Private hospital patients and NHS inpatients report near-identical recommendation
rates when measured with the same instrument. PHIN data for Circle Health Group
(38 hospitals, n=86,772 patient questionnaires, Jan-Dec 2025) shows 97.9% would
recommend their consultant; across the PHIN estate, individual private hospitals
cluster at 96-99%. Inverting gives roughly 3% who would not recommend. On
the NHS side, Borrelli et al. (2024) analyzed provider-level FFT data for
128 non-specialist acute trusts (April 2016 to March 2019) and found approximately
95.5% of inpatient responses were positive, giving roughly 5% who would not
recommend. The 2-percentage-point gap falls within the balanced zone of the
Gilovich pattern.
The large NHS dissatisfaction numbers circulating in public debate — 21% BSA
satisfaction in 2024, 59% dissatisfied — do not translate into a bilateral
inaction-dominates regret pattern. Those surveys measure general public attitudes
toward the NHS as a system, asking all adults including those who have had no
recent inpatient episode. The IHPN Going Private 2025 survey (n=2,011, Public
First) shows 88% of private care users say it was value for money. But these two
figures are not directly comparable: one surveys a general population on
institutional sentiment, the other surveys self-selected recent private users on
a cost-satisfaction question. When the same FFT question is applied to both
populations in comparable inpatient contexts, the gap narrows to 2 percentage
points. UK private medical insurance market growth (ABI 2024: 6.5 million
insured, up from 6.2M in 2023) is consistent with incremental demand for
supplemental care, not evidence of mass regret about NHS reliance.
The entry’s geographic and temporal limits bear stating directly. The NHS FFT
inpatient data runs only to March 2019; the CQC Adult Inpatient Survey 2024
(approximately 77,000 NHS patients, 52% rating experience 9-10/10) suggests
in-treatment quality has not deteriorated, though waiting times remain a
structural pressure. In Germany, Finanztip (n=3,337, March 2025) found 27% of
PKV private insurance holders would not re-choose private insurance, reflecting
premium escalation and exit-trap effects in a dual-mandate system. Australia
lost approximately 1.3 million hospital cover holders from the 2015 peak by
2019 as premium unaffordability drove behavioral exit. Both signals demonstrate
that in market structures with cost pressure and lock-in, private healthcare
regret becomes measurable. The balanced bilateral signal observed in the UK
context is specific to its supplemental-care model and current premium levels.
Sources: action
Claim ledger
Every number below is what each source reported, with the verbatim quote we relied on and how we arrived at our figure. Click any link to verify directly.
[1]Private Healthcare Information Network (PHIN) — PHIN Patient Feedback methodology and Circle Health Group data
Reference source
97.9% of Circle Health Group patients (n=86,772, Jan–Dec 2025) would recommend their consultant; individual private hospitals across PHIN cluster at 96–99%
Excerpt
“"PHIN uses the Friends and Family Test question: 'How likely are you to recommend our service to friends and family if they needed similar care or treatment?' Results are published per provider on phin.org.uk on a rolling 36-month basis."
”
Source data from
2025-12-31
Accessed
2026-05-02
Calculation
Circle Health Group PHIN data represents 86,772 patient questionnaires across 38 UK private hospitals for Jan-Dec 2025. 97.9% recommend = 2.1% would not recommend. Rounded to 3% as the action-side regret proxy to account for the cluster range (96-99%) across individual PHIN hospitals. This is a "would not recommend" proxy, not a direct regret measure. Same FFT question wording as NHS inpatient surveys enables cross-sector comparison. PHIN does not publish a national sector aggregate; the Circle figure is used as representative of the sector range.
[2]Independent Healthcare Provider Network (IHPN) / Public First — Going Private 2025: Headline Findings
Reference source
88% of people who have accessed private healthcare say it was value for money
Excerpt
“"Patient satisfaction remains very high with 88% of people who have accessed private healthcare — both through insurance and via self-pay — saying it was value for money."
