In June 2025, over 200,000 people in England were waiting for an autism assessment. Nine in ten had already waited longer than the 13-week timeframe recommended by NICE.1

For hundreds of thousands of families, the choice is simple: pay privately now or wait years for support.

Investors have noticed. Private equity firms acquired 574 autism service sites in the United States between 2015 and 2024, with almost 80% of those deals occurring between 2018 and 2022.2 As demand for neurodiversity services continues to grow, capital is increasingly flowing into a market built around one of healthcare's biggest bottlenecks.

The question is no longer whether autism services have become a business. It is who should profit from Britain's autism waiting list crisis.

Demand Is Growing Faster Than Systems Can Respond

The rise in autism diagnoses has become one of healthcare's most debated trends. In the UK, the prevalence of autism among 16 to 20-year-olds reached 4.5% in 2023, while Sweden reported a prevalence of 3.9% among the same age group in 2021.3 The numbers have increased across virtually every demographic, although growth has been particularly pronounced among White populations and those with parents born in Sweden.

Data caveat: These figures come from a preprint that has not yet been peer-reviewed, and they track recorded diagnoses rather than underlying prevalence. Whether the rise reflects a genuine increase or improved recognition – the question raised below – is precisely what a diagnosis count alone cannot resolve.

Whether this represents a genuine increase in prevalence or simply better recognition remains heavily contested. Greater awareness, reduced stigma and improved screening have undoubtedly played a role. Children who may have previously gone undiagnosed are now being identified earlier, while growing awareness among adults has fuelled a wave of late diagnoses.

At the same time, expectations around support have changed. Parents, schools and employers increasingly recognise the importance of obtaining formal diagnoses to access specialist services, educational support and workplace accommodations. For many families, an assessment is no longer viewed as optional, but as the gateway to appropriate care.

The problem is that public services have struggled to keep pace. The Children's Commissioner found that some children wait more than two years before their first contact with certain services, with school nursing referrals taking a median 923 days.4 Meanwhile, the average wait for an autism assessment in England now exceeds sixteen months.5

Why Investors Love Autism Services

Healthcare investors are ultimately looking for the same thing: growing demand, predictable revenues and fragmented markets that offer room for expansion.

Autism services tick all three boxes.

Demand continues to rise, while long waiting lists create a steady flow of patients seeking private assessments and therapies. Unlike many areas of healthcare, autism support often involves long-term relationships with families, creating recurring sources of revenue rather than one-off interventions. At the same time, the sector remains highly fragmented, with thousands of independent providers operating across different regions.

Private equity firms have moved aggressively to capitalise on this opportunity. Researchers at Brown University found that investors acquired 574 autism service sites across the United States between 2015 and 2024, with almost 80% of those deals taking place between 2018 and 2022. The study also found that investment activity was concentrated in states with higher autism prevalence and fewer restrictions on insurance coverage.2

Data caveat: The hard numbers on private equity consolidation – the 574 centres, and the CARD case discussed below – come from the United States, where autism therapy is funded largely through insurance and Medicaid. Comparable, systematically collected data on private equity ownership of UK autism services is not yet available, so the US evidence is best read as indicative of the model rather than a direct measure of the British market.

Supporters argue that this capital is desperately needed. Earlier this week, Cathay Capital launched Ascendia Autism Care, a new platform operating across eight states with 20 centres and hundreds of clinicians.6 The firm says its role is to provide operational support and resources that allow providers to reach more children without compromising quality.

From an investment perspective, the appeal is obvious. Autism services combine strong social demand with high barriers to entry, specialist workforces and opportunities for consolidation. In many ways, they possess the same characteristics that have made healthcare one of private equity's most attractive sectors for decades.

The question, however, is whether financial returns and patient outcomes always move in the same direction.

Can Profit and Patient Care Coexist?

This is where the debate becomes far more complicated.

