Why you should care
The National Health Service is struggling to hold on to public goodwill, despite a cash infusion.
Public satisfaction with Britain’s taxpayer-funded National Health Service (NHS) has fallen again, despite a big injection of cash into the system as other government-run services continue to suffer far greater austerity.
Waiting times for treatment, staff shortages and inadequate funding were the top three concerns among those who were dissatisfied with the NHS last year. The work was carried out shortly after Prime Minister Theresa May announced an extra $26.6 billion per year for the NHS by 2023–24.
Following a sharp drop in 2017, public satisfaction with the NHS fell by a further 3 percentage points in 2018 to 53 percent, its lowest level for more than a decade.
That’s 16 percentage points below its peak of 70 percent in 2010, according to the King’s Fund and the Nuffield Trust, which analyzed data from the British Social Attitudes survey. Despite the evidence of discontent, there is no sign of people cooling on the U.K.’s model of state-funded health provision. The founding principle of the NHS, that it should be free at the point of use, remains one of the main reasons people are happy with the service. Some 62 percent of satisfied respondents mentioned it.
The survey, undertaken over the past 35 years and considered the most authoritative measure of opinion on the NHS, also reported an increase over the past three years in the proportion who cited quality of NHS care as a reason for their satisfaction. It stood at 71 percent.
Respondents’ impressions of hospital services improved in the past year. Satisfaction with inpatient services was 63 percent, but this represented an 8 percentage point increase on the year, taking it to its highest level since 1993. Meanwhile, a 5 percentage point year-over-year increase in satisfaction with outpatient services took it to 70 percent, the highest level since the survey began.
Satisfaction with both inpatient and outpatient hospital services was higher among those who had recent personal experience with them, either as a patient, or relative or friend of one, compared with those who lacked a similar personal insight.
However, one of the most striking findings was the level of dissatisfaction with general practice, which, at 63 percent, remained at its highest level since the survey began in 1983.
Underlining the potential significance of a long-delayed document on the future of social care due to be published by April, satisfaction with social care services stood at just 26 percent, little changed from the year before.
Ruth Robertson, a senior fellow at the King’s Fund, says that in the short term at least “the promise of more money doesn’t appear to buy satisfaction.” Cash alone would not solve long-standing issues such as staff shortages and waiting times, which, she pointed out, were driving people’s dissatisfaction.
For the Nuffield Trust, John Appleby, chief economist, says the level of satisfaction with general practitioners — historically the service people were most satisfied with — “may reflect continued strain on general practice, with mounting workloads and staff shortages, and the evidence shows that people are finding it harder to get appointments than before.”
Yet the NHS long-term plan, published in January, “expects even more of general practice, [so] these problems will need to be addressed quickly if that vision is to be made possible,” Appleby adds.
An NHS spokesperson said the results “as a whole understandably reflect a health service still under pressure” but insisted the long-term plan “sets out an effective blueprint for making the NHS fit for the future as funding comes on stream and does so on the back of the public’s enduring support for NHS services.”
Niall Dickson, who leads the NHS Confederation, representing health and care organizations, says the findings showed “the inevitable consequence of starving the NHS of funding for the best part of a decade.”
“We should be under no illusions about the scale of the task we face to restore public confidence in the health service,” he adds.
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