BBK Manifesto 2026: Improve accountability within private healthcare
Private healthcare is growing rapidly as NHS waiting lists rise, and nearly one in eight people now have private medical insurance. Many patients assume that private treatment offers safeguards comparable to the NHS, but clinical negligence cases show that these protections can fall short, especially when something goes wrong.
At BBK, we believe private healthcare needs greater checks and safeguards to protect patients from harm.
When indemnity cover fails, patients are left unprotected
A major issue arises when a private clinician has no indemnity cover available to meet a claim after negligent treatment.
In a recent case I handled, the surgeon’s insurer refused to provide cover, leaving my client unsure whether they would ever receive compensation. In the NHS, claims are met through a national scheme. In private healthcare, the system relies on individual clinicians maintaining insurance and notifying their insurer of any incidents, even though doing so can increase premiums or jeopardise future cover. This creates a built‑in conflict and leaves patients exposed.
A system that leaves too much to chance
Unlike NHS consultants, who are employed by a trust, many consultants in private hospitals work as independent practitioners and are granted “practising privileges”. While private hospitals check qualifications and insurance at the outset, gaps in ongoing oversight could arise.
When repeated complaints or concerns arise, the question becomes whether the private hospital’s governance systems – designed to protect patients – were actually functioning. Regulations require providers to ensure safe care and manage risk, but these duties are not always met in practice.
When negligence occurs, liability may fall on the clinician, the hospital, or both, but the legal routes are complex and inconsistent. Patients can be left navigating uncertainty at the very moment they need clarity and support.
What needs to change
Patients treated in private hospitals should have confidence that if negligence occurs, compensation will be available. Yet the current system relies heavily on individual clinicians keeping their insurance up to date and notifying insurers of complaints.
Hospitals may require proof of insurance, but they do not always ensure that insurers are informed when incidents arise.
This gap is unacceptable.
To protect patients, the UK should create a scheme similar to the Motor Insurers’ Bureau and strengthen private hospitals’ responsibility for overseeing consultants’ indemnity cover.
The proposed scheme would be a central fund that steps in when a clinician’s indemnity cover fails or is not available.
Just as the Motor Insurers’ Bureau protects victims of uninsured or untraceable drivers, a similar mechanism could provide a guaranteed route to compensation for patients, removing the risk of being left dependent on a clinician’s personal finances.
Alongside this national safety net, private hospitals should face stronger governance obligations. This could include requiring consultants to confirm that insurers have been notified of relevant incidents and linking governance systems more closely to indemnity oversight.
Better alignment between hospital processes and insurance requirements would reduce the risk of cover being declined later.
This blog is part of our 2026/27 Manifesto for Injured People. At Bolt Burdon Kemp, we support injured people not only by winning their cases but by driving positive change. Guided by our clients’ experiences and partnerships with charities across the UK, we are raising awareness of the changes needed to better support injured people. We will continue working with politicians from all parties to ensure injured people’s needs are not overlooked in Westminster or beyond. You can read our full manifesto here.
