There are 625,000 people on a hospital waiting list in Scotland. That figure is the highest on record and equivalent to one in nine of the population.
Backlogs have soared since the Covid pandemic and more people faced with long waits are seeking private treatment.
An opinion poll commissioned by BBC Scotland suggests one in five of those who replied said they – or one of their family – had paid for private medical care in the past 12 months.
Most (73%) said they would have preferred to use the NHS.
Health Secretary Humza Yousaf said he was worried about the poll results and that the Scottish government was determined to tackle the NHS treatment backlog.
‘I was lucky enough to have that money’
Linda Fyfe, from South Ayrshire, was among those not prepared to wait for NHS treatment when she needed a hip replacement.
Within months Linda went from living with the “bearable” pain in her right hip to being unable to comfortably move more than 100 yards.
The 75-year-old said the pain changed her whole lifestyle and she could not wait between 12 and 18 months for an operation on the NHS.
The retired social work administrator was quoted £14,000 to go private in the UK but this was more than she could afford.
She opted to have the same procedure done in Lithuania for about half the price.
“I thought, for the good of my health and my husband’s, because he’s got to do so much for me, I’ve no other option,” Linda told BBC Disclosure at a clinic in Lithuania’s second-largest city Kaunas.
“I made the right decision. I couldn’t have gone another year or 18 months and it might even have taken longer.
“I was lucky enough to have that money but there’ll be a lot of people won’t have. A lot of people will have to live with pain. A lot of pain.”
The Kaunas clinic that treated Linda said it sees about 10 people a month from Scotland and more from across the UK.
‘It seems a bit unfair’
When amateur photographer Douglas Currie had an NHS cataracts operation on his right eye seven years ago he could not have been happier.
“Everything worked out fine,” he said.
When his left eye started to deteriorate in 2020, the 77-year-old said it took about two years to confirm he needed the operation and then he was warned it could take another two years before he got the procedure on the NHS.
He said the progress of the cataract had deteriorated over the two years he had waited to get on the list.
“If I’ve got to wait another two years then I would have to give up my driving because I wouldn’t be able to see properly.
“And my hobbies, I would have to give them up as well. So it’s not a good scenario.”
The prospect of a lengthy wait meant Douglas, from Midlothian, reluctantly looked into private options and paid about £3,000 from his savings for the procedure to be done at private clinic, Vision Scotland, on the outskirts of Edinburgh.
He said: “I started work when I was 15 and retired when I was 60 so it’s been a long time I’ve been paying National Insurance contributions and tax.
“It seems a bit unfair that you’ve got to end up spending more of your money, more of your savings, to get an operation that is not life-threatening, but you really need.”
Data from Phin – the private healthcare information network – shows Douglas is not alone in going private.
In the first three months of 2019 a total of 885 cataracts procedures were undertaken in Scotland’s private hospitals.
During the same period in 2022, the tally was 2,045.
‘I couldn’t afford to pay £12,000 straight out the bank’
David Thompson said he was starting to rely heavily on the crutches and losing confidence in his ability to get around but he was told he faced a two-year wait for a hip operation.
This was in stark contrast with the four months from diagnosis to operation when the other hip was replaced by the NHS in 2008.
The 66-year-old keen golfer had the dilemma of whether he should go private and how to pay for it.
Mr Thompson said: “I had a few pounds saved, entering into my retirement, but not that much that I could afford to just pay £12,000 straight out the bank. So we decided that the best way to tackle this was to take a loan.
“I don’t feel too good about it. That money was for my retirement, or potentially my children’s inheritance at some point, which is now £12,000 less.
“So you’ve got to watch now a little bit about what you’re spending. It’s a hard one to accept, that you’ve paid into a system for so long and that you’re struggling to get something back out of it again.”
‘I don’t want anybody to look at other options’
Scotland’s Health Secretary Humza Yousaf said some people felt that they had to go private because the waits were too long and excessive.
“I don’t want that to be the case,” he told the BBC.
“That’s why for a number of months now we’ve been focusing on those who have been waiting the longest.
“I don’t want anybody to look at any options other than the NHS. I am committed to make a significant dent into the backlog but I’ve also got to be really upfront that it will take time.”
Mr Yousaf also responded to the results of the opinion poll commissioned by BBC Scotland.
He said he was “worried about the perception” that some people felt the NHS would still not be free at the point of use in 10 years’ time, and added that he would “protect robustly the founding principles of the NHS”.
What does the BBC poll suggest?
Almost one in 10 (9%) Scottish respondents had paid for private medical care in the previous 12 months, instead of using the NHS. And 13% said a family member had done so.
Most (73%) said they would have preferred to use the NHS.
People under 35 and those with higher incomes were most likely to have paid to go private.
Four in 10 people (43%) in Scotland said they would be likely to pay for private care if they required non-urgent treatment – such as hip or knee replacements – and faced a long wait on the NHS.
People who earned the most were more likely to say they would pay for private care.
In general, most people (59%) thought only higher rate taxpayers (earning over £43,662) should pay more tax to fund the NHS.
One in five (22%) thought everyone should pay more and 13% said no-one should.
The planned 1p rise in the income tax rate for higher earners to be spent on the NHS in Scotland was supported by 71% of respondents.
Those with higher incomes were less likely to support the move but backing was still high.
The poll asked about charging for some parts of NHS treatment such as prescriptions or missed GP appointments.
Three in five (61%) Scottish respondents said all prescriptions should be free – as they currently are in Scotland.
A similar number (62%) said they supported introducing a £10 charge for patients that miss GP appointments.
The poll indicates the majority of people think the NHS will stick to its “free at the point of use” founding principles.
But there are some doubters, with almost a third of respondents saying this will probably not be the case by 2033.
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