Does the NHS discriminate against children who attend private school?

Independent

09-06-2025

On the face of it, the idea that the NHS would withhold treatment to a child with special needs because they attended private school is a clear outrage. I say this as someone who went to a state school, whose children are schooled in the state sector, and who supports VAT on school fees.
The NHS has, however, flatly denied the Mail on Sunday 's exclusive about it happening, a story about yet another 'two-tier' system operating in Britain – see also justice and policing – which has predictably grown legs, with other such incidents now being reported.
'The story is not true,' the Department of Health & Social Care said in a statement, 'NHS services are free at the point of use to all.' Well, yes, that's the theory – but we'll get to that.
'NHS occupational therapy services are provided for all children with an Education, Health and Care Plan (EHCP). For those without an EHCP, some schools provide on-site NHS occupational therapy,' it continued.
So what's going on here? Let's run through the story first. I'm going on what has been reported, because the mother wished to remain anonymous – understandably, at a time of polarisation, when nasty social media pile-ons for perceived wrong-think are all too common.
We are told that her eight-year-old son was referred to a paediatrician at Kingston Hospital in south-west London after she noticed he was 'struggling to hold the pen well enough to write properly', along with other mobility issues.
It was at the hospital that the problems arose. She was asked to fill in a form which included the question: 'Where does your child go to school?'
The mother hoped for an appointment at the children's occupational therapy service in Richmond for a crucial part of his assessment. However, days later, she received a text message saying the child had been declined.
She claimed the specialist unit wrote a letter to her GP saying that it was 'only commissioned to provide a service' to children in mainstream schools.
Point of order: Many children with disabilities don't attend mainstream schools, and some of those who go private do so with funding from local councils because of the gaps in state provision. But let's move on.
The website of the Kingston & Richmond NHS Foundation Trust states: 'Children and young people of school age can be referred via their School SENCo [Special Educational Needs Coordinator] for assessment if they attend a state-funded Richmond school and have a Richmond or Kingston address.'
A spokesman declined to address claims by the Mail on Sunday that pupils from private schools had been discriminated against, but 'apologised if the wording in our correspondence caused upset": 'We are in the process of revising it to ensure greater clarity.'
Which is about as clear as mud. Nevertheless, he added: 'Occupational therapy services are available to all school-age children who have an Education, Health and Care Plan either through the NHS or the local authority. For children without an EHCP, advice may be available through existing NHS services provided in state school.'
Here's where it gets kafkaesque: EHCPs are extraordinarily hard to get, even if you do have mobility issues and struggle to hold a pen. It took us years of exhausting battles to secure one for our eldest, who has autism.
You need a battery of assessments to get past first base, often including occupational therapists. It is obviously problematic if you can't get occupational therapy without an EHCP in the first place.
By now, you've probably guessed that this appears to be a case of 'heads we win, tails you lose'. Your name's not on the list, you're not getting in for this, that, or any other service you might need.
My reading of this story is that it is less about discrimination against private schools than it is yet another case of the NHS using any excuse to say no – and of the horrible bureaucratic hellscape that parents with children with special educational needs and disabilities are thrown into.
It is a system that crushes those involved with it. It is like being constantly hit on the head with a sledgehammer while being stretched on a medieval rack.
As a family, we've been in the same boat with occupational therapy services: denial of service followed by letters followed by the runaround. At one point, in despair, we went to see our local MP Wes Streeting who is now – ding ding ding! – the health secretary.
It doesn't much matter if your child is in the private or the state education system. If they have special needs or disabilities, they and their parents will rapidly come to the conclusion that all the agencies supposed to assist them – the NHS, the local authority, sometimes even the school – are actually against them.
That, for me, is the takeaway from this story. It is about a scandalous failure to provide assistance to children who need it.
Reform has been repeatedly promised, but we all know that money is tight. Worse still is the fact that bad actors – by which I mean some of the worst local authorities – appear to have the government's ear.
Perhaps stories like this will make ministers think twice before listening to them?
As for the NHS, it was set up to treat people. It shouldn't matter if your children are schooled publicly or privately. Nor should your postcode play a role. Nor whether or not you have a disability. But the battles I have had to fight in order to overcome what feels like institutional ableism could fill a book.
We all pay for the service with our taxes, and we should be able to access necessary treatments. Occupational therapy for a child with mobility issues clearly qualifies, regardless of where they go to school. It really shouldn't be this hard.