- Author, Jane Deith and Alys Harte
- Role, BBC file at 4
The number of children treated in private hospitals in Britain rose by almost a quarter last year to more than 46,000, according to new data from the BBC.
In both cases, families paid for treatment or used health insurance, rather than being referred by the NHS.
The record figures from private healthcare providers come as England’s NHS Trusts tell File on 4 that children have become the “forgotten generation” in the race to reduce healthcare backlogs.
The Department of Health says NHS staff are “working tirelessly” to reduce waiting lists.
But the Royal College of Surgeons in England told us that children are lagging behind adults and have to wait years for NHS surgery – with potentially lifelong consequences for their health and development.
NHS Providers, which represents trusts, says some hospitals may find it easier to carry out large numbers of operations for adults as they are often easier and quicker to perform.
‘A cloud over my head’
The BBC has spoken to a number of families whose children’s circumstances have deteriorated due to the long wait.
Among them is 16-year-old Georgina Smith from Hertfordshire, who is awaiting open heart surgery to repair a valve on her right side that is not closing properly. It can cause her blood to flow the wrong way, making it harder for her heart to work.
Georgina is one of 601 children waiting for heart surgery in England; 139 have been waiting for more than six months.
She has suffered from chest pain, extreme fatigue and fainting and has had to miss a lot of school.
Ten years ago, Georgina’s parents were told she needed immediate surgery. But then doctors at Great Ormond Street Hospital for Children said it was better to wait until her heart was fully grown.
However, last year an ultrasound showed that Georgina’s heart was getting weaker. Doctors said she would need surgery within six months. But Georgina has been on the waiting list for nine months.
Georgina says she feels like her operation will never happen. “It’s like a cloud over my head, it’s always just waiting and waiting and waiting,” she says.
In a statement, Great Ormond Street Hospital told the BBC: “Although we have reduced our cardiac surgery waiting list by 25% since the pandemic, there are still many challenges we face.” It added that this included demand for beds, often from emergency patients.
After the BBC approached the hospital for a statement, Georgina was given a date for surgery in July.
Jane Deith examines children waiting years for surgery on the NHS
Data released under a freedom of information request shows that in Britain the number of children who have to wait very long before being admitted to hospital.
This shows that at least 20,000 people have to wait longer than a year for treatment, including surgery.
Most of these long waits are in England: at the start of this month there were almost 16,000, an increase of 15% in a year.
Before the pandemic, it was extremely rare for children to have to wait more than a year for surgery.
Trusts in England say children should be explicitly prioritized by the government, including more funding so trusts can commission more operations.
NHS England, which runs the health service in England, said it realized it could be distressing for families waiting for their child’s operation. It said it would increase the number of fenced pediatric surgery beds, in addition to intensive care beds.
The Department of Health added that NHS England had set up a taskforce specifically aimed at reducing waiting times for pediatric surgery.
In Wales, the Department of Health told us it was putting more money into the NHS and prioritizing reducing long waiting times for children.
The Scottish Department of Health said it is maximizing productivity and deploying additional resources to reduce waiting times for children, especially the longest waiting times.
Overall, the number of children seen privately across Britain has increased by 38% since 2019, before the pandemic.
The Private Healthcare Information Network figures do not include the NHS trusts that use private hospitals to provide treatment.
They show that the number of children undergoing private surgery increased by almost a fifth last year to more than 24,000.
Children aged 15 to 17 years form the largest patient group for operations. The most common procedures include insertion of grommets into the ears, removal of tonsils and adenoids, and orthopedic surgery.
‘Does damage’
In Northern Ireland, the Royal College of Surgeons has described the wait for pediatric surgery as “horrendous”.
Niall McGonigle, a thoracic surgeon in Belfast, says thousands of children have been waiting for four or five years. He says he has sent “an SOS” to the Northern Ireland Assembly over the serious backlog.
“Children suffer. We can no longer stand by and allow this to happen because we know patients are being harmed,” the surgeon told the BBC.
“What was a relatively simple operation turns into a more complex operation that is more difficult for the surgeon, but more importantly, more difficult for the child.”
In extreme cases, there is a risk that a very long delay in surgery will make a child inoperable.
Six-year-old Jack Dorrity, from Ballymena, has cerebral palsy and has been waiting for hip surgery since he was three.
At the time, surgeons at the Royal Belfast Hospital for Sick Children said Jack needed immediate surgery on both his hips to stop his muscles pulling them out of their sockets.
Image source, Aodhan Roberts/Belfast Telegraph
But he has been on the waiting list for so long that one hip is now dislocated and growing up to his waist. Jack’s father, Leon, says the longer his son waits, the more he suffers.
‘Every time we put our arms under his legs to lift him out of his chair, he is in pain. He shudders, he cries. He’s quite upset, so we know it’s hurting him,” he said.
Because Jack’s hip has dislocated, performing surgery will be more difficult and it would take too long to do both hips at the same time. So Jack now needs two six-hour surgeries.
But the hospital has told Jack’s parents it cannot perform a six-hour operation because it would mean canceling too many other patients. Last year the trust canceled 566 children’s procedures.
Leon has been warned that if Jack waits much longer for the operation, it may not be possible to replace his hip. Instead, surgeons may have to completely cut off the top of his leg bone. Jack would remain more disabled and would no longer be able to bear weight on his leg.
“He develops a weak leg and his hips are out of balance, which can lead to scoliosis. But if we miss the hip surgery, do we also miss the scoliosis surgery?
‘I’m getting mad at Jack. It is failing children and it is the children with the greatest needs who are being left behind.”
Belfast Health and Social Care Trust said in a statement that it was under increasing and persistent pressure and was very sorry it could not provide Jack with his operation. It said it was exploring all possible options to help him.
The Northern Ireland Department of Health told us it was trying to maximize existing capacity in pediatric surgery, but was unable to add more capacity with the funding it received from the budget.