SNP 'creating two-tier health system' amid rise in private consultants
It comes as private hospital admissions in Scotland are hitting record levels
The SNP has been accused of creating a “two-tier” health system after figures showed the highest rate of consultants on record working in the private healthcare system.
The number of consultants active in private healthcare in Scotland has risen by almost 10 per cent in two years.
Figures show there were 523 such consultants in the third quarter of last year, which is the highest level on record.
This compares to 477 in the same period in 2023, and 432 at the start of 2019, when the Private Healthcare Information Network (PHIN) began compiling the data.
It comes after it was reported private hospital admissions in Scotland are hitting record levels and are growing at a greater rate than the rest of the UK.
Consultants working in the NHS are free to undertake private work over and above their contracted hours, as long as private practice does not result in a detrimental effect on NHS patients or services, or diminish the public resources that are available for the NHS.
Meanwhile, BMA Scotland, the doctors’ union, has warned of “alarming” consultant vacancies within the NHS, which it says are much higher than official figures suggest.
Scottish Conservative health spokesman Dr Sandesh Gulhane, a practising GP, said: “It’s a measure of the SNP’s mismanagement of the NHS that more and more consultants are taking on private work.
“John Swinney and successive SNP health secretaries have failed miserably to give them the resources they need to carry out their work within the NHS, while punishing them with far higher taxes than they would pay elsewhere in the UK.
“That is having the domino effect of creating huge vacancies within the health service and it is Scots patients who are suffering the consequences.”
Scottish Labour health spokeswoman Jackie Baillie accused the SNP of creating a “two-tier” health system.
She said “The SNP’s disastrous mismanagement of our NHS has created a two-tier system that threatens the founding principles of our health service.
“Private healthcare in Scotland is booming as record numbers of patients are forced to pay for treatment.
“While thousands of Scots spend their savings on basic healthcare, others have no choice but to languish on endless NHS waiting lists.”
PHIN, which describes itself as the independent, government-mandated source of information on privately funded healthcare in the UK, previously said there appeared to be “an increasing appetite or need” for the private sector.
It said the 13,140 reported private hospital admissions in the third quarter of 2025 were at the highest level ever for that time of year and represented a 7 per cent increase on the same period in 2024.
There were increases in admissions for every age group, PHIN said, except for children aged 0-9. The biggest increase was in the 40-49 year old group. The highest number of admissions (2,550) was for patients in the 50-59 age group.
Cataracts were the most common reason for admission (2,255) and were up by 5 per cent. The next two highest admissions were for hip replacement (620) and upper gastro-intestinal endoscopy (580).
Data compiled by PHIN shows the number of consultants active in the private sector dipped during the pandemic. However, there was then a fairly steady rise back to previous levels, before these were exceeded from 2023 onwards.
Dr Joanna Bredski, chair of BMA Scotland’s consultant committee said: “There is plenty of evidence that, with waiting lists at historically high levels and patients struggling to get the timely care they need, more and more people are being forced to use their own money to pay for care in the private sector.
“This trend suggests the founding principles of our NHS are at risk, with only those who can afford to pay getting the care they need in a reasonable time scale.
“As a result, given the rising demand in the private sector, it is no surprise that more consultants are active in that space to service that demand. This is simply a symptom and warning light that the NHS is unable to cope with demand or deliver what we ask of it.
“It also demonstrates the self-defeating, vicious circle whereby boards are underfunded and struggle to deliver services, hence are either unwilling or unable to fill vacant consultant posts, or fund waiting list initiatives and in the worst case scenarios services end up being outsourced to private providers which is a vastly more expensive and less efficient way of delivering care and services which boards themselves should be providing.
“A properly resourced NHS, with a proper workforce plan that includes measures to retain our senior doctors is the only answer here and something we have being calling for over a number of years.
“Those solutions, which would lead to less demand in the private sector, would see an equivalent drop in consultants active in the private sector.
“In many ways the solution in that respect is simple – but we now need urgent action to put the NHS on a sustainable, long term footing, with the staff it needs in place both now and in the future.”
A Scottish government spokesperson said: “Scotland continues to have a substantially lower rate of take up of private healthcare compared to England.
“There are a record high number of medical and dental consultants in NHS Scotland, including director-level consultants.
“Since 2006, the number of consultants has increased by 74.7 per cent and now stands at over 6,300 whole time equivalents. Our NHS workforce has seen 14 consecutive years of growth.”
Research previously suggested the NHS and the cost of living will “define” the upcoming Holyrood election in May. Around half (48 per cent) of voters named healthcare and the NHS as a top priority, according to the Understanding Scotland Economy Tracker.
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