The number of patients dropping off NHS Scotland waiting lists because they have opted to pay for operations privately instead has more than tripled since the pandemic.
Figures released under freedom of information (FOI) reveal that a total of 2,687 people were removed from NHS inpatient and day case lists in 2023 because they had self-funded the procedure at a private hospital.
This compares to 861 in 2019.
The data also shows a steady increase year-on-year, from 1,299 in 2021 and 1,936 in 2022.
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In total, nearly14,400 Scots have paid to go private for an operation since 2019 rather than remain on an NHS waiting list, including 935 so far in 2024.
The true figure for the numbers of patients going private will be even higher, however, as only eight of Scotland's 14 health boards were able to supply the figures.
These were: Ayrshire and Arran, Borders, Dumfries and Galloway, Forth Valley, Grampian, Orkney, Tayside and Shetland.
NHS Greater Glasgow and Clyde was unable to differentiate between patients removed from NHS lists because they were self-funding private treatment and patients who were being sent to private hospitals for treatment paid for by the NHS.
However, these numbers had increased overall, from 529 in 2019 to 940 in 2023.
Jackie Baillie, health spokeswoman for Scottish Labour - who obtained the FOI data - said thousands of Scots are being "forced into the arms of private healthcare" due to NHS backlogs.
By the end of March this year, there were more than 156,000 people on an waiting list in Scotland for an inpatient or day case procedure - a number than has doubled since 2019 - including 7,140 patients who had been waiting longer than two years.
She added: “It’s no surprise that individual patients are emptying their savings accounts or going into debt because they just want the pain to stop.
“But it’s also clear that the NHS in Scotland is struggling to deliver the services it used to just a few years ago and is forced to rely on referrals to private health services as a result.
“The UK Labour government is providing the funding for 160,000 additional appointments to reduce waiting lists but it’s up to the SNP not to fritter that money away on sticking plaster approaches.
“The SNP must act now to tackle waiting lists and get the NHS back to full strength so that everyone gets the healthcare they need.”
In October 2023, the Scottish Government pledged £300 million over three years would be targeted at bringing down NHS waiting lists, with the £30m first tranche of investment handed to health boards in April this year.
Updated waiting list statistics - covering the period from April to June - will be published in August.
A Scottish Government spokesman said the investment was being targeted at specialties where it "can have the greatest impact against the longest waits, including cancer, ophthalmology, orthopaedics, dermatology and diagnostics".
He added: “NHS Scotland makes limited use of the independent sector.
"In 2022/23, total spend represented just 0.7% (£116 million) of the total frontline health budget, and has been consistently below 1% since 2006/07.
"This compares to NHS England who spent 10.4 per cent of their £159.6 billion total outturn in 2022 - 23 on the purchase of healthcare from non-NHS bodies.
“The use of the independent sector to provide additional capacity is not a new development.
"As is the case across the UK, in certain circumstances limited use of alternative providers, within or without the local area, including independent sector providers, may be required in response to capacity constraints.”
It comes as documents have suggested Scottish ministers knew the construction of new national treatment centres (NTC) would be delayed months before it was confirmed publicly.
In January, the Scottish Government announced a two-year delay to a network of 10 dedicated elective hubs designed to drive down backlogs for procedures such as hip and knee replacements or planned heart surgery.
However, papers released under FOI show that officials warned in September 2023 that developments may have to be paused.
The document from the Directorate of the Chief Operating Officer for NHS Scotland warned the commitment to reduce waiting times year-on-year "would not be met".
The Scottish Government later announced that work on half the NTCs - in Ayrshire and Arran, Grampian, Lanarkshire, Lothian and Tayside - would be temporarily halted.
NTCs in Highland and Fife have already opened, with a delayed NTC in Forth Valley due to open later this year.
A revised timeline outlining when the new buildings would be constructed was due to be published this spring, but this has been pushed back until after the Scottish budget in December.
A Scottish Government spokesman said: "As we have said consistently, due to significant increases in construction costs due to inflation, and a lower than expected capital grant from the UK Government, a capital review is currently under way.
"We plan to publish a revised Scottish Government infrastructure investment pipeline alongside the 2025-26 budget."
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