More People Are Going Private — What the Two-Tier NHS Means for Care Workers

In 2023, 9% of people in England used private healthcare. By 2025, that figure had risen to 16% — nearly double in just two years. This isn’t a story about lifestyle choices or preference for luxury. It’s a story about a public health system under sustained pressure, and the people being left behind by it.

In March 2026, Healthwatch England published its most comprehensive report to date on the state of health and social care. Drawing on nearly 390,000 real experiences shared by the public between 2023 and 2025, the findings paint a detailed picture of a system where access to timely care is increasingly determined not by clinical need — but by the ability to pay.

For health and social care professionals, this matters. The people you support are navigating this system every day. Understanding what’s happening — and why — helps you support them better.

The numbers at a glance

These four figures from Healthwatch England and NHS England summarise the scale of the problem.

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