It doesn't work like that, though, pdq. With all the changes coming up in April, the processes are becoming clearer. If (for example) the new clinical commissioning groups only commission say 60 hip operations from one hospital, that's the amount of money that hospital has to perform that procedure - they couldn't then take your voucher and do another one. At the beginning of the financial year, they cost up how much 60 hip operations will be (including the staffing and accommodation and equipment to do that) and if the hospital bid is accepted, the CCG will hand over that amount of money for those operations. The private facilities you speak of then have to be paid for - your voucher would have to pay the consultant surgeon and all his team, over and above their NHS work (most do both). I can't see how your suggestion would work - and with the state of the NHS budget, there's no way people could "build up a pot for future use". If you want to build up a pot, you take out private health insurance.