The Portland Charity announcement and what it reveals
A Nottinghamshire disability charity announced with a digital PR campaign that it’s offering autism and ADHD assessments for £2,000 per person. The Portland Charity, which runs Portland College in Mansfield, frames this as responding to “hefty NHS waiting lists.“
The MSN article this announcement came through — purely commercial PR, dressed up as journalism — presents this as a charitable service. A solution to a problem. Helping people access diagnosis they desperately need while the NHS fails to keep up with demand.
Here’s what the announcement actually reveals: charities (charities!) are now profiting from diagnostic gatekeeping, at £2,000 per assessment (considerably higher than the average private pricing), because the neurodivergent treatment industrial complex system deliberately creates both the scarcity and the demand, and the reasons why it all continues rising exponentially.
So we now have not-for-profit neurodiversity organisations charging two grand for assessments that should already be freely available through our public healthcare system that is meant to be “free at the point of use”. And nobody questions whether this might indicate something fundamentally broken about how we’ve structured access to support.
The National Autistic Society reports over 200,000 people currently waiting for NHS autism assessments, with some waiting years despite government guidance stating nobody should wait longer than 13 weeks.
Two hundred thousand people. Thirteen-week guidance routinely ignored. Years-long waits becoming standard.
Into this gap step private companies, assessment clinics, and now charities — all charging between just below £1,000 and way beyond that for something that should be publicly funded. The Portland Charity have now sat at that table.
£2,000. Charity. Okay.
Why charities now profit from diagnostic gatekeeping
The Portland Charity states the money from assessments “will go back into the charity, supporting facilities at the college, including specialist equipment and wheelchairs.”
Noble. Except: why does a disability charity need to charge disabled people £2,000 for diagnostic assessments to fund facilities? Why has charitable infrastructure become dependent on extracting payment from the population it exists to serve?
This is where the real scrutiny is, not necessarily towards the charity themselves — as I’ll be clear, if I had in my employ those who could diagnose, I’d be sat at that table, too. There’s demand, after all. And providing a solution to that demand is charitable in and of itself, so by sitting at that table The Portland Charity have just secured themselves a brace
But why? Because we’ve built a system where diagnosis operates as the primary gatekeeping mechanism for all support, creating permanent demand, while simultaneously ensuring supply remains artificially constrained through underfunded public services.
This isn’t a bug. It’s the design.
I’ve written about this as “the neurodivergent treatment industrial complex” — the self-perpetuating cycle thanks to the emergence and combination of industrial standardisation and the medical model of: pathologise, diagnose, treat, repeat. Each stage requires the previous one. You can’t treat without diagnosis. Can’t diagnose without pathologisation. Can’t pathologise without deficit frameworks positioning neurodivergent traits as disorders requiring correction.
The system functions beautifully. For everyone except the people trapped within it, that is.
NHS waiting lists grow, as it’s an institution fundamentally failing at almost everything it was built to do, and totally dependant on the required tumours (contracts with private companies that serve the people its most to serve for it). So the private companies profit. With assessment clinics multiplying. And now charities join that extraction economy, charging £2,000 for access to labels people need to function in systems built without them in mind in the first place.
The Portland assessment process: self-referral, behaviour observation, questionnaires around mental health, activities to observe responses to different environments, examination of “eye contact” and speech patterns, interviews with someone who knows the person well, two assessors meeting to give final diagnosis, detailed report produced.
Standard diagnostic procedure. Nothing exceptional. Available through NHS for free — if you’re willing to wait years. Available privately for £2,000 if you have the money now.
And if you don’t have £2,000? Ha, well that’s it isn’t it? You wait. Or you stay as you are, navigating systems that punish your cognitive differences while being unable to explain why basic tasks feel impossible. That’s the system. Is what it is.
The pathologise, diagnose, treat, repeat cycle
Here’s the pattern I’ve documented:
Pathologise: Frame neurodivergent traits as deficits requiring medical classification. Attention Deficit Hyperactivity Disorder, and Autism Spectrum Disorder. The language positions cognitive differences as deviations from norm requiring correction.
Diagnose: Create gatekeeping mechanisms requiring expert validation before any support becomes accessible. You can’t just be someone who struggles with time management and focus — you need a professional to confirm you have ADHD. Can’t just be someone whose brain processes social interaction and sensory information differently — you need formal autism diagnosis.
Treat: Once diagnosed, you enter treatment pathways: medication, therapy, workplace accommodations, educational support. All contingent on maintaining diagnostic status. All funded through systems that profit from ongoing treatment.
