Self-employed and on the NHS waiting list?

The new Health and Social Care Secretary, Sajid Javid, has warned that the number of people on a waiting list for NHS care in England could reach as many as 13 million. For many self-employed people, including freelancers and contractors, sick pay isn’t an option. So, when they have a health issue that is making them sick and they are on the waiting list, what can they do?

The current situation, based on new modelling from the Institute of Fiscal Policy, shows the scale of the NHS waiting list challenge ahead. Millions who have missed out on care will come forward and the NHS is potentially hamstrung by infection control measures and the continued need to treat a high number of Covid-19 patients.

The IFS analysis shows that whether or not waiting lists rise as far as 13 million depends crucially on the ability of the NHS to expand its capacity and treat more patients than it did pre-pandemic. If that proves impossible, waiting lists could indeed rise to 13 million – or even higher.

Is it time to consider private healthcare?

With certain self-employed health insurance policies, you can buy a plan that includes hospital treatment and access to specialists, surgeons, room, dressings, and medication. You’ll also be able to make unlimited GP appointments, 24 hours a day, according to Simply Business, the insurance specialist for small business owners.

Or you might prefer to simply pay for support and diagnostic services, and then seek treatment on the NHS.

However, you won’t be able to claim for everything, so make sure you’re familiar with the conditions excluded in your policy before you take out a plan, suggests Simply Business.

If you have a pre-existing medical condition you might not be able to claim physiotherapy, diagnosis, or treatment. That would be the same for anyone applying for a new insurance policy, self-employed or not.

Care and treatment of cancer and normal pregnancy are sometimes not covered by health insurance as this is coordinated by the NHS. This is the same for Covid-19.

If you are self-employed, healthy for the most part without any health conditions, you may want to consider taking up private health insurance sooner rather than later to cover “the big stuff”, for example surgery (eg. removal of tumours).

If you are looking to combine NHS care and keep the serious stuff, like urgent specialist surgery to private insurance then there are some things you need to look into, according to Simply Business:

1. Check how much treatment you’re covered for

How much you can claim when it comes to treatment for an illness isn’t likely to be capped. But there may be a limit on how many times you can use a service, for example how many counselling sessions you can access.

2. Are chronic conditions covered?

A chronic illness is a health condition that requires long-term treatment, and may not have a cure. Healthcare plans are unlikely to cover treatment for conditions that become chronic, so it’s a good idea to familiarise yourself with what’s included, whether there are limitations, and if you’re particularly at risk of developing an excluded condition.

3. Are you eligible?

If you’re looking into health insurance either as a self-employed person or a small business owner, you’ll need to be registered as self-employed with HMRC or on Companies House.

How much does self-employed health insurance cost?

Simply Business’ Solo plan, for example, is £27 a month and includes unlimited GP appointments, a health check, nurse helplines, stress support, and the cost of diagnosis. Once you’re diagnosed, you’ll need to seek treatment from the NHS. If there wasn’t the waiting list or the treatment wasn’t urgent, then this may be a cost-effective option.

But what if your medical needs are urgent or life-threatening?

The Solo Plus plan is a bit more at £39 a month and covers everything under the Solo plan, plus hospital treatment as a private patient, meaning that once you’re diagnosed, you’ll get access to private treatment – whether that’s in-patient care or fast access to a specialist.

Access to specialists and hospitals are via an approved AXA Health network, which will help you book your treatment.

Alternative medicine: when to consider it?

The availability of complementary and alternative medicine (CAM) on the NHS is limited, and in most cases, the NHS will not offer such treatments. However, they may suggest you try some, but this may be out of your own pocket.

The National Institute for Health and Care Excellence (NICE) provides guidance to the NHS on effective treatments that are value for money.

For example:

• the Alexander technique for Parkinson’s disease
• ginger and acupressure for reducing morning sickness
• manual therapy for lower back pain

Finding a CAM practitioner

If you think you may have a health condition, first see your GP. Do not visit a CAM practitioner instead of seeing your GP, says the NHS.

It’s particularly important to talk to your GP if you have a pre-existing health condition or are pregnant.

Some CAMs may interact with medicines that you’re taking or should not be taken if you’re pregnant.

That said, those who have been suffering from back pain, for example, may opt for physical exercises, such as running or yoga, to align their back muscles and vertebrae, rather than being solely reliant on pain killers. The great thing about that treatment is it’s free.

Osteopaths are increasingly being referred by the NHS to handle neck and other debilitating issues affecting stature, the back, legs and joints. Some osteopaths work privately as well as on behalf of the NHS. Many are self-employed, so they will understand your predicament when it comes to having little time off to recover.

Supplements: are they an option for certain conditions?

Vitamin and herb supplements are increasingly coming into favour in traditional medicine.

• Tumeric otherwise known as curcumin has been known to be prescribed by neurosurgeons to help patients with inoperable brain tumours keep cancer cells under control. It is also known to keep overall inflammation down, which is the root of many ailments, such as arthritis.

• Lactoferrin, a protein found in breast and cows milk, has been used in medical studies to test if it can inhibit the growth of tumours in different parts of the body including the breast, neck and brain. It has also been tested to inhibit the attack on human cells brought on by the COVID virus.

More times than not a GP will not be well versed in complementary medicine or supplements, so it is important to keep this in mind when asking about them. Always see a GP or specialist about your condition first and ask if there are any known indications of your medicine or your condition that could be helped or worsened by certain activities or supplements.

Supplements should be considered a prevention measure and not always the silver bullet to a problem. But after taking supplements and you start to feel better and notice conditions are going away, you should inform your GP or specialist right away. You can then set up check-ups to see how things are progressing while continuing with the supplement or if you decide to take a break from it. Your GP may request that you take blood tests or scans to measure certain factors in your system that may prove that the supplement is working.

If you have a private insurance policy that covers diagnostic tests, then you may get answers quicker.

PINGDEMIC: A guide for contractors, freelancers and sole traders

7 million “missing patients” : why the NHS waiting list is so long

NHS waiting lists have grown by less than a million since the start of the pandemic despite there being 3 million fewer planned admissions and 17 million fewer outpatient appointments in the first ten months of the pandemic alone. This is because 7 million fewer people joined the waiting list between March 2020 and May 2021 than would otherwise have been expected.  What happens to the waiting lists in the short term will therefore depend crucially on what fraction of these 7 million “missing” patients come back for treatment.

What’s the solution to the NHS waiting list problem?

In the longer term, NHS capacity to deal with non-Covid patients will be crucial. Even if only two-thirds of the missing patients return then with capacity at 95% of pre-pandemic levels – much more than the NHS is currently managing – waiting lists could easily exceed 13 million (and keep growing). 

Expanding capacity will be the only solution to cut waiting lists in the future.

Finding ways to boost NHS capacity will therefore be a major and pressing challenge for the new Secretary of State and NHS Chief Executive, and will undoubtedly feed into discussions around NHS funding at this autumn’s Spending Review. 

“More than 4 million people were on an NHS waiting list even before the pandemic. Covid-19 has only made matters worse, as millions of people have missed out on treatment and millions more haven’t even been referred onto the waiting list, to begin with,” said Max Warner, a Research Economist at the IFS and an author of the analysis.

“There is a real risk that if the NHS cannot find effective ways to boost its capacity – a challenge at the best of times, let alone after a major pandemic – then much longer waiting lists will be with us for years to come,” said Warner.

Are you affected by the NHS Waiting List? Leave you comments.

• Are you a locum or contractor working in the healthcare industry with a viewpoint on the situation? We welcome your comments.
• Are you a freelancer looking at alternative ways to keep illnesses at bay? We’d like to hear your ideas.

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