Independent health care and the NHS

Think tank: The King’s Fund

Author(s): Jonathon Holmes

January 24, 2023

This report from UK think tank The King’s Fund looks at the role of the independent sector in providing health care.

Discussion around the role of the independent sector in providing health care often focuses on the ‘privatisation’ of the NHS. Private providers have always played a role in the NHS, and while there was a small increase in NHS expenditure on independent sector providers following the implementation of the Health and Social Care Act 2012, it has flatlined at a lower level since. Although the role of the independent sector in providing NHS services has not increased substantially in recent years, according to some data sources, private spending by individuals on health care – known as ‘out-of-pocket’ spending – has. As waiting lists continue to grow and the public continues to experience difficulties accessing health services, and as the NHS workforce crisis intensifies, more people may choose to opt out of the NHS and pay for treatment privately. In this briefing, we set out some of the trends in public and private spending on independent sector health care providers. We consider what factors may be driving these trends, look at the impact this has on household spending among different groups, and consider some of the implications for the public and the NHS.