Two-tiered medicine: the increasing disparity in medical care in the UK.

Abstract

One of the many impacts of the coronavirus pandemic has been on the already complex interplay between the NHS and the private sector. During the worst of the lockdown in March, significant government funding underpinned the finances of the main private providers in order to purchase additional capacity for treating public-sector patients. All of the funding for ‘NHS’ Test and Trace has gone into the private sector, preventing development of a sustainable legacy for COVID-19 testing capacity in the health service, and delivering lucrative contracts to Serco and Deloittes.1 Even now, after the NHS should be returning to business as usual, in some parts of the country it is possible only to access screening for malignancy through private referral, including for patients who fall into groups where regular monitoring is recommended owing to genetic risk or previous malignancy. From the letters that cross my desk, there is also an increase in private activity where patients are starting …