My Medical Gateway Blog

Reports suggest the government is exploring a new private finance model to build NHS facilities, with orthopaedic hubs likely among the first projects. NHS England is said to be developing an off-balance-sheet funding approach, while Treasury signals cautious support. Alan Milburn, now DHSC’s lead non-executive board member, has declared private-sector interests in health. Even if approved, such projects will take years – MMG offers patients immediate access to safe, timely orthopaedic care abroad without the wait.

Whispers around Whitehall suggest the government is exploring a reboot of private finance to build and equip parts of the NHS estate, particularly high-throughput elective facilities such as orthopaedic hubs. Nothing official has been announced, and the Treasury has recently sounded cautious. But a series of public signals points to a direction of travel that’s hard to ignore.  

First, the context: the NHS faces a multibillion-pound maintenance backlog and a pressing need for modern, ring-fenced elective capacity to cut waiting lists. Elective “surgical hubs” (notably in orthopaedics) have proved they can increase throughput by focusing on high-volume, low-complexity procedures and insulating planned care from emergency pressures. That model now underpins national efforts to recover productivity.  

Against that backdrop, reports in recent months indicate NHS England has been developing an off-balance-sheet private finance mechanism to fund parts of the estate – explicitly framed as not a return to the old, expensive PFI contracts of the 2000s, but still a form of private capital stepping in where public capital is constrained. Health leaders argue capital budgets are flat through 2028–29, making private investment one of the few levers left to upgrade infrastructure at pace.  

Official messaging remains cautious. In June, the Treasury said private finance would be used in “very limited circumstances” for public-sector infrastructure. Campaign groups have also urged ministers to rule out any PFI/PPP revival altogether. Yet the policy door has not been slammed shut, and the service imperative to add elective capacity is only intensifying.  

Where do orthopaedics fit? Orthopaedic procedures – joint replacements in particular – are the textbook case for elective hubs: predictable, high-volume, with clear pathways and measurable outcomes. The government’s earlier wave of surgical hubs already highlighted orthopaedics as a core use case (e.g., the Southwest London Elective Orthopaedic Centre), and any new financing model would likely prioritise similar “factory floor” theatres, diagnostics and recovery bays to tackle the backlog quickly.  

The Alan Milburn factor

One element adding fuel to the speculation is Alan Milburn’s current role and historic policy footprint. Milburn, Health Secretary under Tony Blair and a key architect of market-style NHS reforms two decades ago, was appointed lead non-executive board member at the Department of Health and Social Care (DHSC) in November 2024 and is publicly associated with the development of the government’s 10-year health plan. His appointment formalised months of behind-the-scenes advice.  

Crucially, DHSC’s Register of Board Members’ Interests shows Milburn’s private interests include majority ownership of A.M. Strategy Ltd (his advisory business) and an advisory/shareholding link with Bridgepoint Capital Ltd, a private-equity firm with historic investments in UK health services. Those interests are declared and managed under Whitehall rules, but their existence is relevant context whenever private finance for health infrastructure is discussed.  

None of this proves a “secret plan.” It does, however, show (1) a live policy problem (capital constraints plus huge elective backlogs), (2) a reported NHSE push to develop a new private finance tool distinct from legacy PFI, and (3) senior DHSC leadership – Milburn included – with deep experience at the public–private boundary. Put together, it’s reasonable to anticipate some form of private-capital route being floated for targeted projects, with orthopaedic hubs near the front of the queue.  

What this means for MMG users

For UK patients, the immediate impact is limited, because any financing model would take time to design, approve, procure and build. Even then, capacity gains would arrive gradually. Meanwhile, waits remain long and uneven across regions, and orthopaedics is one of the hardest-hit specialties.

That’s where MMG’s value is immediate and practical:

• Fast access to joint replacements and other orthopaedic procedures at accredited European centres that already operate on the hub model, with dedicated theatres, predictable scheduling and short inpatient stays.
• Transparent pricing for all-inclusive treatment packages supported by Klarna finance options integrated at booking.
• Continuity of care with remote pre-op assessments, post-op care in situ and coordinated post-op follow-up back in the UK.

If the UK does pivot to private finance for new elective capacity, even optimistic timelines mean relief will take years, not months. Until then, medical travel remains the pragmatic third way between years on a waiting list and costly, capacity-constrained private care at home.

MMG will keep tracking this closely. If you’re considering an orthopaedic procedure, you don’t need to wait for Westminster’s financing debates to resolve. Talk to us today about safe, timely options abroad – and get moving again, sooner.