You have been advised an operation — a hip or knee replacement, a hernia repair, something gynaecological or urological — and from the UK there are three routes in front of you: wait on the NHS, pay to have it done privately at home, or have it done in India. Each route is legitimate, each has a different bill and a different clock, and honest comparison means holding all three up without a sales pitch attached to any of them.
This article explains how each route works, what each one actually costs, and what to verify before choosing. It is information, not advice: we do not give medical, insurance or financial advice, and your treating team knows your case.
Route one: the NHS wait
The NHS route costs you nothing at the point of use, and its price is paid in time. In England, the NHS Constitution gives you the right to start consultant-led treatment for non-urgent conditions within a maximum waiting time, and hospitals report their waiting positions publicly every month.
We have written a separate article on how the 18-week pathway works and what the RTT statistics show, with the published England-wide figures and the specialty detail for trauma and orthopaedics. The short version: the right exists, published performance has run well below it in recent years, and the wait you live can be longer than the officially measured clock, because time before the decision to treat is not counted the same way. Your own trust’s current position, which your treating team can confirm, is the number that matters for your case.
Two things are worth knowing about this route. First, the clock is not passive: your priority classification is a clinical judgement, and it can be reviewed if your condition changes. Second, a second opinion while you wait does not affect your place on the list, and it is often the cheapest option on this page.
Route two: paying privately in the UK
Going private in the UK does not mean abandoning the NHS. Guidance from the Department of Health is explicit that where a patient opts to pay for additional private care, their entitlement to NHS services remains and may not be withdrawn. You can sit in the NHS queue and separately buy a private operation if you choose; the two need to be managed as distinct pathways, and your GP can help keep them that way.
What does it cost? PHIN — the official source of data on private healthcare in the UK — publishes average self-pay package prices by city from data collected in March 2026. For the two procedures patients most often price, the averages by city ran roughly: hip replacement packages from about £13,800 to £17,500, knee replacement packages from about £14,300 to £18,200, and cataract surgery from about £2,500 to £3,400 per eye. London sits inside those bands rather than above them; the spread between UK cities is modest.
The fine print matters as much as the headline. PHIN’s own guidance is that a package usually covers the surgeon, anaesthetist and hospital fees, does not always include your first consultation, and may charge extras such as physiotherapy separately — so ask the hospital to confirm what is included in writing before you book. And on timing: private surgery does not queue in a public list at all. Your date is negotiated with your chosen surgeon and hospital, around their theatre sessions and your readiness. That is the real product you are buying privately: scheduling control, close to home, at a five-figure price.
Route three: treatment in India
The third route is the same operation, self-funded, in India. It is the one that requires the most homework and, for deferrable procedures with a large price gap, can produce the largest savings — but the honest version comes with its own overheads: flights for you and often an attendant, accommodation near the hospital for the recovery weeks, and a longer arc of follow-up across a time difference.
The mechanism side is well-worn for UK patients: the e-Medical visa is applied for online (with the hospital invitation letter we coordinate), nonstop flights link London with Delhi and Mumbai, and hospitals’ international desks work in English. Our guide to treatment in India from the UK covers the practical journey end to end.
The price side has one non-negotiable rule: a written, itemized quote for your specific case is the only real number. It should name the implant class, the room nights included, and the exclusions — extra days, complication management, post-discharge physiotherapy — because the exclusions are where budgets slip in any country. Our article on what treatment in India really costs shows what those quotes look like and how to compare them. Note also that UK private insurers do not generally cover planned treatment in India, so this route is self-pay by default; confirm with your own insurer rather than taking our word for it.
The three routes, side by side
| NHS wait | Private in the UK | India | |
|---|---|---|---|
| What you pay | Nothing at the point of use | The full package price (PHIN city averages above) | The full itemized cost, plus flights and stay |
| What sets your timing | The public list and your urgency classification | Your surgeon’s and hospital’s schedule | Your admission date, planned around you |
| What to verify | Your trust’s current position; your priority classification | What the package excludes; the consultant’s separate fees | The exclusions list; the implant named; follow-up plan |
| What it does not change | Your clinical position in the queue | Your NHS entitlement | The clinical question: is the operation right at all? |
One row deserves emphasis: none of the three routes answers whether the advised operation is the right one. That question sits in front of all three, and it is answerable from home, from the reports you already have.
The independent read that belongs before all three
A written second opinion from a specialist relevant to your condition reviews your diagnosis and the advised treatment, sets out the alternatives, and gives you the questions worth taking back to your own surgeon — without affecting your place on any list and without committing you to any route. Ours is $150, with every fee published before you share a single report; the second opinion service page explains how it works. If the honest conclusion is that the NHS plan you are on is right, we will say so — that is a good outcome, not a failed sale.
Sources
- The NHS Constitution for England — Department of Health and Social Care. Establishes the right to access certain services commissioned by NHS bodies within maximum waiting times — the constitutional basis of the 18-week right referenced for the NHS route. Accessed 5 October 2026.
- Guidance on NHS patients who wish to pay for additional private care — Department of Health (England), 23 March 2009. Paragraph 4.1 establishes that where a patient opts to pay for additional private care, their entitlement to NHS services remains and may not be withdrawn. Grounds the claim that paying privately does not cost you your NHS place. Accessed 5 October 2026.
- Average private hospital package prices — Private Healthcare Information Network (PHIN). Publishes average self-pay package prices by city from data collected in March 2026: hip replacement packages about £13,847–£17,540, knee replacement about £14,341–£18,236, cataract surgery about £2,522–£3,417 per eye; notes packages usually cover surgeon, anaesthetist and hospital fees but may not include the first consultation and some extras. Grounds the UK private price figures and the package fine print. Accessed 5 October 2026.
- NHS consultant-led Referral to Treatment Waiting Times — NHS England (via our RTT explainer). Our separate article carries the sourced waiting-list figures and specialty detail, so no waiting-time statistics are restated here. Accessed 5 October 2026.