An online magazine for and about businesses of all sizes, in Edinburgh and beyond
NHS under strain: what private health insurance can (and can’t) do for you
According to the latest data, 639,579 people are estimated to be on the waiting list for NHS Scotland hospital treatment. This equates to one in nine of Scotland’s population.
The UK-government-backed, Private Healthcare Information Network (PHIN, reports that Scotland saw a five per cent increase in private hospital and clinic admissions in January to March this year, compared with the same period in 2024. PHIN’s most recent data also reveals that the number of admissions (13,195) during this time was the highest ever recorded in a single quarter in Scotland.
As more people consider their options, Liz Hunter, commercial director at online price-comparison site, MoneyExpert, shares insights into what patients can expect from private health insurance, what it can do – and what it can’t:
“The NHS is a cornerstone of British society, providing healthcare for all, free at the point of use, regardless of income. NHS Scotland employs an army of around 160,000 professionals, but the system is under immense strain. Soaring demand coupled with underfunding and staff shortages is putting unprecedented pressure on the NHS, leading to concerns about the quality and accessibility of care for many.
Private hospitals generally have fewer patients, potentially offering faster access to diagnosis and treatment. It can also provide a faster route to potentially life-saving treatment in cases requiring urgent or emergency care.
Do bear in mind, though, that private services aren’t immune to delays, and you could still be placed on a waiting list. The NHS inform website can help you decide whether to wait for NHS care or proceed in the private sector.
Private health care often (but not always) offers access to a wider range of specialists, providing patients with greater choice and potentially more specialised care.
Additionally, private hospitals have higher budgets than the NHS and frequently invest in cutting-edge technology, allowing them to offer a broader spectrum of specialist drugs and treatments, which may not be readily available within the NHS. This can be particularly beneficial for patients with complex or rare conditions or those who need further investigation to determine a diagnosis.
Private hospitals often offer a more comfortable, convenient and patient-centric experience. Unlike the shared-ward environment typically found in the NHS, private patients often benefit from private rooms, often with en-suite bathrooms. They also offer complementary services. While these vary between providers, they typically include therapies such as massage and aromatherapy to aid recovery.
The cost of private health insurance
The latest research from private health insurance and health-care consumer information website, My Tribe, found that the average annual cost of Bupa health insurance is currently around £904.20, equating to roughly around £75.35 a month. However, private health insurance quotes will depend on your age, lifestyle, location and any pre-existing health conditions. It will also vary between insurers and policies.
The best way to get an idea of how much private health insurance would cost for you and your family is to get a few quotes using a price-comparison website.
Accessing private healthcare without insurance
If you don’t want to take out insurance, but would still like to access private health care, you can do so through the ‘self-pay’ option. This is when you pay for health care only when you need it, which can be convenient, fast and flexible.
It’s important to remember that self-pay prices vary between private hospitals, locations and the treatment required. A simple, private GP appointment could cost around £140 for a 30-minute face-to-face appointment, but bear in mind that any medication required, as well as further tests or appointments, would incur additional costs.
To give you an idea of what the cost of specific treatments might be, here are some guide prices for a variety of treatments at Spire Edinburgh hospitals:
· Hip replacement: from £17,640
· Back surgery: from £10,743
· Varicose veins: from £4,839
What do health insurance policies cover/not cover?
Depending on your level of cover, a private health insurance policy in the UK may cover you for day-patient and/or inpatient care. Day patient refers to GP or specialist consultations and diagnostic tests such as X-rays, whereas inpatient care refers to hospital stays, surgery and intensive care.
Private medical insurance doesn’t typically cover you for conditions that you are already diagnosed with or have already sought medical advice for. Likewise, they don’t generally cover the costs of treating chronic conditions that require ongoing or long-term care.
They also don’t cover accident and emergency; intensive care; pregnancy or childbirth; fertility treatment; sleep problems and disorders; and allergies or intolerances, amongst some other conditions.
What should I look for when taking out a policy?
Firstly, think about the level of cover that you need. Options range from basic to comprehensive. A basic policy often usually covers out-patient care, but not inpatient care. This means you’ll use the NHS for diagnosis and private hospitals for inpatient care. A comprehensive policy, on the other hand, provides you with unlimited out-patient cover.
Remember to check carefully what is and what isn’t included before you take out a policy. Which conditions are included? Are they relevant to you? What choice of hospitals will you get with the policy? These are all questions to ask the provider before you take out a policy.
Secondly, check the policy limits and excess. Each insurer will offer a maximum amount that you can claim annually, as well as how much you can claim per condition. Look for the policy that offers the highest limit for your budget. Like other types of insurance, health-insurance policies usually come with an excess. This is the amount you pay before the insurance covers the rest. Make sure you’re comfortable with this figure.
Lastly, consider the costs. The more comprehensive the cover, the more expensive the policy will be. Still, there’s likely to be some variation in price between providers even if they’re offering similar levels of coverage, so use a price-comparison site to check who can offer the best cover for your budget.
