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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell Health policy editor

Public satisfaction with NHS sinks to lowest level since 1997

Sad old woman wearing a face mask looking out the window
Four in 10 people in England are now either on the NHS waiting list or have a family member who is. Photograph: Solarysys/Alamy

Public satisfaction with the NHS has sunk to its lowest level since 1997, with just 36% of voters content with the way the health service is run and performing.

More people in England, Scotland and Wales are now dissatisfied (41%) with the NHS than are satisfied for the first time since 2002, according to research from the National Centre for Social Research (NatCen). Discontent then led to Tony Blair’s Labour government raising taxes to improve the service and introducing targets to ensure speedy care.

Satisfaction has dropped 17% since 2020 – the biggest drop since records began in 1983. The collapse has been driven by frustration over long waiting times for all main types of NHS care, the service’s persistent staff shortages and a widespread belief that the government has denied it the funding it needs.

NatCen’s British Social Attitudes survey found the lowest levels of satisfaction with GPs (38%), dentists (33%), A&E (39%) and both hospital inpatient (41%) and outpatient (49%) services since it began tracking public attitudes.

The shift has occurred among people of all ages, income groups, sexes and party political affiliations.

The King’s Fund and Nuffield Trust thinktanks, which published the findings, said they were unprecedented and represented “the most extraordinary set of results we have seen”.

The Covid pandemic and the ensuing disruption to NHS services have deepened the fall in satisfaction but unhappiness – especially with access to GP appointments and routine surgery – was evident well before then. The NHS has seen a decade-long funding squeeze and a failure to address the chronic lack of staff, the thinktanks added.

“People are often struggling to get the care they need, and identified access to general practice, waiting times for hospital care and staff shortages as areas that need to improve,” said Dan Wellings, a senior fellow at the King’s Fund.

While the pandemic’s arrival in 2020 initially created “a halo effect” around the NHS, this gave way last year to more negative public attitudes when people “were seeing other services opening up [and] thinking ‘well, why isn’t the NHS opening up?’” he added.

About four in 10 people in England are now either on the 6.1 million-strong waiting list for planned NHS care or have a family member who is. “That’s the story behind the frustration – people deteriorating and in pain, people visiting their GP because they can’t get into hospital because of the waiting lists,” Wellings said.

In better news for the NHS, the representative survey of 3,112 Britons undertaken in September and October found strong enduring support across voting lines for its founding principles: that it is funded by general taxation and available free of charge. The public also remain happy with the quality of care they receive and with the attitude and behaviour of staff they encounter when being treated.

“People can be very supportive of the NHS and be dissatisfied simultaneously,” said Prof John Appleby, the Nuffield Trust’s director of research and chief economist.

Wellings declined to draw parallels with high public dissatisfaction now and the discontent that was a key issue in the 1997 general election, and which contributed to the defeat suffered by Conservative prime minister John Major.

But the dissatisfaction could coalesce into a political problem for Boris Johnson, he added. “It’s a very worrying set of findings for the government, given the place of the NHS in the British public’s mind and fact that it’s one of the key issues that people vote on at election time.”

The Department of Health and Social Care did not comment directly on the findings. A spokesperson said: “The pandemic has placed enormous pressure on the NHS, which is why we are focused on recovering from the impact of Covid and delivering reform. We have set out our plan to tackle the Covid-19 backlog, backed by our record multibillion-pound investment over the next three years.

“We have seen record numbers of staff working for the NHS this year, with over 4,300 more doctors and over 11,700 more nurses compared to last year, and we recently commissioned the NHS to develop a long-term workforce strategy.”

Prof Martin Marshall, the chair of the Royal College of GPs, said he was “extremely disappointed and saddened” at the record low satisfaction with GP services. He highlighted family doctors’ key role in the Covid vaccine rollout and pointed to the major problems besetting the GP workforce as the key reason some patients struggle to get an appointment.

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