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Self-help guide

Private healthcare – making a claim for compensation

Even though care can be provided through the private system, the standard of care expected of doctors and healthcare providers is the same as with NHS funded care. This means that the legal tests applied when assessing a claim for compensation are the same. However, there are some issues which uniquely apply to private healthcare claims.
Patients and familiesAccess to justice

In this guide

Claims for breach of contract

Prior to receiving treatment from a private healthcare provider, a patient typically signs up and enters into a contract with either the individual doctor and/or the hospital itself. This will have a number of express and implied terms, e.g. to carry out a certain procedure with reasonable care and skill.

If it can be shown that the doctor did not carry out the procedure with reasonable care and skill, they may be in breach of contract as well as being negligent. The test for negligence is the same as that which is applied to NHS healthcare providers, details of which can be found in our guide to bringing a claim for compensation. Some of the detail of how to bring a claim will vary according to whether you live in England, Scotland, Wales or Northern Ireland.

If there is a breach, the patient may be entitled to damages for any pain and suffering incurred, as well as to put the patient in the same position they would have been if the terms had been adhered to. For more information, please see our self-help guide on what compensation can be claimed.

Where private care costs have been incurred, you may also be entitled to receive a refund for any treatment paid for by you, or you can make a claim on behalf of your private insurer if they covered the cost of private treatment.

Care paid for using a credit card

If you paid for the whole or part of your medical treatment with a credit card, you may be able to claim the money back from your credit card provider under section 75(1) of the Consumer Credit Act 1974, which states: “If the debtor under a debtor-creditor-supplier agreement falling within section 12(b) or (c) has, in relation to a transaction financed by the agreement, any claim against the supplier in respect of a misrepresentation or breach of contract, he shall have a like claim against the creditor, who, with the supplier, shall accordingly be jointly and severally liable to the debtor.”

The debtor in such claims would be the patient, the supplier would be the healthcare provider, and the creditor would be the credit card company.

The Act generally applies to treatments that were valued at more than £100 but less than £30,000, although there are certain circumstances where amounts greater than £30,000 can be claimed.

Under the Consumer Credit Act, if the claim is successful the claimant can recover the same damages as they would have done if they had a successful claim against the healthcare provider under breach of contract. This means that damages can be claimed from the credit card supplier or from the healthcare provider. This is particularly useful if the healthcare provider no longer exists, or if their insurers refuse to indemnify and pay out on any claim. It should also be noted that a claimant does not have to try and pursue a claim against the healthcare provider in the first instance — they can make a claim against the credit card company in the first instance if they so wish.

Time limits involved

Where the transaction/contract is one involving medical treatment and claim is pursued to obtain damages as a result of personal injury, the limitation period will usually be three years from the date the cause action arose or the claimant had knowledge under section 14 of the Limitation Act 1980.