A long-term decline in NHS access and quality, rapidly accelerated by the pandemic, has begun to supercharge a trend of people opting for private healthcare and products, according to the IPPR.

The think tank warns that this growing ‘opt out’ is a symptom of the NHS being under resourced, and struggling to recruit and retain the workforce it needs to deliver truly universal care.

Polling found that 31 per cent of adults in Britain, the equivalent of 16 million people, struggled to access the care they needed during the pandemic. Of these, almost one in eight used some form of paid-for alternative and one in five considered doing so, with this proportion rising for wealthier people.

The report provides a snapshot of the declining access and quality of NHS care, heightened by the pandemic, including more than half of adults believing it is harder to speak to a GP compared to before the pandemic, only four in 10 people with dementia receiving a proper care plan, or care plan review, in 2021, compared with around seven in 10 in 2018-19, and estimates indicating that it will take around a decade to recover the cancer treatment backlog.

Polling also reveals that one in six say that they would go private if they knew that they faced waiting longer than 18 weeks from referral to begin treatment on the NHS. A further 59 per cent say they wouldn’t opt for private healthcare because they couldn’t afford it, and just 10 per cent rejecting private healthcare on principle.

The report argues that this move towards private healthcare by those who can afford it could be undermining the foundations of a universal health system and the spirit of the NHS. According to the report, this could produce the emergence of an unequal two-tier system whereby ‘the best is only available to those who can and are willing to pay’.

Chris Thomas, IPPR principal research fellow, said: “People aren’t opting-out the National Health Service because they’ve stopped believing in it as the best and fairest model of healthcare. Rather, those who can afford it are being forced to go private by the consequences of austerity and the pandemic on NHS access and quality – and those without the funds are left to ‘put up or shut up’.

“The risk is that, in the future, the idea you have to pay to get the best healthcare becomes normalised. This would erode public support and the electoral coalition that has underpinned the success and popularity of our NHS. In turn, this would further embed inequality, leave the NHS more liable to budget cuts, and to the poorly evidenced whims of politicians. Leaders should listen to what the public want and reinvigorate the NHS as a means to ‘universalise the best’ healthcare, for everyone, free at the point of delivery.”