”
Source data from
2025-01-01
Accessed
2026-05-01
Calculation
IHPN-commissioned Public First survey of 2,011 nationally representative GB adults. This is a broader "value for money" satisfaction proxy (D3=3), corroborating the PHIN recommendation-based estimate. The 12% "not worth it" figure is likely higher than the 3% "would not recommend" because it includes cost-relative dissatisfaction, not just care quality. IHPN represents private healthcare providers; interpret with awareness of commissioner bias.
Sources: inaction
Claim ledger
Every number below is what each source reported, with the verbatim quote we relied on and how we arrived at our figure. Click any link to verify directly.
[1]Health Services Management Research (SAGE) — How does staff and patient feedback on hospital quality relate to mortality outcomes? A provider-level national study
Peer-reviewed
~95.5% of NHS inpatient FFT responses were positive (extremely likely or likely to recommend); the remaining ~4.5% were neutral, negative, or extremely unlikely
Excerpt
“"Provider level FFT responses were obtained for 128 English non-specialist acute providers for staff and inpatients between April 2016 and March 2019."
”
Source data from
2024-05-01
Accessed
2026-05-02
Calculation
Large-scale analysis of NHS England FFT administrative data for inpatient wards, April 2016 – March 2019, covering 128 non-specialist acute providers. Approximately 95.5% positive rate (extremely likely or likely to recommend) -> 4.5% not positive. NHS England's own 2019 implementation guidance states "at least nine out of ten patients respond positively." Rounded to 5% for the inaction-side regret proxy to be consistent with rounding approach on action side. PMC mirror: https://pmc.ncbi.nlm.nih.gov/articles/PMC11041065/ Construct limitation: "would not recommend this ward" does not equal "regret relying on NHS rather than going private."
52% of NHS inpatients rated their overall experience 9-10 out of 10 in 2024 (n approx. 77,000)
Excerpt
“"The Adult Inpatient Survey 2024 asked patients about their experiences of inpatient care in NHS acute trusts in England."
”
Source data from
2024-12-01
Accessed
2026-05-02
Calculation
CQC Adult Inpatient Survey 2024, approximately 77,000 NHS patients. The 52% rating experience 9-10/10 measures experience quality directionally; different question from FFT and included here as corroboration only, not as the primary regret proxy. Up from 50.8% in 2023, suggesting in-treatment experience has not declined despite system-level dissatisfaction.
Caveats
Both sides use "would not recommend" as a proxy for regret, a weaker construct than direct re-choice intent or stated regret. The same FFT question wording on both sides is the entry's main methodological strength; it is also why the bilateral gap is narrow. The NHS FFT data is from 2016-19; NHS inpatient experience has changed since (CQC 2024: 52% rate 9-10/10, up from 50.8% in 2023, suggesting in-treatment experience has not collapsed despite system-level dissatisfaction). UK private medical insurance market is growing (+4-7% per year; ABI 2024: 6.5 million insured, up from 6.2M in 2023), and behavioral evidence does not strongly support an inaction-dominates framing; if NHS users broadly regretted not going private, market growth would be steeper and cancellation rates would be visible. The large NHS system satisfaction gap (21% BSA 2024 vs 88% IHPN private "worth it") conflates two incomparable populations: BSA surveys all adults including those who have not recently been NHS inpatients; IHPN surveys past private users only. Germany Finanztip (n=3,337, March 2025): 27% of PKV private insurance holders would not re-choose private insurance, showing geography matters significantly; in dual systems with exit traps and premium escalation, private healthcare regret is real and measurable but structurally different from the UK supplemental context. Australia behavioral signal: net loss of approximately 1.3 million hospital cover holders from the 2015 peak (approximately 47.4% to approximately 43.7% population coverage by 2019), driven primarily by premium unaffordability, suggesting the balanced bilateral signal is cost-contingent. UK scope: entry is primarily UK-applicable; US framing is different (no universal baseline); German and Australian systems have structurally different private/public divides. Temporal gap risk: NHS waiting times have worsened since 2016-19; if current FFT data were available, the inaction-side "would not recommend" rate may be higher than 5%, potentially widening the gap and shifting the pattern toward inaction_dominates.
