Its difficult for me to say here because although my procedure was paid for by the NHS, the operation was carried out in a private hospital.
The pre op dealings with the MRI were brilliant, I could not fault the level of care or dignity that I was treated with. I was treated like a real person, no one made judgements about me only how to help me. Waiting times were ok on the days I attended the various meetings and clinical assessments, and everyone was polite.
My treatment in the Alexander was exactly that you which you would expect if you were paying cash, and why should it not be the NHS pay with cash too you know

The staff were great, my treatment was great, my surgeon was the best in the UK.
Aftercare is a bit patchy, but seeing as the MRI has lost the contract for WLS resulting in the team being split up, well I can live with that I guess.
I think where attitude issues arise, I think the patients attitude has a lot to do with it. If we are bolshy the people we are dealing with will mirror our attitude. If we act like second class citizens because we are getting it free, that's how we will be treated. If we act confidently and politely that's how we will be treated.
Obviously "paying customers" can take their business anywhere so there is always going to be a financial incentive for the provider to supply a great level of service