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“Without the operation, you’ll be in a wheelchair.”
They are the words Liz Robertson will never forget hearing after 18 months of debilitating pain and repeated struggles to secure the NHS referral she desperately needed.
The 59-year-old says she was left with no choice but to spend £50,000 on private healthcare, draining her savings and putting retirement on hold, after discovering a bone was compressing her spinal cord.
As NHS waiting lists swelled in the wake of Covid and repeated visits to her GP did not result in a hospital referral, she felt as though she was “just existing”.
Paying for private spinal surgery transformed her prognosis – but at a cost she never imagined having to bear.
Seven million waiting for treatment
“I couldn’t move my arms, I could barely work, I couldn’t sleep, I couldn’t do anything,” she says.
Robertson underwent two spinal operations, each costing £16,000, and also paid for acupuncture and cortisone injections to help manage the pain.
“I was told there was still a waiting list because there’s a lot of people in my position. But not everyone can pay to go private, and as my surgeon said, a lot end up in wheelchairs because they’ve not had the treatment they need.”
Robertson says had she not paid for the surgery, “there was a good chance I could have become paralysed in time”.
As Britain’s state healthcare system struggles to cope with a patient backlog, Robertson is among a growing cohort being forced into making an excruciating choice: spend their life savings on treatment, or risk waiting it out.
The number of patients awaiting NHS treatment rose to 7.28 million last month, up from around 4.5 million in the year before the pandemic. More than 1.92 million are in a virtual queue for a diagnostic test.
At the same time, the average waiting time has hovered around 13 weeks, but only two thirds of patients are seen within the NHS’s own 18-week referral-to-treatment target.
For people with manageable conditions, it can be a source of ongoing frustration. But for more serious cases, the backlog can start to impede everyday life and even put lives at risk.
Gill Millen, of wealth adviser Bowmore, says it is leaving a growing number in a position where they must choose between their long-term health and financial future.
“It’s a choice of: ‘Do I put my life on hold? Do I just exist until I can? Or do I do it now, recognising that I might not then be able to spend as much as I hoped on other things?’”
For those who have spent a lifetime paying taxes to fund the NHS, being forced to spend more of their hard-earned cash can feel like an injustice, particularly if it is to stay fit enough to work.
But Millen adds that many “have no other option than to pay any which way”.
“NHS support and care is so limited nowadays that I have had clients saying: ‘Well, I’ve had to cancel two holidays to pay for surgery and rehabilitation, but at least I’ve got the money to do it.’”
Since 2020, the number of self-funded admissions has nearly doubled, reaching 283,000 last year, according to the Private Healthcare Information Network.
While insurance-funded care is more common, patients will typically pay out of pocket for one-off treatments or where they cannot get insured because of pre-existing health conditions.
Mark Dayan, at healthcare think tank Nuffield Trust, says that the recent “boom” in self-funded healthcare has been driven by necessity rather than because people feel richer.
“Unlike previous periods of rising private healthcare spending – like the 1990s – this hasn’t been a good period for the UK economy generally,” he says.
“So it’s unlikely the increase in private healthcare is because people have more money in their pockets. The inability to get an NHS appointment is the most common reason to seek private care.”
‘It wiped out an awful lot of my reserves’
It’s not just life-threatening conditions that prompt patients to go private either. In many cases, people simply want to regain control of their lives.
Deborah Green, 71, from Lincolnshire, needed knee replacements and cataract operations, but says the waiting times after Covid for NHS care were “unbelievable”.
After seeing a friend wait two years for knee surgery, she realised she would have to go private if she wanted to continue working and living like normal.
“They are things you can’t wait for,” she says. “I work as a psychotherapist and I’ve got dogs that need walking everyday.
“It’s not just the fact you’re not very mobile – you have an awful lot of pain with knees.”
The knee operations cost around £14,500 each, while it cost £11,000 to remove both cataracts.
Alongside other consultations and check-ups, Green estimates she has spent £60,000 in total – around half of her life savings.
Despite this, she is acutely aware that others are in a similarly desperate position without the means to receive treatment.
“It wiped out an awful lot of my reserves,” she says. “I’m glad I had the money to do it, but I have family members in that situation.
“It’s heartbreaking that people can’t afford to get the care that they need.”
In May, the Department of Health hailed a “huge moment” in the battle to bring down waiting lists for treatment, after recording a decline of more than 500,000 to 7.11 million, the lowest level in three and a half years.
Just a month later, however, numbers had inched back up amid ongoing staff and funding challenges that predated the pandemic.
“There was a long-term funding pressure on the NHS and it was struggling to keep up before Covid,” says Dayan, adding that while waiting lists are showing signs of coming down since 2023 peaks, it is “in fits and bursts rather than in the transformation the Government has sometimes implied”.
“To make ongoing progress, you really want steady improvements all the time. But there isn’t some sort of immediate whiz-bang solution,” he says.
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‘Why would I go back to the NHS?’
There are fears in some corners that the longer the backlog persists, the more normalised a “two-tier” healthcare system will become, whereby those who can “afford” private care are implicitly expected to pay for it.
Wealth planners such as Millen say they are increasingly “building in” the possibility their clients may have to spend thousands of pounds on care when modelling their future finances.
Even for those who are insured, rising premiums in the past few years mean it must be factored in as a substantial cost when deciding on their goals. “It could be planning a £10,000, £20,000 a year insurance premium, or that they may need to spend £20,000, £30,000 a year on treatments,” Millen says.
Green’s experience means she now ringfences a certain amount of her income each month specifically for healthcare after giving up hope that waiting lists will ever come down sufficiently to receive the care she expects.
“I think if anyone does think NHS will improve, they’re living in cloud cuckoo land,” she says. “If I need anything done, I will automatically go to my local private hospital. I get a diagnostics appointment in a week and a result the following week – why would I go back to the NHS?”
A Department of Health and Social Care spokesman said: “Nobody should be forced to go private for healthcare, but waiting lists are falling and the NHS is on the road to recovery.
“We’ve cut the overall waiting list by 340,000 since July 2024, and more people are being treated within 18 weeks than at any point in almost half a decade.
“We know there is more work to do, but through record funding and delivering the largest expansion of diagnostic capacity in a generation, we will make sure people get safe, timely care, free at the point of use.”
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