“Start private, end private”—a principle that could help protect the NHS from subsidising private care

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Public satisfaction with the NHS is at its lowest, and the use of private healthcare is on the rise. The number of UK adults with health insurance doubled in recent years, with one in eight people in the UK using private healthcare and one in four considering it in the previous year. The relationship between the NHS and private healthcare is complex, with arguments made both for and against private provision. A proposed “start private, end private” principle suggests that all costs of follow-up NHS care should be included upfront in the purchase of private healthcare, with regulations and clear information provided to patients. Private providers should be responsible for covering costs to prevent the NHS from subsidizing the private sector.

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