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Private Healthcare (Industrial Report) - UK - March 2014

“The private healthcare market faces a year full of change, with the provisional remedies proposed by the Competition Commission following its two-year investigation into the sector potentially marking a shift in the balance of power from private hospital operators to private medical insurers.”

- Angus Handley, Research Analyst

This report answers the following key questions:

  • How has falling demand for private medical insurance affected private hospitals?
  • What impact will the Competition Commission’s investigation have on the market?
  • Is legislation bringing NHS and private care closer together?
  • How can insurers broaden the appeal of private medical insurance?
  • What role does the private sector have in delivering NHS care?

This report covers the private healthcare sector comprising the provision of healthcare services through private hospitals and clinics, and the private medical insurance sector that is so important to the financing of private medical care. It is estimated that some 67% of the expenditure of the private medical sector is met through private medical insurance.

Private residential care and nursing care for the elderly is covered in a separate report also available from MBD and published quarterly. Other related reports published by MBD include the UK occupational healthcare market.

The private healthcare sector operates alongside the publicly available system operated by the NHS. There is a strong inter-relationship between the two systems and the private sector relies on NHS consultants for some 85% of its medical manpower. The development of the private sector is to a large extent reliant upon NHS consultants being available to undertake private work.

The DoH also encourages the NHS to utilise private healthcare facilities where this offers an economic opportunity. For this reason the sector incorporates a number of different scenarios in addition to the publicly financed and public supply health services:

  • Publicly financed/private supply
  • Privately financed/public supply
  • Privately financed/private supply
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Table of contents

  1. Executive Summary

      • The market
        • Private healthcare market worth £7 billion in 2013
          • Figure 1: UK expenditure on private acute healthcare, 2009-13
          • Figure 2: Estimated geographic penetration of private medical insurance, 2010-12
        • Hospitals and clinics account for two-thirds of the market
          • Figure 3: Segmentation of private healthcare expenditure, by type, 2013
        • Private healthcare spending forecast to grow 12% by 2018
          • Figure 4: Forecast UK expenditure on private acute healthcare, 2014-18
        • Private medical insurance sector worth £3.6 billion in 2013
          • Figure 5: The UK market for private medical insurance, 2009-13
        • More than 70% of health insurance policies held by businesses
          • Figure 6: Segmentation of private medical insurance, by policyholder type, 2009-13
          • Figure 7: Average annual PMI premium, by sector, 2003-12
        • PMI market forecast to lose 9% of value by 2018
          • Figure 8: Forecast UK market for private medical insurance subscription income, 2014-18
          • Figure 9: Forecast UK market for private medical insurance, by number of policyholders, 2014-18
        • Market factors
          • Private hospitals are increasingly reliant on NHS patients
            • Figure 10: Origin of finance for private acute hospitals, 2013
          • Legislation blurring the lines between private and NHS provision
            • Insurers offer modular policies to hold on to customers
              • Competition Commission intervention to benefit PMI providers
                • Companies and brands
                  • Top five providers control 80% of hospital capacity
                    • Figure 11: Private acute healthcare market share, by capacity, 2013
                  • Bupa and AXA PPP account for two-thirds of PMI premium income
                    • Figure 12: Private medical insurance market share, by gross premiums earned, 2012
                  • What we think
                  • Introduction

                    • Definitions
                      • Methodology
                        • Abbreviations
                          • Market positioning
                            • UK economy
                              • Inflation
                                • Interest rates
                                  • Consumer spending
                                    • Business investment
                                      • Market factors
                                        • The economy
                                          • Corporate expenditure
                                            • Fiscal incentives
                                              • Employment trends
                                                • Healthcare environment
                                                • Independent Hospitals and Clinics

                                                  • Chapter summary
                                                    • Market size
                                                        • Figure 13: UK expenditure on private acute healthcare, 2009-13
                                                        • Figure 14: UK expenditure on private acute healthcare graph, 2009-13
                                                        • Figure 15: Analysis of the development of private acute hospitals in the UK, 2008/09-12/13
                                                        • Figure 16: Development of private acute hospital capacity, UK, 2008/09-12/13
                                                        • Figure 17: Development of private acute hospital capacity graph, UK, 2008/09-12/13
                                                      • Market segmentation
                                                        • Expenditure
                                                            • Figure 18: Segmentation of private healthcare expenditure, by type, 2009-13
                                                            • Figure 19: Segmentation of private healthcare expenditure graph, by type, 2013
                                                            • Figure 20: Sources of funding for acute hospitals and clinics, 2012 and 2013
                                                            • Figure 21: Sources of funding for acute hospitals and clinics graph, 2013
                                                          • Analysis by type of operator
                                                              • Figure 22: Analysis of private acute hospitals in the UK, by type of operator, 2012/13
                                                              • Figure 23: Analysis of private acute hospitals in the UK graph, by type of operator, 2012-13
                                                            • Regional analysis
                                                              • Figure 24: Regional analysis of UK independent acute hospitals, 2012/13
                                                            • Market share
                                                                • Figure 25: Major private acute hospital operators, 2012/13
                                                                • Figure 26: Major private acute hospital operators graph, 2012/13
                                                              • Company profiles
                                                                • Spire Healthcare
                                                                  • Figure 27: Financial analysis of Spire Healthcare, 2008-12
                                                                • Ramsay Health Care UK
                                                                  • Figure 28: Financial analysis of Ramsay Health Care UK Operations, 2008-12
                                                                • BMI Healthcare
                                                                    • Figure 29: Financial analysis of BMI Healthcare, 2008-12
                                                                  • HCA International
                                                                      • Figure 30: Financial analysis of HCA International, 2008-12
                                                                    • Nuffield Health
                                                                        • Figure 31: Financial analysis of Nuffield Health, 2008-12
                                                                      • St Martins Healthcare
                                                                        • Figure 32: Financial analysis of St Martins Healthcare, 2008-12
                                                                      • Care UK
                                                                          • Figure 33: Financial analysis of Care UK, 2009-12
                                                                        • Forecast
                                                                            • Figure 34: Forecast UK expenditure on private acute healthcare, 2014-18
                                                                            • Figure 35: Forecast UK expenditure on private acute healthcare graph, 2014-18
                                                                        • Private Medical Insurance

