Government urged to take bolder action to address rising health inequality


As Rishi Sunak plans to charge NHS patients £10 for ‘no shows’, reports show a growing disparity in access to healthcare and rising health inequality across the UK.

In another policy aimed at wooing Tory membership, the former chancellor has announced plans to fine people for missed appointments with their GP in a bid to “crackdown on those abusing the NHS.”

Most patients who miss GP appointments are among the poorest, have complex needs and chaotic lifestyles, and are from minority backgrounds, a review from the British Journal of General Practice shows.

Sunak’s plans that would likely impact the poorest and most vulnerable the most, come in a wake of a number of reports that point to rising health inequality in Britain. 

In the last three months of 2021, the UK saw a 39% increase in patients opting for self-funded treatment, while 6 in 7 patients report they cannot afford to pay for private healthcare. Under the current conditions, health inequality in Britain is poised to increase significantly.

These were the findings of research carried out by moneytransfers.com, which collated evidence from recent reports into the reality of British health outcomes.

The research confirms that the Covid-19 pandemic has exacerbated the problem, with a huge backlog of cases in the NHS limiting access to healthcare.

Lengthy waiting times pushing people to pay for treatment

Analysis by the BBC of data from the Private Healthcare Information Network (PHIN) published in July, found that long NHS waiting times were appearing to push people into paying thousands of pounds for private treatment.

According to the analysis, in the last three months of 2021, there were 69,000 self-funded treatments in the UK, a 39% rise on the same period prior to the pandemic. Last year, the number of people paying for private care surpassed 250,000.

The figures from PHIN do not include patients with private healthcare insurance and are instead confined to those funding treatment themselves. Common operations such as knee and hip replacements can cost as much as £15,000, and the BBC saw evidence of patients resorting to crowdfunding or using loans to pay for private treatment.

The BBC’s analysis follows research carried out by Healthwatch, an independent patient watchdog that is committed to making sure NHS leaders and other decision makers listen to patients’ feedback and improve the standards of care.

Going private is not an option for many

Healthwatch’s study involved public polling into private healthcare. It found that 22% of people it surveyed had either paid for private treatment or were considering it. However, for two-thirds of the people it polled, with the rising cost of living, going private is not an option.

More than 6.6 million people are currently on waiting lists for hospital treatment in England. Ministers warn that it could be 2024 before numbers start to fall.

Healthwatch says more needs to be done to support people while they wait and prioritise those in greatest need.

Louise Ansari, national director at Healthwatch, commented on the findings of the research and the UK’s rising health inequalities.

“We know that some people who would previously have gone down an NHS pathway have already had treatment privately during the pandemic, and almost one in seven of those on waiting lists say they can afford to go private and are considering it. Yet, for two-thirds of people going private simply isn’t an option, and with the rising cost of living crisis, the gap between these groups is only likely to grow.

“Our evidence also shows that people on the lowest incomes are the most likely to wait the longest for NHS treatment and will have a more negative experience of waiting. In turn, this leads to a worse impact on their physical health, mental health, and their ability to work and care for loved ones.

“Tackling the NHS backlog is a huge challenge, but decision makers must find a way to do so without exacerbating health inequalities, the extent of which has been laid bare by the pandemic,” Ansari continued.

A ‘two-tier’ system

Jonathon Holmes of the King’s Fund health think tank, referred to the record number of people on waiting lists as ‘worrying’.

“The risk is we’re left with a two-tier system where some people have to wait too long for care and others feel forced to bust the bank to get the care they need,” he said.

Alzheimer’s Research UK is also calling on the government for bolder action to address health inequalities in dementia risk.

Research presented on August 2 at the 2022 Alzheimer’s Association International Conference (AAIC) in San Diego links socioeconomic deprivation, including persistent low wages and neigbourhood disadvantages, to lower cognitive performance, faster memory decline and higher dementia risk.

Responding to the research, Dr Susan Mitchell, Head of Policy at Alzheimer’s Research UK, said:

“Addressing health inequalities is a key part of the challenge of tackling dementia. These findings add to the growing body of evidence that the environment people live and work in affects their dementia risk, which government plays a key role in helping to shape.

“We urge government to make dementia prevention a key priority in its aim to level up healthcare across the country, and hope the forthcoming health disparities white paper lays the foundation for a fairer, healthier nation.”

Gabrielle Pickard-Whitehead is a contributing editor to Left Foot Forward

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