This documentary is by Giorgio Bounous and James Spry.
This is the story of a public-private partnership gone wrong: private cataract surgery within the NHS.
The NHS created enterprise-friendly contracts to speed up the waiting times for common treatments: cataract surgeries, ADHD, and weight loss injectables. Ostensibly it means lower waiting times. In reality, it leads to unnecessary treatments, rejected patients and millions of pounds flowing out of the NHS, and into private companies.
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Every year, more than 300,000 people in England undergo cataract surgery—a routine and usually safe procedure that restores vision by replacing the eye’s clouded lens. But in recent years, the delivery of this care has shifted from NHS hospitals to private providers. The government claims it’s about increasing capacity and reducing wait times, critics say the reality is far murkier—and potentially dangerous.
Over the last six years, the number of private cataract clinics operating in England has exploded from just 19 to over 150. Companies like Spamedica, CHEC, ACES, Optegra, and Newmedica now dominate the market. In 2023 alone, these five providers received £536 million in payments from the NHS—of which an estimated £169 million was private profit.
David Rowland, Director of the CHPI think tank warns that this surge in outsourcing is not just siphoning funds from the NHS, but also draining its talent pool. Many experienced eye surgeons now split their time or leave entirely for better-paid work in private settings.
“Very large amounts of money are leaking out of the NHS,” he says.
For most patients, cataract surgery is quick and effective. But when it goes wrong, the consequences can be devastating. As part of the film, we spoke to Nick Tinsley, a 68-year-old from Bootle, Liverpool, whose vision deteriorated after a botched cataract procedure in 2023.
Nick says his life has been turned upside down. “My eyesight is a lot worse after the operation,” he says.
We also spoke to Sasha Rodoy, a campaigner and former laser eye surgery patient, who has been supporting Nick and others like him. As “I despise this industry.”
Despite repeated requests, none of the major providers agreed to take part in the investigation. The Department of Health and Social Care also failed to respond, although a Freedom of Information request revealed the government hasn’t met with any of the five main companies in the last five years.
What started as a way to relieve NHS backlogs is now raising serious questions about oversight, accountability, and patient safety. As the private sector’s role in essential healthcare grows, the UK must reckon with the true cost of outsourcing—and ask whether the drive for profit is blinding us to the risks.
