I STARTED seriously contemplating the state of the NHS while watching the General Election debate on ITV last Tuesday, featuring Keir Starmer and Rishi Sunak. Journalist Julie Etchingham asked a pointed question: Would they ever use private healthcare to help a loved one on an NHS waiting list?

The Prime Minister replied affirmatively, while the Labour leader – Sunak’s likely replacement – was adamant in his refusal, categorically stating he would not.

This got me thinking: Am I missing something here? If my child were in pain and faced a long wait for surgery, it’s a no-brainer – I’d do whatever it takes to ensure my child gets the care they need, even if it meant going private.

To me, this debate misses the point entirely.

It shifts the focus on to the choices individuals are forced to make, rather than addressing the systemic issues that necessitate those choices. This focus on individual decisions obscures the larger problem. And this is deeply troubling because it signals we are not genuinely committed to solving the NHS’s problems.

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The reality is that NHS staff are working under increasingly challenging conditions. These are skilled, dedicated and passionate professionals but they’re also stressed and exhausted.

NHS waiting lists in Scotland have soared to unprecedented levels. The latest data from Public Health Scotland reveals a staggering figure of more than 690,000 people waiting for appointments or treatment for non-urgent care as of March 31. These numbers underscore the strain on the NHS and the growing demand for healthcare services.

Moreover, the report highlights the plight of more than 8000 patients who have been waiting for more than two years, alongside 85,000 individuals enduring waits of more than a year for either outpatient appointments or the initiation of treatment. As a result, more and more people are turning to private healthcare not because they want to, but because they have to.

The Financial Times reported that according to the Private Healthcare Information Network, an independent, government-mandated research body, self-pay treatment – healthcare – not covered by medical insurance or NHS-funded private care – has surged by 32% from pre-pandemic levels.

This includes not just cosmetic and dental work, which have long had payment plans available but now also diagnostics and surgeries. Hospital groups and independent clinics are advertising financing packages to cater to this growing demand.

Queen Elizabeth University Hospital, Glasgow (image: NQ)

This trend highlights a troubling economic shift in healthcare.

A growing number of patients are seeking private treatment loans to fund elective medical procedures due to long NHS backlogs.

While this option provides immediate relief for those who can afford it, it poses significant risks for people on lower incomes and those with serious conditions. These patients are at greater risk of accruing debt, which could further harm their health.

THE NHS is in such a dire state that private healthcare has become an attractive perk for employers seeking to attract talent.

Novara Media highlighted a couple of years ago the point that in the face of an eroded welfare state, employers were adjusting the perks they offer, making benefits such healthcare, income protection and increased pension contributions increasingly vital.

This shift creates a workplace welfare state and highlights the pressing need for systemic change to ensure essential services are accessible to all, not just those with the right job.

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This is the conversation we should be having, rather than remaining on the surface, having blind faith in a system that is collapsing – some would say it has already collapsed. This idolisation of the NHS is hugely damaging because it prevents us from discussing the urgent fixes needed.

The NHS isn’t a religion. Using private healthcare when necessary isn’t an act of apostasy. People shouldn’t be made to feel guilty for making the choices they need to make for their health and the health of their loved ones. It’s not their fault they find themselves in situations where private healthcare is the only viable option.

It’s a bit like when train services and public transport are cut in rural areas and then people are made to feel guilty for using their cars to go to work, medical appointments, or even to buy groceries. There is a pattern here, and frankly, it is getting old. People are pushed into making less-than-ideal choices and then blamed for those choices.

The NHS should not just be a source of national pride but a reflection of the collective commitment to health equity and social justice. Critiquing the system is not an act of disloyalty – it is an act of care and responsibility. It is a way to honour the institution by striving to make it better, more efficient, and more accessible to all.

Talking about the failings and shortcomings of the health system provides an opportunity to engage in meaningful discussions about how to preserve the core values of the NHS. It is about ensuring the system evolves to meet the needs of the population without compromising its foundational principles.

I understand that those who talk about the rise in private healthcare use and criticise the NHS often advocate for more privatisation. That is not what I am saying here.

For me, a system that provides comprehensive care, where people can routinely see a dentist, a GP, an ophthalmologist or a gynaecologist, is essential and anything but a luxury in a wealthy country like the UK.

Sometimes it seems like there’s something in the British psyche that feels you should just be grateful for having the NHS, so much so that you dare not criticise it or seek to change it, fearing you might lose it altogether.

In my French brain, this mindset is perplexing. Yes, the NHS is invaluable. It is a remarkable institution and we must not take it for granted. Many countries don’t enjoy universal healthcare like we do here in the UK. But guys, you do realise that it is totally normal that you should have universal healthcare, right? Right?!

What is not normal is people having to borrow money to have a hip replacement. The existence of the NHS, providing healthcare to everyone regardless of their financial situation, is indeed a tremendous achievement.

However, acknowledging this achievement doesn’t mean we should ignore its flaws and hide in starry-eyed praise.

Universal healthcare should be seen as a basic right in any wealthy, developed nation. It’s not something to be merely grateful for—it is something to be expected, demanded, and continuously improved.

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The longer I live here, the more I see that while people love and value their public services, it is almost as if they don’t believe they deserve them. So, they allow these services to be cut and diminished, perhaps thinking it was too good to be true in the first place.

So, dear United Kingdom, I need you to repeat after me: “We deserve good things. We deserve good healthcare. We are worth it!”

If people start believing this, then we might begin to look for ways to make it a reality.