NHS waiting lists in North driving people towards private healthcare, says provider

When radiographer Mark Regan quit his job to work in private healthcare 15 years ago, friends told him to stay put.

“Everyone said, ‘What’s that? It’s a club for the elite. Nobody really uses that in Northern Ireland. Stay where you are.

“I chose to ignore the advice and went out on a limb.”

As chief executive of Kingsbridge Healthcare Group, Regan has overseen Northern Ireland’s largest private provider expand rapidly – it had a turnover of £41.9 million (€47.6 million) at the end of March 2021 – during a period of unprecedented NHS pressures.

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In May, open heart surgery was performed for the first time at its main Belfast hospital – there are others in Co Derry and Sligo – as part of a new cardiac service. Costing up to £28,000 per surgery, 10 operations have taken place to date.

The surge in demand for the sector comes at a time when latest figures show more than a third of Northern Ireland’s population – over 654,000 patients – is on a waiting list.

These are businesses through and through. They are earning money hand over fist, but they are able to pay people beyond what the NHS can remunerate

—  Belfast GP Dr Michael McKenna

There are seven-year delays to see a specialist in areas such as rheumatology and neurology, while suspected cancer cases are waiting months in certain health trusts for a hospital appointment (the target is a fortnight).

Those waits are slashed to a matter of days or weeks, however, if a patient pays for a private consultation – which is often with the same NHS medic in Kingsbridge or other private clinics.

Dr Michael McKenna, a Belfast GP based in a practice off the Falls Road for more than 20 years, said there has been an increase in his patients choosing to go down the private route, though he has “no idea” how they pay for it.

“What we’re seeing is the waiting list issue being pushed right back to what are known as red flags, or suspected cancers. Those waiting lists have become prolonged and people are voting with their feet in terms of not wanting to wait, naturally, and seeking private services,” he says.

The medic expressed concerns about some private clinics that are “directly advertising to that group of people” worried about a life-threatening diagnosis.

“There are private sector websites using advertising slogans such as ‘Worried About Cancer’ – so it’s not that they’re shying away from it.

“These are businesses through and through. They are earning money hand over fist, but they are able to pay people beyond what the NHS can remunerate.”

For Regan, the growth in private medicine is down to fundamental failings within the NHS.

“Yes, I’m a radiographer, but I’m in business in Northern Ireland. We’re a significant player in business and employ 700 people,” he says.

Nurses don’t leave because they want to work for me, they leave because of what others are not doing for them. So it’s others who should feel guilty

—  Kingsbridge Healthcare Group chief

Despite repeated recruitment drives, the staffing problem in the NHS has not abated; nurses in the North and other healthcare workers are about to embark on strike action for the second time in three years as their pay is the lowest in the NHS. They also say work conditions are unsafe due to inadequate staff cover.

During the pandemic, staffing shortages were compounded when many burnt-out frontline workers – particularly nurses – left their jobs to work in private clinics, retire early or quit the profession altogether.

And due to Stormont’s collapse, pay parity with their UK colleagues cannot even be introduced as Ministers are no longer in place and the North’s Department of Health is being run by civil servants.

Health service sources have also told The Irish Times about a recent increase in hospital consultants quitting their NHS careers for full-time posts in private clinics. Up until now, the vast majority of consultants work across both sectors.

Asked whether he felt guilty about employing highly skilled NHS health professionals during the current crisis, Regan replied: “No, I don’t take the guilt, as it’s others who are not delivering.

“Nurses don’t leave because they want to work for me, they leave because of what others are not doing for them. So it’s others who should feel guilty; I don’t feel any guilt in valuing a nurse, promoting a nurse.

“There are a lot of people who judge doctors and nurses for working in the private sector, but at the end of the day they are treating patients in the NHS and then they’re coming here and they’re still treating patients, maybe many more patients.

“They’re also valued – many nurses say they do not feel valued working in the public sector. They all know me and they can all lift the phone to me. It’s personal.”

He pointed to the creation of the Kingsbridge Community Foundation fund as a “means of giving back to society”.

“I really feel passionate about making sure we are not seen as a one-way street, and we do reinvest in society.”

While demand for private medical care in specialities such as orthopaedics, gynaecology and neurology has remained high over the past five years, there has been a recent spike in the number of people seeking private GP appointments at a cost of £110.

Many of those using the GP service in Kingsbridge have addresses in more deprived areas of the city.

“We had a really interesting look at private GP access, and given our location and given the socio-economic background, you would expect that the highest number of people using the service would be from the [more affluent] BT9 area,” adds Regan.

“But what when you looked at the second and third lines of our list, it was areas that are economically challenged, in west and north Belfast, the inner city areas.

“That’s where increasingly we’re seeing more patients coming from. I’ve don’t know why.

“People talk about a two-tier healthcare system in Northern Ireland and I think that shift is now gaining momentum. Be it right, be it wrong, I’m just giving it as a fact. It’s the reality of it.”