Money: Pay as you go under

As medical insurance premiums rise, self-pay surgery is in demand, says Harvey Jones

If you need surgical treatment but the NHS makes you wait, you can get private treatment even if you have no medical insurance. Paying a lump sum for a hospital operation is increasingly popular; last year 150,000 people funded treatment from their own pockets - a 25 per cent increase on 1997 - according to Bupa, the health insurer.

It can cost you thousands of pounds but, as dissatisfaction with the NHS continues and the cost of private medical insurance (PMI) soars, it is likely to become more common. A full range of surgical procedures are available under these "self-pay" schemes, some covering operations excluded by PMI policies. Probably the most common self-pay operation is for cosmetic surgery, which insurers usually won't cover. But operations cover anything from varicose veins to major heart surgery. Nuffield Hospitals Direct, a national network of private hospitals, says self-pay treatment is the fastest growing part of its business - particularly now that many over-65s have cancelled their PMI policies since the abolition of tax relief on premiums.

"This is a quiet revolution in private medical care," says Simon Burton, Nuffield spokesman. Many people opt to pay themselves after hearing how long they must wait on the NHS. Young professionals with spare money, but no insurance, are also happy to pay. You can request a fixed, guaranteed price, according to the complexity of your particular operation, after a consultant confirms the diagnosis. This includes accommodation, nursing care, operating theatre fees, drugs, dressings, X-rays, tests and consultant fees. Work is guaranteed for 30 days after leaving hospital.

Or, you can choose a lower "pay-as-you-go" fee, with extra costs if there are complications or further treatment is needed. With Nuffield, varicose veins cost pounds 1,300-1,420 a leg; a hernia pounds 1,350-1,700; a cataract pounds 2,100-2,550, and a hip replacement pounds 6,700-7,500. Nuffield can arrange interest-free credit for a year via Mercantile Credit, on a 10 per cent deposit.

A family with parents in their thirties and two young children would pay pounds 45-90 a month for a standard PMI policy; a single person of 30, pounds 20-40; but a couple in their 60s would pay pounds 90-150, as they're far more likely to need treatment.

Whether self-pay or PMI is better for you is impossible to call - except in hindsight - as it depends on your future state of health. The disadvantage of regular premiums is that you may never claim, or see any return on your money - but if you fall ill and make a claim, all those monthly payments may suddenly seem worthwhile. George Connelly, of Healthcare Matters, sees nothing wrong with paying for care as needed, but argues that private insurance cover has advantages.

"With premiums accelerating it is no surprise that more people are looking at self-funding. I have no problem with that. But when it comes to the crunch you should ask yourself whether you will be willing to pay. If it is a matter of life and death you may be willing to fork out pounds 12,000 for a heart by-pass, but with a hip replacement costing pounds 6,000 or more, you might decide to live with the discomfort. With insurance you don't have to make that choice."

"Self-pay is quite attractive for younger people who don't expect to have too much go wrong, but can pay if necessary - also for conditions not covered by PMI, of which cosmetic surgery is the most common." Since premiums rise sharply the older you get, he says people in their late fifties and over are often attracted by this route. The cost of operations are sometimes borne by their children.

"However, I would advise against cancelling your medical insurance policy as you get older, as you are more likely to need it. If you are retired your income may be fixed or lower and paying thousands for an op would be out of the question," Mr Connelly says. There is another problem with putting money aside. "You've got to be sure you are putting it away: if you do need an op, your coffers will then be empty. With insurance you know you're covered: you're buying peace of mind."

Bupa hospitals sales and marketing director, Howard Beveridge, says most people don't realise they can go into a private hospital without having insurance. "Yet you can go into 90 per cent of Bupa hospitals and pay. The wait for NHS hip replacement is anything from six months to two years, so many people find this tempting."

Bupa has a central service directing prospective patients to its 36 hospitals that offer self-pay treatment. Loans can also be arranged. Mr Beveridge says self-pay may also appeal to people with PMI that excludes cover for a pre-existing medical condition when they took out the policies. "There are more wealthy people out there who can afford to do this, and prefer to do so, rather than endure discomfort."

Surgicare, with centres in London, Birmingham and Manchester, offers cataract, varicose veins and hernia operations, as well as cosmetic surgery.

n Contacts: Bupa, 0345 520 520; Nuffield Hospitals Direct, 0800 688 699; Surgicare 0800 622 222.

SELF-PAY OPERATION COSTS

Through Bupa

Operation Typical cost

Cataract - per eye pounds 1,800-pounds 2,000

Coronary heart bypass pounds 9,600-pounds 12,300

Hernia pounds 1,250-pounds 1,450

Hip replacement pounds 5,500-pounds 6,200

Hysteroscopy pounds 950-pounds 1,100

Knee replacement pounds 6,500-pounds 7,500

Prostate pounds 2,650-pounds 3,100

Varicose vein - per leg pounds 1,250-pounds 1,450

Vasectomy pounds 325-pounds 375

Costs may vary according to the hospital. Prices are inclusive, covering anaesthetist fees, follow-ups and complications.