Supporters argue that private investment is helping to solve a problem that public services have struggled to address for years. Additional capital can fund new clinics, hire specialist staff and expand access to therapies that families desperately need. Without outside investment, many providers simply would not have the resources to grow at the pace demand requires.

Cathay Capital has framed its investment into autism services in exactly these terms, arguing that operational support and long-term capital can allow high-quality providers to reach more children while maintaining clinical standards. From this perspective, profit and patient care are not mutually exclusive. Financial returns become a by-product of expanding access to essential services.

Critics, however, paint a very different picture.

A recent Guardian investigation into private equity ownership across children's and care services described intense pressure to expand rapidly, with former employees alleging that growth often outpaced managerial capacity. One staff member claimed that providers were encouraged to "employ anybody" to keep up with demand, leading to mistakes and high levels of staff turnover.7

The concerns extend beyond individual examples. The Center for Economic and Policy Research points to Blackstone's acquisition of the Center for Autism and Related Disorders (CARD) as a cautionary tale. Following the buyout, the company accumulated significant debt, closed more than 100 sites and eventually filed for bankruptcy in 2023. Critics argue that private equity firms often prioritise financial engineering over long-term service provision, despite having little or no expertise in autism care.8

Researchers at Brown University have echoed some of these concerns. They warn that the incentives driving private investment could encourage providers to increase the intensity of care beyond what is clinically necessary, creating additional pressures on state healthcare budgets and potentially widening inequalities in access.9

Yet the reality is unlikely to be entirely one-sided.

Private investment did not create Britain's autism waiting lists, nor did it create the growing demand for neurodiversity services. But as public systems struggle to cope, investors are increasingly stepping into the gap. The challenge for policymakers is ensuring that financial incentives remain aligned with patient outcomes, rather than allowing one to come at the expense of the other.

Final Thoughts

The market for autism services exists because the need for support exists.

Families need assessments, therapies and long-term care, while public systems are struggling to keep pace with rising diagnoses and growing awareness. For many, the private sector is no longer an alternative. It is the only realistic option.

Private capital did not create Britain's autism waiting list crisis, but it is increasingly positioning itself as part of the solution. Additional funding, operational expertise and the ability to scale services could help thousands of families access support far more quickly than would otherwise be possible.

Yet healthcare markets are different from other industries. When financial returns become disconnected from patient outcomes, the consequences are measured not in quarterly earnings, but in the quality of care that vulnerable children and families receive.

The question, therefore, is not whether investors should make money from autism services. The reality is that they already do.

The more important question is whether Britain can build a system in which expanding access, improving outcomes and generating financial returns all happen at the same time.

Who should profit from Britain's autism waiting list crisis may be the wrong question entirely.

Footnotes

  1. Autism Statistics, July 2024 to June 2025 (opens in a new tab), NHS England Digital, 14 August 2025. ↩

  2. Private Equity in Autism Services (opens in a new tab), JAMA Pediatrics, 5 January 2026. ↩ ↩2

  3. Changes in the profile of adults diagnosed as autistic since 2010: population based studies in the United Kingdom and Sweden (opens in a new tab), medRxiv, 28 May 2026. ↩

  4. Waiting times for assessment and support for autism, ADHD and other neurodevelopmental conditions (opens in a new tab), Children's Commissioner for England, October 2024. ↩

  5. Autism assessment waiting times (opens in a new tab), National Autistic Society, 13 November 2025. ↩

  6. Cathay Capital Launches Ascendia Autism Care, Backed by 20-Center Network (opens in a new tab), Behavioral Health Business, 1 July 2026. ↩

  7. 'Treating children like cattle': what happens when private equity takes over a UK care home? (opens in a new tab), The Guardian, 28 June 2026. ↩

  8. Pocketing Money Meant for Kids: Private Equity in Autism Services (opens in a new tab), Center for Economic and Policy Research, 14 June 2023. ↩

  9. Private equity firms acquired more than 500 autism centers in past decade, study shows (opens in a new tab), Brown University, 7 January 2026. ↩