When Leigh White remembers her brother Ryan, she thinks of a boy of extraordinary ability who “won five scholarships at 11” including a coveted place at Bancroft’s, a private school in London. He was, she said, “super bright, witty, personable, generous and kind”.
Ryan killed himself on 12 May 2024. A report written after his death acknowledged significant shortcomings in the support he received while seeking help for attention deficit hyperactivity disorder.
Ryan had followed the “right to choose” pathway, whereby patients can pick a private provider anywhere in the country for assessment, diagnosis and initial treatment. They then ask their GP to enter a shared-care agreement for prescriptions and monitoring. However, Ryan struggled to get the two services to link up.
The problem lies in the fact that shared care is voluntary and not all GPs agree to it. Some patients told the Guardian their doctor had rejected their private diagnosis on the grounds that it did not meet their standards. This was even after the NHS had paid for it – and despite there being no official rules for private providers to follow. Some, like Ryan, end up stuck in administrative limbo.
Ryan is one of many people who have been failed by the right to choose system. Psychologists and psychiatrists who spoke to the Guardian shared their concerns that allowing NHS patients to obtain ADHD assessments at private providers was “premature” and had led to a “wild west”.
Right to choose was introduced for mental healthcare and neurodevelopmental care in 2018, in part to ease pressure on waiting lists that were up to a decade long.
But Marios Adamou, a consultant psychiatrist and founder of the UK Adult ADHD Network (UKAAN), said this had come too soon, because “there was no standard in what good assessment looks like and there’s still no standard for what a qualified assessor would look like”.
Right to choose was “poorly regulated, poorly managed and some people are making lots of money out of it”, Adamou said, adding: “If you don’t have regulation for that you are inviting a wild west.”
Source: The Guardian, 13 January 2026
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