Increased private care could lead to ‘inequalities’, says report

There has been a ‘relentless drift to the private sector’ within UK healthcare and dentistry, according to a new report by the Nuffield Trust.

Published on 16 May, the Nuffield Trust report explores the changing role of the private sector in UK healthcare.

The trust described ‘serious problems with access to care, workforce relations and financial stability’ in state-run health services. It said this has lead many to perceive, fear or argue for a greater role for the private sector.

It also analysed the amount of NHS budget spent on care conducted in facilities not owned by the NHS. This includes NHS dentistry delivered through the UDA system.

According to the report the proportion of NHS spending dedicated to dentistry has declined from 2.9% in 2009/10 to 1.6% in 2022/3.

The report says that the decreased percentage of spending has lead to ‘a gradual shrinkage in the proportion of people who are genuinely covered by the NHS in practice’. It also discusses the impact of this on dentists, highlighting a ‘relentless drift to the private sector’.

Dentists ‘squeezed out of NHS provision’

Researchers also considered the amount that individuals are paying for private healthcare. Their findings show ‘a rapid growth in spending on private dentistry’ between 2011 and 2015. The report suggests that this is due to more dentists being ‘squeezed out of NHS provision’.

The Nuffield Trust has previously warned that the move away from NHS dentistry is largely due to a ‘dysfunctional contract’.

Nuffield’s data shows that private spending by individuals decreased sharply during the COVID-19 pandemic across all healthcare sectors. The most recent figures for dentistry have not returned to pre-pandemic levels. Private dentistry spending in 2023 was found to be lower than in 2011, before the ‘rapid growth’ described in the report.

The Nuffield Trust said that private sector involvement is helping with long waiting times to access healthcare. The report says: ‘Waiting times without private sector involvement would be much worse than even the difficult reality today.’

However the trust also criticised the ‘potentially troubling’ reasons that many people are turning to private care. It said: ‘These patterns may be being forced on the UK by a lack of NHS provision and pressure from emergency demand.’

Nuffield continued to warn against the potential for ‘health inequalities’ as a result of increased private provision. The trust said: ‘A three-tier system will be the result: those lucky enough to get NHS care, those rich enough to pay, and the rest of the population, left to wait in pain without help.’

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