The slogan on a promotional billboard in Glasgow city centre advertising the soon-to-open Elanic private hospital promises patients the chance to "Get well, sooner".

It is a message that taps into the changing trends in healthcare which have seen record numbers of Scots forgoing the NHS in favour of faster treatment in the private sector.

Those who have booked their appointments already have a short time to wait, with construction work on the facility in Bath Street on track for completion by November 7 and the first patients due to be admitted shortly thereafter.

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It will be the city's third private hospital alongside the Nuffield and Ross Hall, but the first new inpatient centre to open in more than 40 years.

Elanic was founded in 2009 as an online cosmetic surgery company by Glasgow-based husband-and-wife team, Vivek Sivarajan and CJ Tollan, who were both consultant plastic surgeons in the NHS.

Its first physical clinic, also in Bath Street, opened its doors in 2013 and by 2016 the couple began expanding its service to include a range of bariatric weight loss surgeries such as gastric bands by hiring theatre and bed space other local private hospitals to carry out the procedures.

By 2019, moves were underway to open an Elanic clinic in Edinburgh - then the Covid pandemic struck.

"We were about to go ahead with that when Covid hit so everything fell apart and the landlord eventually turned [the Edinburgh space] into offices," said Dr Sivarajan.

"But coming out of Covid, we were really busy, so we looked again at whether we would go into Edinburgh or expand locally."

When the two floors immediately above their Elanic clinic in Bath Street were vacated by RBS, the couple seized the opportunity to reshape their business as the scale of the backlogs facing the NHS became clear.

The space now includes two state-of-the-art operating theatres - including one in a converted bank vault - plus six inpatient rooms, including one with high-dependency equipment, to enable patients undergoing more complex procedures to stay overnight.

An imaging suite, including MRI, will be added next year.

Elanic Medical Director Vivek Sivarajan and Director CJ Tollan SivarajanThe husband-andwife team behind Elanic: Medical Director Vivek Sivarajan and Director CJ Tollan Sivarajan (Image: BigPartnership) The larger of the two operating theatres, with floor-to-ceiling windows overlooking Bath Street, will be mostly dedicated to hip and knee replacement surgeries, while the second concentrates on general surgery - such as hernias - and gynaecology or endoscopy procedures.

A third, existing, theatre space on the ground floor will continue to focus on cosmetic procedures such as facelifts and breast augmentation, but the creation of inpatient beds mean medics can now carry out bariatric surgery in-house for the first time.

All three are ventilated with ultra-clean air filtration technology which has been shown to cut the risk of post-operative wound infections.

Working at full capacity, the facility is expected to see around 400 patients a month - mostly on a day case basis.

Elanic has recruited almost a dozen orthopaedic surgeons who are experts in performing joint replacements as a day-case procedure in the NHS, meaning that patients can get in and out the same day and recuperate at home.

The hospital in Bath Street will have three operating theatres, six inpatient beds and an imaging suite, and is expected to carry out around 400 procedures each month at full capacity  (Image: Colin Mearns/Herald&Times) As well as reducing the risk of infections, the lower overheads associated with day surgery mean that the price tag for a hip replacement is around £9000-£9,500 compared to a market rate of around £13-15,000.

Dr Sivarajan said: "It's well-evidence that there's lower infection rates, quicker recovery, faster mobility, less risk of [deep vein thrombosis], when you mobilise faster.

"That's been the move, particularly with hip and knee replacements: the more advanced NHS units in the UK are now doing that as day procedures, whereas the private hospitals are still using that older system of staying in hospital two to three nights after your procedure, which isn't really necessary or even ideal.

"We're moving to day case hips, day case knees.

"The guys we're working with, that's their orthopaedic specialty, so we're just going to transfer what they already do [in the NHS] to the private sector for the first time in Scotland."

The number of inpatient and day-case admissions to private hospitals in Scotland reached a record high of 11,980 between January and March this year.

Around 5000 were self-pay - where patients fund the treatment themselves - but a record 7000 were patients covered by medical insurance.

Overall, admissions are up by around 33% from 9000 during the same quarter in 2019.

Private healthcare providers in Scotland have seen demand steadily increasing from both self-pay and insured patients (Image: PHIN)

The growth in demand has coincided with spiralling waiting list backlogs which the NHS in Scotland is struggling to clear, despite Government promises to "eradicate" the longest delays and £300 million in funding earmarked to tackle the problem.

By the end of June this year, the number of waits in excess of one year had reached 37,972 - up from 36,437 in June 2023, and 1,904 in June 2019.

A third of the waits in excess of one year affected orthopaedics patients, including 1,665 who had been waiting over two years.

Dr Tollan said Covid was "a big turning point" for the business.

She said: "Suddenly there were these long NHS waiting times and no ability for healthcare and the staff to catch up.

"By then we had been running the business for 10 years so we knew how to run a surgical centre efficiently at the same time as there were suddenly a lot of patients unable to access the NHS.

"It became clear that while, surgically, our area of expertise is aesthetic and plastic surgery, the need was actually moving into the whole of elective."

A criticism regularly levelled at private providers is that - as they expand - they attract doctors and nurses in a way that exacerbates workforce shortages for the NHS, making it even harder for those who cannot afford to pay for treatment to be seen quickly.

Elanic is expanding from cosmetic and bariatric work into elective activity such as orthopaedics for the first time, prompted by lengthy NHS waiting lists for hip and knee replacements  (Image: Colin Mearns/Herald&Times) Dr Tollan, who still works part-time in the NHS, stressed that the "majority" of Elanic surgeons continue to hold NHS contracts as well as working privately.

She said: "Surgeons and medical staff have always traditionally worked in both sectors.

"I think the moral issue now is that there are patients who cannot access NHS healthcare in the time period they want.

"Ultimately, I think patients should be entitled to a choice. It shouldn't be a case of 'levelling down' - that everybody waits.

"At the end of the day, there is a volume of healthcare that needs to be delivered and if the capacity doesn't exist in the NHS, then the waiting lists get longer, and anything you can do to take patients off that list - even if that means going privately - will reduce the time for everyone else on that waiting list.

"It isn't as if, if the private sector didn't exist, the NHS would be better off."

Competition should also drive down prices for consumers, added Dr Sivarajan.

He said: "In a more developed private sector, prices come down. If you've got lack of availability in the private sector - you've only got one or two hospitals - prices go up."

One of the first patients booked for orthopaedic surgery at Elanic is a 57-year-old man who was told to "take painkillers and come back when he's ready for sticks".

"He has a building contractor business and a two-year-old granddaughter - it wasn't an option for him to just deteriorate," said Dr Sivarajan.

The couple say they are also keen to make private surgery accessible to more self-funding patients through "car finance-style" payment plans where people can pay off procedures in instalments of around £250 per month.

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For now, however, there is little sign of the Scottish Government procuring large-scale contracts with the private sector to help clear NHS backlogs - something that has been happening in a much bigger way in England. 

Dr Sivarajan said: "When we look at healthcare between Scotland and England prior to Covid, the Scottish health service was doing really well.

"The biggest change was during Covid, where there wasn't the same private capacity [in Scotland] to take up volume that the NHS couldn't do.

"Since Covid, the NHS in England has taken more advantage of the private sector and that hasn't been mirrored in Scotland due to the way the health service is set up here and because the size of the private sector isn't really big enough.

"And there's probably a political edge to that as well.

"We've been discussing our plans with the NHS for over two years now, and I have no doubt that if the budget was available they would like to take advantage our facility but, unfortunately, that doesn't appear to be the case."