BigBettha1 - it stopped fairly soon after that. 2 factor were in play;
1. the much longer waiting lists, so that we could be seen as 'jumping the queue'. If you are fast tracked through a system were the wait isn't long, it's a small perk; being fast tracked when waiting lists were 18 months is more visible.
2. the fragmentation into 'internal competition'. When I started in the NHS if you worked for hospital X, you got seen quickly there. Later, if you worked there, but lived in area Y, especially if area Y didn't have a contract with hospital X, it got messy.
Of course it's wrong, but it's a sign of how bad things have become.
And yes, purchasing from private providers has been the norm for a long time now. I hate it, but felt obliged to accept a referral to our local private hospital a few years ago. The local commissioning group had handed over all joint replacements to them, and insisting on a NHS referral would have been awkward for everyone, as it would have taken up precious admin time to organise.
It was very interesting. They had separate waiting rooms. In the NHS room, instead of the usual posters about health promotion and support groups, all of the posters were advertising their services 'only £x for such-and-such service' (nonsense of course, because anything difficult would be referred to the NHS).There were separate menus; and NHS patients were last for all non-urgent care, such as washing, physio, and discharge.
The nursing care was OK, but not the quality I was used to in the NHS.
My follow-up appointment has been re-arranged 4 times at the last count - it is now a year since I should have been seen.
Please don't think I am complaining, I am fortunate to have had care, and to be doing OK. It's just not a good or efficient system, but it suits our current government.