PROMOTED VIDEO
Voices
voicesBryony Beynon: This is something every woman can relate to
Arts and Entertainment
film

News
Mock the tweet: Ukip leader Nigel Farage and comedian Frankie Boyle
peopleIt was a polite exchange of words, as you can imagine
Arts and Entertainment
Steven, Ella Jade and Sarah in the boardroom
tv
Life and Style
fashion
Life and Style
Britons buy more than 30 million handsets each year, keeping them for an average of 18 months
tech
Arts and Entertainment
Benedict Cumberbatch is reported to be in final negotiations to play Doctor Strange for Marvel although the casting has not yet been confirmed
film
News
people
Arts and Entertainment
Alloysious Massaquoi, 'G' Hastings and Kayus Bankole of Young Fathers are the surprise winners of this year's Mercury Music Prize
musicThe surprise winners of the Mercury Prize – and a very brief acceptance speech
Arts and Entertainment
TV Presenters Ant McPartlin and Dec Donnelly. Winners of the 'Entertainment Programme' award for 'Ant and Dec's Saturday Night Takeaway'
musicAnt and Dec confirmed as hosts of next year's Brit Awards
Arts and Entertainment
Orson Welles made Citizen Kane at 25, and battled with Hollywood film studios thereafter
film
News
ebooksAn unforgettable anthology of contemporary reportage
Life and Style
fashion

World Beard and Moustache Championships held last week

News
video
Arts and Entertainment
Copycat culture: the Chateau Zhang Laffitte in China, top, and the building which inspired it, in Paris, bottom
architectureReplicas of Western landmarks are springing up in unlikely places
Sport
Rolando Aarons watches as his effort finds the corner of the Manchester City goal to give Newcastle the lead
footballManchester City 0 Newcastle 2: Holders crash out on home turf
News
i100
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs Money & Business

Finance Assistant - Part time - 9 month FTC

£20000 - £23250 Per Annum pro rata: Clearwater People Solutions Ltd: Pro rata ...

Marketing Manager

£40 - 48k + Benefits: Guru Careers: We are seeking a Marketing Manager to join...

Market Risk Manager - Investment Banking - Mandarin Speaker

£45,000 - £65,000: Saxton Leigh: Our client is a well-known APAC Corporate and...

Compensation and Benefits Manager - Brentwood - Circa £60,000

£60000 per annum: Ashdown Group: Compensation and Benefits Manager - Compensat...

Day In a Page

Isis in Syria: A general reveals the lack of communication with the US - and his country's awkward relationship with their allies-by-default

A Syrian general speaks

A senior officer of Bashar al-Assad’s regime talks to Robert Fisk about his army’s brutal struggle with Isis, in a dirty war whose challenges include widespread atrocities
‘A bit of a shock...’ Cambridge economist with Glasgow roots becomes Zambia’s acting President

‘A bit of a shock...’ Economist with Glasgow roots becomes Zambia’s acting President

Guy Scott's predecessor, Michael Sata, died in a London hospital this week after a lengthy illness
Fall of the Berlin Wall: History catches up with Erich Honecker - the East German leader who praised the Iron Curtain and claimed it prevented a Third World War

Fall of the Berlin Wall

History catches up with Erich Honecker - the East German leader who praised the Iron Curtain and claimed it prevented a Third World War
How to turn your mobile phone into easy money

Turn your mobile phone into easy money

There are 90 million unused mobiles in the UK, which would be worth £7bn if we cashed them in, says David Crookes
Independent writers remember their Saturday jobs:

Independent writers remember their Saturday jobs

"I have never regarded anything I have done in "the media" as a proper job"
Lyricist Richard Thomas shares his 11-step recipe for creating a hit West End musical

11-step recipe for creating a West End hit

Richard Thomas, the lyricist behind the Jerry Springer and Anna Nicole Smith operas, explains how Bob Dylan, 'Breaking Bad' and even Noam Chomsky inspired his songbook for the new musical 'Made in Dagenham'
Tonke Dragt's The Letter for the King has finally been translated into English ... 50 years on

Buried treasure: The Letter for the King

The coming-of-age tale about a boy and his mission to save a mythical kingdom has sold a million copies since it was written by an eccentric Dutchwoman in 1962. Yet until last year, no one had read it in English
Can instilling a sense of entrepreneurship in pupils have a positive effect on their learning?

The school that means business

Richard Garner heads to Lancashire, where developing the 'dragons' of the future is also helping one community academy to achieve its educational goals
10 best tablets

The world in your pocket: 10 best tablets

They’re thin, they’re light, you can use them for work on the move or keeping entertained
Lutz Pfannenstiel: The goalkeeper who gave up Bayern Munich for the Crazy Gang, Bradford and a whirlwind trawl across continents

Lutz Pfannenstiel interview

The goalkeeper who gave up Bayern Munich for the Crazy Gang, Bradford and a whirlwind trawl across continents
Pete Jenson: Popular Jürgen Klopp can reignite Borussia Dortmund’s season with visit to Bayern Munich

Pete Jenson's a Different League

Popular Klopp can reignite Dortmund’s season with visit to Bayern
John Cantlie video proves that Isis expects victory in Kobani

Cantlie video proves that Isis expects victory in Kobani

The use of the British hostage demonstrates once again the militants' skill and originality in conducting a propaganda war, says Patrick Cockburn
The killer instinct: The man who helps students spot potential murderers

The killer instinct

Phil Chalmers travels the US warning students how to spot possible future murderers, but can his contentious methods really stop the bloodshed?
Clothing the gap: A new exhibition celebrates women who stood apart from the fashion herd

Clothing the gap

A new exhibition celebrates women who stood apart from the fashion herd
Fall of the Berlin Wall: Goodbye to all that - the lost world beyond the Iron Curtain

The Fall of the Berlin Wall

Goodbye to all that - the lost world beyond the Iron Curtain