The government does not pay private health companies twice as much as GPs

Calculations posted on social media have led to claims that the government is spending twice as much on private healthcare as on GP services. But this depends on exactly how you count the spending, and in some cases the claims aren’t quite right.

Dr Steve Taylor posted on X (formerly Twitter) and Facebook that NHS spending on GP services per patient was approximately £160, making the spend per patient per day 45p. He also wrote that NHS spending on “private healthcare providing NHS care” was about £320 per person and so 90p per person per day.

These figures were shared and reported by a number of others.

Dr Dan Goyal shared the figures on X, claiming: “The U.K. govt are currently spending twice as much on Private Healthcare as they do on the entire Primary Care Service (GP Practices)!!”[sic] 

Whether that’s correct depends on exactly how you interpret those categories, as we’ll explain.

This post has been shared and liked thousands of times on X, as well as being reported on Skwawkbox, with the headline: “Tories ‘spending twice as much on private health companies as on GPs’”. But that’s not the case. 

The estimated spend per patient per day on so-called “private healthcare providing NHS care” is based on the total spend on non-NHS healthcare as set out in the Department of Health and Social Care (DHSC) annual accounts. But while this does primarily include spending on independent sector providers, it also includes care purchased from the voluntary and not-for-profit sector, local authorities and devolved administrations.

So it would be misleading to suggest all spending on non-NHS healthcare went entirely to private healthcare, or healthcare “companies”. 

Whether “twice as much” was spent also partly depends what you’re comparing. If you’re comparing all non-NHS healthcare with payments to GPs, then it is broadly correct, but it’s not right if you’re comparing independent health sector providers and GPs. If you compare all non-NHS healthcare or private companies with all primary care then it also isn’t correct.

Misleading health claims online have the potential to harm trust in Government, politicians and health organisations. Online claims can spread fast and far, and are difficult to contain and correct. 

How were the figures calculated?

Dr Taylor told Full Fact that he had started with the £19.7 billion total spend on non-NHS healthcare in England from the DHSC 2021/22 accounts, taken from the British Medical Association’s website. Using the latest Office for National Statistics population estimates for England this would suggest a spend per patient of £348 and then 95p per day per patient. 

But Dr Taylor said he rounded the figures down to £320 per patient to make the post easier to read.

Dr Taylor said he approximated the average amount the NHS in England paid GP services at £160 per registered patient, then used this to get his total of 45p per patient per day. NHS England’s most recent data shows that nationally the NHS paid on average £163.65 per registered patient in 2021/22.

But NHS England warns that average payments per patient at national level should be treated with caution, as some patients may be double counted, and no information for patient list size is known for 188 practices.

Since we approached Dr Taylor he has posted new figures to his X and Facebook pages, including updating the average paid to GPs per patient to £163 and the spending per person on non-NHS care to £348 and 95p per person per day. 

Is the NHS paying private healthcare companies more than GPs?

The DHSC accounts break down the money spent by NHS England on “non-NHS healthcare”. This includes money for independent sector providers but also voluntary and not-for-profit organisations, local authorities and devolved administrations.

There are many different ways you could classify what counts as “private healthcare”; the definition could include just private companies, or extend all the way to things like GP practices and opticians.

While the DHSC accounts do not set out what they mean by independent sector providers, the NHS data dictionary defines them as: “a private sector healthcare company that is contracted by the NHS in the provision of healthcare or in the support of the provision of healthcare.” 

So to say, as Dr Taylor did in his original tweet and as Dr Goyal did, that this money is all going to private healthcare, is missing context, as it depends on how you define that. And it’s not quite right to claim, as Skwawkbox has done, that this spending is all going to “private health companies”, because it also includes charities and local authorities. 

When Dr Taylor posted his new figures he also changed his wording from “private healthcare providing NHS care” to “NHS ‘non-NHS’ healthcare”.

Both Dr Goyal and Skwawkbox compared spending on private healthcare with that on either primary care or GP practices. Dr Goyal claimed twice as much was spent on private healthcare as “on the entire Primary Care Service (GP Practices)”. Skwawkbox compared “private health companies” and GPs in their headline. Again whether this is correct partly depends on what exactly you’re counting.

About twice as much was spent on all non-NHS healthcare by DHSC in 2021/22 (the £19.7 billion we’ve already mentioned), as by NHS England in payments to general practice. NHS England figures show that the payments made to general practice during this financial year totalled £10.1 billion.

But as we’ve already said, non-NHS healthcare isn’t the same as “private health companies”, and GP practices are part of, but not the whole of, the primary care sector. Primary care includes other services such dentistry, pharmacy and optometry.

The DHSC accounts show £14.9 billion was spent on primary care in 2021/22, while NHS England spent £10.9 billion purchasing care from independent sector providers specifically in 2021/22. 

Spending per person per day

As we’ve said, the money spent by DHSC on all non-NHS healthcare amounts to a spend of £348 per patient and then 95p per patient per day. 

Looking just at the money spent by NHS England purchasing care from independent sector providers, spending per person would be £192, or 53p per patient per day.

While still higher than the amount spent on general practice, it is not double the spending (£163.65 per patient or 45p per patient a day).

Using the same method to look at total spending on primary care using DHSC’s figures for 2021/22 (£14.9 billion) we estimate the spend per person would be £264 and 72p per person per day. 

Image courtesy of Jet Stouten.