Repeat: The population aware of these categories grows. Self-diagnosis surges. Demand for formal assessment explodes. Waiting lists extend. Private pathways multiply. Costs rise. The cycle accelerates.
Each stage depends on the previous. Remove diagnosis requirements, and the treatment industry loses its gatekeeping mechanism. Remove pathologisation, and diagnosis becomes unnecessary. Remove the requirement that people prove deficit to access support, and the entire structure collapses.
Which is precisely why it won’t collapse voluntarily.
The Portland Charity announcement is just the latest iteration. Charities now profiting from diagnostic gatekeeping at £2,000 per assessment represents the system’s expansion, not its failure. When even non-profit organisations depend on charging disabled people for access to labels they need to function, you’re simply witnessing the industrial standardisation of extraction.
So who benefits from the NHS waiting lists and neurodiversity failures?
Not the people in need, obviously.
The beneficiaries are clear:
Private assessment clinics charging £1,000+ per diagnosis, with implicit longer-term financial entrapment (titration, follow-ups, etc), operating at capacity with months-long waiting lists themselves, generating millions annually from demand the NHS refuses to meet.
Pharmaceutical companies whose ADHD medication prescriptions surge alongside diagnosis rates, creating permanent customer bases requiring ongoing prescriptions to function in incompatible systems.
Consultancy firms selling neurodiversity training and neurodiversity consulting to corporations who need to appear progressive without restructuring hostile work environments, charging tens of thousands for awareness sessions that change nothing.
HR departments who can point to accommodation policies and neurodiversity initiatives while three-quarters of autistic workers receive nothing and employment rates remain lowest of any disability category.
Charities (now eating at the table) like Portland who can now further fund (they weren’t already struggling) their operations and executives through diagnostic assessment fees, creating dependency on the very gatekeeping mechanisms that create the problems they exist to address.
The article quotes India Golder-Wood, an assessor at Portland: “Being neurodiverse can show up as anxiety and depression and it’s neither. So some people go their whole life thinking ‘I’m depressed’ when it’s actually burnout.”
Correct analysis. Wrong conclusion.
Yes, neurodivergent people often experience burnout misdiagnosed as depression. Not because they need better diagnostic access, but because the systems they’re forced to navigate are fundamentally incompatible with how their brains operate.
The solution isn’t more efficient diagnosis at £2,000 per person. It’s questioning why systems are built so rigidly around neurotypical baselines that anyone deviating requires expert validation, years-long waiting, and thousands in private fees to access basic support.
The article mentions Portland assessments are for “people aged 13 and above.” Note the lower age boundary expansion. As awareness grows and parents recognise traits earlier, diagnostic demand extends younger.
Meanwhile, adult diagnosis surges. People in their 30s, 40s, 50s finally understanding why they’ve struggled for decades, seeking formal validation to access workplace support or simply explain their own experiences to themselves.
This creates exponential demand growth. Every generation entering diagnostic awareness adds to waiting lists. But assessment capacity doesn’t scale at the same rate because training psychiatrists and clinical psychologists takes years, NHS funding remains constrained, and private pathways prefer maintaining scarcity that sustains premium pricing.
The gap widens continuously. Which means more Portland Charities emerging, more £2,000 assessment fees, more people choosing between years of waiting or immediate private payment.
Government guidance states nobody should wait longer than 13 weeks. Hundreds of thousands of people (only those that are documented, and disclosed to us, that is) currently violate that guidance. The government does nothing to enforce it. And the NHS and GPs hold their hands up and refer you elsewhere. Because enforcement would require taking responsibility and massively scaling assessment capacity, which would require acknowledging the system is designed to fail in the first place, and denying the “tumours” of their dough.
Easier to let charities charge £2,000 and call it “responding to NHS waiting lists.”
Their PR treats this as positive development — “Life-changing” assessments now available through charitable service. But the framing obscures the structural reality: we’ve built systems where charities can now profit by charging the disabled people they’re meant to serve thousands of pounds for the diagnostic labels they need to access that support because public healthcare refuses to even attempt to keep up with the demand IT created through its diagnostic gatekeeping requirements.
And, for them to even understand and discuss what I’ve just said in that one paragraph, they’d probably take a committee meeting each quarter for two years and then publish their findings that ultimately find what we already know, while leaving us unable to find the only information that matters — what are they going to do about it, and when, and why haven’t they already done it, and what are they then doing?
I struggle to see any charity here, just further extraction with the same old progressive branding.
Citations
MSN — Nottinghamshire charity running £2k autism and ADHD assessments in response to NHS waiting lists