                                                                          • Chapter summary
                                                                            • Market size
                                                                              • Figure 36: Ownership of PMI and other health and protection products, October 2013
                                                                              • Figure 37: Proportion of employers offering selected benefits as core, March 2013
                                                                              • Figure 38: Average annual PMI premium, by sector, 2003-12
                                                                              • Figure 39: Average annual PMI premium graph, by sector, 2003-12
                                                                              • Figure 40: The UK market for private medical insurance, 2009-13
                                                                              • Figure 41: The UK market for private medical insurance grpah, 2009-13
                                                                              • Figure 42: Claim amounts incurred as a proportion of gross earned premiums, 2008-12
                                                                              • Figure 43: PMI gross profits and claims paid, 2008-12
                                                                              • Figure 44: The UK market for PMI, by number of policyholders and people covered, 2008-13
                                                                              • Figure 45: The UK market for PMI, by number of policyholders and people covered graph, 2008-13
                                                                            • Market segmentation
                                                                                • Figure 46: Segmentation of private medical insurance, by policyholder type, 2009-13
                                                                                • Figure 47: Segmentation of private medical insurance graph, by policyholder type, 2009-13
                                                                                • Figure 48: Segmentation of private medical insurance graph, by policyholder type, 2009-13
                                                                                • Figure 49: Estimated geographic penetration of private medical insurance, 2010-12
                                                                                • Figure 50: Estimated geographic penetration of private medical insurance graph, 2010-12
                                                                                • Figure 51: Average weekly household expenditure on medical insurance premiums, by age group, 2010-12
                                                                              • Industry structure
                                                                                • Figure 52: Private medical insurance market share, by gross premiums earned, 2012
                                                                                • Figure 53: Private medical insurance market share graph, by gross premiums earned, 2012
                                                                              • Company profiles
                                                                                • Bupa
                                                                                    • Figure 54: Financial analysis of Bupa, 2008-12
                                                                                    • Figure 55: Divisional analysis of Bupa, 2011-12
                                                                                  • Aviva Healthcare UK
                                                                                      • Figure 56: Financial analysis of Aviva Plc, 2008-12
                                                                                    • Simplyhealth
                                                                                        • Figure 57: Financial analysis of Simplyhealth Access, 2008-12
                                                                                      • PruHealth
                                                                                          • Figure 58: Financial analysis of Prudential Health Limited, 2009-13
                                                                                          • Figure 59: Financial analysis of Prudential Health Insurance Limited, 2009-13
                                                                                        • AXA PPP Healthcare
                                                                                            • Figure 60: Financial analysis of AXA PPP Healthcare, 2008-12
                                                                                          • Western Provident Association
                                                                                              • Figure 61: Financial analysis of Western Provident Association, 2007-11
                                                                                            • Forecast
                                                                                                • Figure 62: Forecast UK market for private medical insurance, by gross premiums earned, 2014-18
                                                                                                • Figure 63: Forecast UK market for private medical insurance graph, by gross premiums earned, 2014-18
                                                                                                • Figure 64: Forecast UK private medical insurance market segmentation, by policyholder type, 2014-18
                                                                                                • Figure 65: Forecast UK market for private medical insurance, by number of policyholders, 2014-18
                                                                                                • Figure 66: Forecast UK market for private medical insurance graph, by number of policyholders, 2014-18
                                                                                                • Figure 67: Forecast UK private medical insurance subscribers, by policyholder type, 2014-18
                                                                                            • Further Sources and Contacts

                                                                                              • Trade associations
                                                                                                • Trade magazines
                                                                                                  • Trade exhibitions

                                                                                                  Companies Covered

                                                                                                  To learn more about the companies covered in this report please contact us.

                                                                                                  Private Healthcare (Industrial Report) - UK - March 2014

                                                                                                  £995.00 (Excl.Tax)