Private healthcare advertising booms amid record NHS waiting lists

There have been hundreds of adverts for private medical companies published on Facebook so far in 2022 targeting users in the UK.

Private healthcare companies in the UK have massively increased their spending on Facebook advertising since the start of the pandemic in line with increased Google searches for private medical services, Left Foot Forward has found.

Private medical companies like Babylon Health, Bupa, Spire, HCA, Nuffield, BetterHelp and One Medical have all started significant Facebook advertising campaigns in the past six months. The Facebook ad library only goes back to 7 May 2018, but none of the companies we looked at had published any adverts before October 2019.

The trend coincides with an increasingly overwhelmed and backlogged NHS, with around 6.4 million people on waiting lists for treatment in May 2022, according to Digital Health.

This has seen a big increase in people searching for private medical care online in the UK. Google Trends shows how searches for private healthcare rose to unprecedented levels in February 2022.

Babylon Health is the most prolific Facebook advertiser, according to Left Foot Forward’s analysis of the Facebook ad library, with 740 adverts on the platform since February 2021, though over 99% of these have been since January 2022. 

Babylon was backed by former Health Minister Matt Hancock, and in 2021 became “the first NHS GP service to register more than 100,000 patients on a single list”, according to GP Online.

Spire Healthcare has published at least 240 adverts on Facebook since August 2021. In July 2021, Spire shareholders rejected a merger with rival Australian private health company Ramsay.

Worcester News reported in September 2021 that “in the second quarter of 2021, April to June, Spire saw an 81 per cent increase in “self-pay spending” when compared with the same period in 2019.”

In 2021, Spire generated about 30% of its revenue from contracts with the NHS, according to the Financial Times. Its NHS income was £314.5 million in 2021, an increase from £285.7 million in 2019. In 2021 Spire’s revenue was over £1 billion for the first time.

The NHS is increasingly forced to turn to private companies like Spire for extra capacity. According to HSJ, “Circle Health and Spire Healthcare were handed the largest contracts to provide extra staff and capacity to the NHS at the start of the coronavirus pandemic.”

These contracts were worth £1.6 billion in total, and give a good impression of which private health companies in the UK are the biggest. Circle Health was founded by Ali Parsa, who also founded Babylon Health, and is a former investment banker with Merrill Lynch and Goldman Sachs.

Data via HSJ.

One Medical has run 230 adverts since May 2022, and like Nuffield (41 adverts since July 2020), it is a charitable foundation, meaning that profits from its private services are generally reinvested in the business, instead of going to shareholders in dividends.

Looking at the finances of some big private medical companies, you can see that when the company’s assets increase, profits are taken out in the form of shareholder dividends. HCA Healthcare International, the UK arm of HCA Healthcare, a US company with a $51 billion turnover in 2020, gave shareholders a £260,605,000 dividend payment in 2017 according to its Companies House accounts.

HCA has published 19 adverts on Facebook since April 2022 targeting users in the UK. HCA’s revenue in the UK was £491,440,000 in 2019, compared to £294,934,000 in 2009 – an increase of 66%.

As well as these big private healthcare companies which run hospitals and GP surgeries, there are companies like BetterHelp which operate online therapy services. BetterHelp has published 170 adverts on Facebook since October 2019, almost all since Sept 2021.

Bupa has published 85 adverts on Facebook since March 2022, while Ramsay Healthcare has published 11 since March 2022, and Benenden Health published 11 since September 2021.

As NHS funding has been cut in real terms over the past 12 years of Conservative government, spending on private healthcare has risen sharply, though it had already been rising before 2010.

And some healthcare services like dentistry had already been heavily privatised decades ago. The Guardian’s Today in Focus podcast recently reported on how a 2006 contract offered to dentists who delivered services through the NHS system has forced many dentists to abandon the public sector entirely – creating ‘dental deserts’ across the UK where it is impossible to see an NHS dentist.

All of these trends are creating a two tier system of health inequality, where those on low incomes are denied healthcare and must wait on increasingly long waiting lists while those who can afford to go private can get seen immediately. 

Health inequality can have devastating long term social and health effects. According to The King’s Fund, “People living in the most-deprived areas have a life expectancy nearly a decade shorter than the least-deprived areas (for example, life expectancy is 78 years in Manchester and 86 years in Westminster).”

The charity also reported that during the Covid-19 pandemic, death rates in the most deprived areas of the UK were more than double those in the least deprived areas.

The Tories protest that their spending on the NHS is higher than ever before, but it is clear for all to see that with an ageing population and increased demand for services, funding does not come close to what is required. The inescapable conclusion is that the government is strangling universal healthcare while encouraging the growth of the private sector.

John Lubbock leads on the Right-Watch project at Left Foot Forward

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