NHS hospitals are increasingly charging patients for treatment, with income rising by a quarter in just a year.
The figure is expected to keep rising, with trusts hoping to take advantage of Labour’s “relaxed” attitude to the private sector.
Analysts said that hospitals – which are facing a deficit of more than £2 billion this year – were seeking to maximise potential income from patients facing huge waiting lists.
Many offer patients private rooms and hotel-style accommodation, including fruit baskets and daily newspapers.
Five of the top 10 central London NHS trusts have released accounts that show combined forecast revenue of £197 million. Great Ormond Street Hospital, Barts Health and Royal Free saw the biggest growth, followed by Guy’s and St Thomas’, and Chelsea and Westminster.
Analysts said growth was similar across the country, with average increases of around 23 per cent at the two-thirds of trusts that had published their accounts.
Across the sector, that could mean more than £770 million raked in by NHS hospitals for private patients in the past financial year – a record, and up from £675 million in 2019-20.
Estimates suggest the figure could reach £1 billion by 2025-26.
Wes Streeting, the Health Secretary, has vowed to go further than Sir Tony Blair in using independent sector capacity to ease NHS pressures, while saying the health service must remain free at the point of use.
Last week, an independent investigation by Lord Darzi found that NHS hospitals were doing less work for their patients despite being handed more money.
His report warned that productivity had dipped sharply, with medics wasting ever more time owing to a lack of beds, diagnostics and other kit.
The figures on income from private patients also come amid warnings from Rachel Reeves, the Chancellor, that next month’s Budget will involve “difficult decisions” to plug a £22 billion black hole. The national debt – the sum total of every deficit – is now 100 per cent of Britain’s gross domestic product.
Many NHS trusts with long waiting lists offer patients fast access to consultations, diagnostics and treatment if they choose to pay for it.
Some have found other ways to bolster their funds, by charging NHS patients extra to stay in better accommodation.
Buckinghamshire Healthcare NHS Trust has begun offering single private rooms to patients for up to £205 a night with an en suite bathroom. The hotel-style package, which began being offered earlier this year, includes a basket of fruit, a widescreen television and a daily newspaper.
NHS hospital trusts are permitted to generate up to 49 per cent of their income from private patients. In recent years, most trusts which earned private income received much less, with most getting less than 10 per cent.
Analysts said the combination of long waiting lists and straitened NHS finances meant hospitals were increasingly trying to maximise their income from private patients.
Experts said hospitals without private patients units were losing out on income, because patients with health insurance were often prepared to use it, but struggled to find private hospitals that could carry out the treatment required.
Many large private chains focus on low-intensity, high-volume surgery, such as cataracts and hip and knee operations.
NHS trusts with private patient units – which can mean a whole wing, or just a few beds – are often more able to carry out complex work, including cancer and heart treatment, and revision surgery, and have the back-up of intensive care facilities.
Philip Housden, of Housden Group, a specialist healthcare consultancy, which analysed the accounts of major trusts with private patients units, said: “If patients with health insurance can’t be seen in a private hospital – perhaps because the case is complex – then the NHS will often end up having to treat them, and footing the bill. It means the public purse is effectively subsidising private health insurers.
“All of this adds to pressures on NHS waiting lists, and costs for hospital trusts. I imagine that the Labour Government will be thinking about this.”
He said NHS trusts were estimated to be losing around £1 billion a year in treating patients that could have been treated as private patients, using health insurance.
He said increasing use of private services in the NHS was a way of “placing more of the rising costs of the NHS on to the broadest shoulders”.
However, another senior health service source described NHS private patient units as the “dirty secret” of the NHS, because facilities funded by the taxpayer were used for those who were able to pay, although staffing costs were paid for by the private sector.
England’s health system is forecasting a deficit of around £2.2 billion across its services for 2024-25.
Health leaders say that despite £165 billion funding for the NHS – a record, outside of the pandemic – trusts are struggling to make ends meet, partly because of major costs in recent years, such as the £3 billion covering strikes.
One NHS source said trusts were seeking ways to maximise their income, while cutting waiting times. He said many trust leaders felt encouraged by the stance taken by the Health Secretary, who has said he will go “further” than Sir Tony in using the private sector to ease NHS pressures.
He said: “I think Labour is in some ways happier to see the grey area between public and private spending, there is a tendency to be more relaxed about it.
“There are some ironclad rules, it can’t come at the expense of NHS patients, but the Health Secretary has made clear his interest in use of the private sector, and trusts will act accordingly”.
Under Sir Tony, Labour introduced Patient Choice, allowing patients to have NHS treatment carried out by the private sector. Meanwhile, private healthcare groups were given contracts to carry out block contracts of work for the NHS, such as cataract operations and hip and knee surgery.
Use of the private sector is expected to feature heavily in the 10-year plan for the NHS, due to be published next year.
The senior NHS source said: “The public is quite pragmatic, as long as the outcome is good they don’t care who provides it.
“Often you have got the same consultants who would be working privately elsewhere doing that work on your site, and bringing in income to your trust.”
The trends come as the public grows increasingly resigned to paying for their care.
A survey by the Independent Healthcare Providers Network shows that almost seven in 10 people (67 per cent) say that they would consider using private healthcare.
Data from the Private Healthcare Information Network show record numbers of hospital admissions of private patients, with 238,000 in the first quarter of 2024, up from 199,000 admissions in the same quarter in 2019.
Sir Julian Hartley, the chief executive of NHS Providers, which represents hospitals, said: “Providing some private care allows NHS trusts to reinvest that income in services for patients. Faced with growing demand and a tough financial climate, trusts have cut the longest waits for treatment and continue to work flat out to see patients as quickly as possible.”
A Department of Health and Social Care spokesman said: “The NHS is broken, forcing many patients who can afford it to choose to go private for faster healthcare. Meanwhile, those who can’t are left behind in a two-tier system.
“This Government will take a principled but pragmatic approach to the use of the private sector to cut the NHS care backlog. In the long-term, our 10-Year plan will reform the NHS so no one feels forced to pay for treatment.”