Private health insurance was a luxury. Now it feels like a necessity

This is the bit where they determine whether the doctor should see you in the flesh or speak to you on the phone; a measure understandably introduced to minimise the spread of Covid, but which means my doctor – relatively new to the surgery – and I have never met, even when it felt warranted.

Last year, I woke up one day to note with alarm that my entire foot was black and blue, as if I were wearing a sock of overlapping bruises. I hadn’t dropped anything on it or accidentally knocked it against something, so I was freaked out by my little goblin appendage.

“Email us some pictures,” said the doctor, so I did. It was like taking a photo of the radge spider in your bathroom that looks like a tarantula in real life and a tiddler on the screen. The true horror could not be conveyed. It was chalked up as a medical mystery.

Recalling this as the receptionist awaits my response, I contemplate conjuring up a health issue so concerning it would merit an in-person inspection. “My bum has grown a funny little hand” or “I’ve started to like Matt Hancock” – but both are too absurd to be believed. A telephone consultation it is.

“The doctor will phone you between one and four this afternoon,” says the receptionist, because nobody has a job or responsibilities anymore and we can all square off three hours of the day to wait around for a 10-minute call. Naturally, the GP phones when I’m perched on the toilet. My bum-hand waves hello. I explain what’s wrong (ach, nothing major, just that I’ve had symptoms of endometriosis for seven years – and one doctor even said she thought she could see signs of it on my left ovary during a scan – but I’ve never had a laparoscopy for a formal diagnosis and the pain is unbearable, no biggie).

The doctor is kind. He listens. And then he refers me for a hospital appointment which he estimates could take around a year to materialise.

This is the part where, if you’re financially comfortable, there’s a lifeline available: phone a friend, and by friend I mean a private healthcare provider. With help from my family I already paid £800 for a colposcopy at a private clinic last year because the average NHS waiting time for the procedure had swelled from eight weeks to 30 due to pandemic-related backlogs. I was anxious and wanted to be seen quickly. Could I afford to do it again? Should I start to think seriously about taking out a private health insurance policy, which has always seemed a luxury but increasingly feels like something of a necessity?

It’s a decision thousands of us are being forced to make as the NHS buckles beneath high caseloads, staffing shortages and funding cuts. Last week it was revealed some of Scotland’s NHS leaders held a meeting a few months ago to discuss how our health service, which was founded on the principle that it would be free to everyone at the point of need, might be reformed to ease the burden. A two-tier system “where the people who can afford to go private” was proposed as a potential solution, as if it’s not already stealthily snuck its way in.

Last week the Scottish Labour leader Anas Sarwar said the number of people in Scotland paying for private treatments has increased by 72 percent over the past two years, citing endoscopies, colonoscopies, cataract surgery and hip and knee replacements as examples of procedures patients are paying for because waiting lists are too long.

At £12,500 a pop, the cost of hip and knee surgery is beyond the realm of what many people can easily afford during buoyant times, let alone in a cost-of-living crisis. But when you are crippled with pain and the health service you pay for has been crippled by austerity, you’ll grab on to any life raft available. Even if that means re-mortgaging your home, as Sarwar claims some have resorted to.

Not everyone has a home to re-mortgage or a family who can provide financial support, however, so what then? How many people are quietly enduring debilitating ‘non-urgent’ health conditions because they have no option but to wait? How many early diagnoses of serious illnesses have been missed?

Macmillan Cancer Care estimates around 50,000 people throughout the UK have not yet been diagnosed with cancer because of delayed screenings and referrals throughout the pandemic. I would wager that income-poor people are disproportionately represented in that number by dint of not having the means to go private. Pre-Covid, there were already strong socioeconomic inequalities in the stage at which cancer patients were diagnosed, with those living in deprived areas more likely to be diagnosed with later-stage cancer compared to people in more affluent areas. If we continue as we are, this gap will only widen.

Even those who require emergency care may miss out on getting the help they need, whether that’s because of long wait times or because money is being invested in NHS Scotland adverts advising us not to go to A&E unless we’re having a stroke or heart attack. Shall we just drop the Accident and call it Emergency, then?

That the NHS is in crisis is not up for debate. But neither is the fact that everyone, regardless of who they are or what they earn, deserves access to free healthcare when they need it. Proper funding, structural reform, improved social care and better health literacy are all needed to get the NHS back on its feet and ease the demand on its services over the long-term.

A two-tier system is a quick fix that permits the privileged to pay for treatment and the poorest to pay with their lives.

From November 21 to November 30 2022 the Herald is running a Black Friday subscription offer which provides full access to our unrivalled coverage of news that matters for just £1. To find out more visit: heraldscotland.com/subscribe

Read more by Natasha Radmehr:

• Well, here's another nice mess I'm very happy with
• This time, just maybe, revolution in Iran might succeed