Private clinics are wooing customers by offering short-notice consultations. Photograph: Anthony Devlin/PA
The Guardian
By Sarah Marsh and Denis Campbell
Signs that NHS’s inability to offer prompt care is creating surge in people resorting to private care
Patients are paying up to £550 an hour to see private GPs amid frustration at the delays many face getting an appointment with an NHS family doctor.
Growing numbers of paid-for GP services are opening up across Britain, in the latest sign of how the NHS’s inability to offer prompt care is creating a surge in people resorting to private healthcare.
Clinics are wooing customers by offering short-notice consultations that involve seeing a doctor face-to-face or remotely – and they can last for much longer than the standard 10-minute NHS equivalent.
“Private GP services are one of the big growth areas of a burgeoning private healthcare sector,” said David Hare, the chief executive of the Independent Healthcare Providers Network, a trade body.
The London General Practice on Harley Street in central London had the highest fees among the 25 non-NHS GP providers the Guardian looked at.
It charges £275 for half an hour with a family doctor, £412 for 45 minutes and £550 for an hour-long consultation. It rises to £348 for a 30-minute slot if it is out of hours or a bank holiday. A GP from the clinic will also do a house call for £500, £550 or £575, depending on the time of day.
Further along the street synonymous with private medicine, another practice charges £220 for a half-hour appointment and £400 for the full hour.
The number of patients accessing a private GP is small compared with the 1 million a day in England who see an NHS family doctor. But it is growing fast as the NHS is struggling with a deepening shortage of full-time GPs at a time when the demand for care is rising and some GPs are retiring due to burnout.
For example, the insurance company Axa has seen “a significant spike in demand” for Doctor at Hand, its virtual-only family doctor service. The number of appointments provided by Doctor at Hand had tripled from 17,000 a month before the Covid pandemic to about 50,000 now, it said.
Similarly, the number of appointments provided by GPs working for Spire Healthcare, the private hospital group, jumped from 23,000 in 2021 to 32,900 last year – a 43% rise.
“People enjoy the flexibility that private GP services offer, including the ability to book longer appointments at short notice, choose the location and format, or they want to see the same GP with each appointment,” said Dr Cathy Cale, the company’s group medical director.
“We believe this heightened demand for private GP services is here to stay, as people prioritise their health and want a service that suits their needs and supports an often busy lifestyle.”
Spire’s acquisition last December of the Doctors Clinic Group of non-NHS GP surgeries made it one of the biggest operators in that market and increased the number of GPs it employs to 128, up from 80 in 2020. It spent £12m on the deal because of a “significant” rise in patients wanting to see a GP face-to-face.
Hare said the boom in paid-for GP care “should come as no surprise. The issues within NHS primary care are well known – there’s a shortage of 4,000 NHS GPs and difficulty accessing appointments. These challenges will take time to resolve, and the situation may even worsen, so we would expect to see continued demand for private GPs, and the market could grow significantly.”
Private GPs’ drive to attract paying customers is helped by the fact that they can refer a patient on to the NHS for any follow-up care they may need, such as a scan or to see a hospital specialist.
Allan Johnson, the chief executive of the London General Practice, said the quality of its service justified its high prices.
“We are proud of the personalised service and high-quality care that we provide, which goes above and beyond what other providers offer, including: access to 30-minute same day appointments; a medical personal assistant, available to all patients, who can arrange access to onward diagnostics or consultant appointments often for the same day; [and] a 24/7 visiting service.”
He added: “Understandably the ability to offer this level of care and service comes with higher costs.”
David Rowland, the director of the Centre for Health and the Public Interest thinktank, said the NHS risked being reduced to a “two-tier health system”, with those who can afford to do so increasingly going private.
“In addition, the growth in private GP practices poses a further challenge to the NHS because they are likely to be staffed by those GPs who are either exhausted from working within the NHS or are newly qualified doctors who are dissuaded from working for the NHS because it has been so badly funded by government over the last decade,” he said.
“This has the potential to create a downward spiral whereby the NHS loses GPs, which makes primary care worse, which then causes more GPs to opt out and more middle-class patients to turn to private options.”
Prof Martin Marshall, an ex-chair of the Royal College of GPs (RCGP), voiced his fear last year that NHS GP services could over time go the same way as NHS dentistry, with dissatisfaction with the care on offer prompting better-off patients to go private.
Patient satisfaction with the NHS has sunk to its lowest level amid unhappiness at waiting times for GP and hospital care.
Prof Kamila Hawthorne, the RCGP chair, said she did not “feel particularly threatened” by the expansion of private GP services. For some people “it can be a useful add-on”, because the clinic is easy to access on their way to work or open at the weekend.
“The vast majority of people would probably not go privately to see a GP. They would still go to their own family doctor rather than going privately. But of course there are people who can afford to and who do,” she said.