11th May 2026

Newsletter Monday

Hello Reader,

I read an article this week by a man who nearly died from sepsis after a private varicose vein procedure.

What struck me wasn’t really the complication itself. Complications happen everywhere in medicine.

NHS. Private. Fancy hospitals with scented hand soap.

Humans remain stubbornly biological despite premium branding.

What interested me was what happened afterwards.

According to the article, when things became serious, the private clinic became increasingly difficult to access, while the NHS stepped in and managed the emergency.

It usually does that.

They don't even send a bill to the private sector either.

And it made me think about the strange relationship we have with healthcare in this country.

New Health Vs Old School

Modern healthcare increasingly sells us the idea that health is something we can optimise, track and personalise. ✨

But serious illness has a habit of exposing what systems are actually built to cope with complexity.

Private healthcare is often marketed as superior to the NHS.

And to be fair, parts of the experience often are better:

-faster appointments,
-nicer buildings,
-better coffee,
-actual eye contact,
and consultations where you don’t feel like somebody has started a countdown timer the moment you sit down.

Those things matter.

But speed and convenience are not the same thing as an entire healthcare system.

The private sector tends to work best when medicine is relatively tidy and predictable:

• planned procedures,
• straightforward diagnostics,
• elective surgery we'll have you but not you,
• routine investigations.

What it generally doesn’t do particularly well is the messy, expensive, labour-intensive reality of healthcare:

• emergency care,
• chronic disease,
• frailty,
• severe mental illness,
• complex multi-system disease,
• palliative care,
• intensive care,
• or picking up unpredictable complications at 3am while somebody’s relative is shouting “HE WAS FINE YESTERDAY.”

If you are trapped in a motorway pile-up, you aren't calling Vitality or Bupa any time soon.

Though bizarrely, I still cannot adequately explain to my 17-year-old why the air ambulance is a charity. 😵‍💫

No need to pick a team.

You don’t have to pretend the NHS does everything brilliantly.

It clearly doesn’t.

Patients struggle with access.
Continuity has worsened.
Staff are stretched.
Some systems feel like they’re being held together with biscuits and goodwill.

I have been very open about that.

But equally, we shouldn’t pretend private healthcare is some entirely separate, self-sustaining parallel universe heroically operating independently from the NHS.

In reality, the NHS often functions as the safety net underneath the whole structure.

Because when things become high-risk, prolonged, complicated or financially unattractive, the NHS frequently absorbs the burden.

Private markets are on the rise

Meanwhile there is now a growing commercial industry sitting adjacent to both:
-private hormone clinics,
-subscription “health optimisation” apps,
-food intolerance testing,
-unregulated reassurance scans,
-private blood panels,
-biological age scores (!),
-functional medicine packages,
and supplement regimens requiring their own direct debit and possibly a small spreadsheet.

A lot of this is sold with the language of empowerment and prevention.

Some of it is useful.
Some harmless.
Some complete nonsense.

But much of it exists in fragments, disconnected from the patient’s wider medical history, medications, risks and long-term care.

And follow-up can become surprisingly thin once the transaction is complete.

Back you go to your own GP.

That’s the bit people often don’t fully appreciate.

Healthcare is not just information.
It’s not just access.
It’s not just a dashboard full of biomarkers and a graph telling you your “biological age” is 43.7 despite your knees sounding like bubble wrap on the stairs.

I suspect most people don’t actually want just NHS or private healthcare.

They want a system that is accessible, humane, safe, responsive and sustainable.

Honestly, so do most clinicians.

Because right now the arrangement sometimes feels oddly skewed.

Profits and convenience can be privatised, while complexity, risk and long-term fallout quietly become public responsibilities.

And perhaps that’s the uncomfortable truth underneath all this:

Healthcare sounds wonderfully simple when it’s being marketed.

It becomes much more complicated once actual humans get involved.