what can the government do to to move quicker and bring these wait lists down even further?

William Pett: That is the million-dollar question for government. No, and and it's one that really clinical leaders close to service delivery will need to contribute to in terms of how the government achieves this over the next few years. But I would say there are a few ingredients that are helping the government to reduce waiting times, and I'll run through a few of those.

The first is using surgical hubs and community diagnostic centres. So these allow the separation of emergency care in hospitals from elective care. And where they work well, they can really help to drive efficiency. Our research shows that patients have really valued community diagnostic centres in particular as a way to get something like an MRI or an X-ray quicker and closer to home. So that's one ingredient.

The second is minimising the number of missed appointments and procedures. So communication is absolutely essential here. We've pressed to ensure that patients are able to receive timely communications about their appointments in a format that works for them – whether that's texts, letters, emails – and with adjustments made if they have special requirements. So, for example, some people need large print; some people need their letters in another language. Ensuring that communication needs are met helps people not to miss appointments and procedures.

And then thirdly, reducing unnecessary appointments. The government is moving towards a model whereby hospital follow-up appointments are only booked in where people say they need them, rather than people receiving automatic check-ups. Again, the key here is ensuring that communications on this are crystal clear for patients, so that people understand that they can have a follow-up appointment if they need one, and that they know how to book one, should it be needed.

So these are some of the steps that might help the government make quicker progress. Ultimately, however, the rate that the government can get the waiting list down will be constrained by the number of staff there are in the NHS, the number of facilities there are in the NHS, and the amount of equipment that the NHS has to use. And unfortunately, those factors open up some quite difficult questions for government about the overall amount of funding that they're willing to put into the NHS to get that waiting list down.

James Rowe: And the NHS is so regularly in the news, whether it is about pay for doctors and nurses or whether it is about, you know, waiting lists for for hospitals, that it just seems to be a never-ending story, doesn't it? Which is is such a shame.

But I guess does this come to the same point around building greater confidence in the NHS for patients as well, to stop them feeling like they need to go private and and sticking with the NHS? How does that happen?

William Pett: Yeah, so I think people's confidence in NHS care will start to improve, and is just starting to improve, as people start to experience quicker waiting times. That that will happen as waiting times get get shorter.

But I think we should consider turning around NHS waiting times a bit like we might consider turning around an oil tanker in the Suez Canal. It takes a long time. It's complex, requiring several different factors to come together. And progress can occasionally stall – for example, when there is industrial action. So while we are continuing to make some steady inroads into waiting times, long waits, particularly in some specialties, are likely to continue over the coming years.

What we have argued at Healthwatch England is that the government should focus, in the more immediate term, on making people's experience of waiting as comfortable as possible. This means ensuring that people receive written communication confirming that their referral's been accepted and that they're definitely on the waiting list – they haven't been forgotten or lost in the system – and receiving, for example, regular updates on their expected wait time.

It's really welcome that the government last month did introduce some new minimum standards for patients on waiting for care, and this will ensure that things like that are happening. But the proof will be in whether those standards are actually delivered by busy NHS hospitals who will have multiple competing priorities over the next few months.

James Rowe: Have you got some key dates in your mind about when we when you hope to see some progress?

William Pett: Well, we hope to start seeing some progress from now, and that's what we're pressing the government on. Ultimately, it's going to be up to NHS hospitals to start reporting on an annual basis about whether they're starting to deliver those standards of waiting for patients. Because as I say, the long waits are not going to go any anywhere anytime soon. But what we can be doing now is just improving that experience of using the NHS, which, as we know from from what I was saying earlier, can be a driver of people into the private sector if they just find the NHS a nightmare to deal with.

James Rowe: And while you're here, we're talking about the National Health Service, but a quick word on the National Care Service. Obviously, this was something that was big on the new Prime Minister Andy Burnham's mind and something he announced last week. This must have been music to your ears last week, was it?

William Pett: Absolutely. I mean, to be honest, it's just brilliant that this is back on the political agenda. The crisis in social care has either been overlooked or put in the too-difficult box by successive governments over the last couple of decades. And there's also continued poor understanding of how social care works amongst the public. So many, for instance, think that social care operates in the same way as the NHS until they need it, and then they find out that they're actually about to be hit by huge costs for their social care.

So great that we're having a national conversation about social care, but but meaningful reform is going to be incredibly difficult.

James Rowe: It's going to take a long time. It's going to be like another oil tanker.

William Pett: Difficult, yeah, absolutely. Politically difficult, because the main parties have different views on reform. Economically difficult, because any any meaningful reform is going to need increased public investment. Practically difficult, as there is such a significant amount of unmet social care need across the country.

But to end on a positive, the personal investment of the Prime Minister is massive. Too often, social care reforms over the years have failed simply because it hasn't been a driving priority of Number 10 Downing Street. So a brilliant start that Andy Burnham has made this such a clear priority for his government.

James Rowe: Now we've got like a figurehead who's going to lead the way, so hopefully good news on that front. William, thanks very much for your time, really appreciate it.

William Pett: Thank you for having me.

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