Sleepwalking into a two-tiered healthcare system

[摘要] If you could afford it, would you pay to get quicker access to health care? Leaked minutes from a Scottish NHS chiefs meeting in September 2022 suggest that within a discussion about the unsustainability of the current service in NHS Scotland, senior leaders mentioned the possibility of designing ‘a two-tier system where the people who can afford to go private’. The British Medical Association slammed the discussion, but aren’t we already ‘sleepwalking’ into a two-tiered healthcare system?CAN PRIVATE HEALTH CARE ACT AS A SAFETY VALVE FOR THE NHS? The UK has always had a parallel private healthcare system alongside the NHS, and as waiting times increase, the proportion of people self-funding their treatment in both primary and secondary care is increasing. A report published by the Institute for Public Policy Research (IPPR) in 2022 described how the COVID-19 pandemic accelerated an existing decline in access to health care, creating ripe conditions for a growing two-tiered healthcare system. More people are paying for private insurance in the UK, and out-of-pocket expenditure is increasing faster here than in any other G7 nation.The IPPR report looked at people’s intentions regarding private health care, and it’s not surprising that 12% of people who found it difficult to access the NHS used a private alternative, and 26% of people thought about using private care in the future, but those more likely to access private care were richer and older. People who would wait for treatment in the NHS did so primarily because they couldn’t afford private health care, which suggests that it’s not the principle of staying in the NHS that is the issue, it’s the cost; reinforcing an inequitable system where those who can afford will go private, and those who can’t have to wait.

[学科分类] 卫生学