Lord Ashcroft has conducted some interesting research into the views of the public on the NHS.  It’s a substantial piece of work with a poll of over 20,000 people and day-long discussions with 80 members of the public.

He found discussing the practicalities of the future of the health service was hard because the subject is laden with emotion: one of the participants  described the NHS as “the soul of Britain”. Talking about potential reforms, even when aimed at ensuring the sustainability of the service in the long term, felt to many like an affront and made  them defensive.  Public understanding of the NHS is poor.  Most participants did not realise that NHS spending had doubled in real terms under the last government; greatly overestimated the proportion of NHS staff who were managers or administrators, and the cost to the NHS of “health tourism”; and were surprised to learn that around nine in ten prescriptions were free, or that most GPs were self-employed.

He found that people could be divided into 5 segments:

  • ‘Concerned Status Quo’ (28%): They see little justification for large-scale reforms. They are the least likely to support proposals like the use of more private providers, consolidating services into bigger units, introducing charges or holding down staff pay as a means of easing financial pressure, and the most positive about increasing funding by borrowing more, reducing the deficit more slowly or cutting other areas of government spending. Younger, poorer, likely to vote Labour.
  • ‘Armchair Realists’ (24%) recognise that the NHS faces big challenges and say reform is needed, but are very sceptical about many of the potential avenues for change.  Well off, educated, likely to vote Conservative not UKIP.
  • ‘Cautious Reformers’ (19%) more positive than most about recent reforms and more comfortable with the use of  private providers, more likely than average to support linking treatment priority with lifestyle. Older, White, homeowners. Likely to vote Conservative or UKIP.
  • ‘Founding Idealists’ (17%) Less worried than other groups about bureaucratic waste, or lack of funding. Generally negative about recent reforms and oppose the use of private providers.  Young. Mostly Labour voters, but many won’t vote at all
  • ‘Entitlement Protection’ (12%)  Rate too many people using the NHS who have not paid into it as the biggest long term issue facing the service. More likely than average to think that people who  smoke, drink or eat too much should receive lower priority. Not highly educated. Poorer. Likely to vote UKIP or Conservative.

79% of those polled said they had used NHS services in the last six months:  70%  had visited their GP; 29% outpatient care;14% had
visited A&E.   74% of those who had experienced day surgery, inpatient care or A&E would recommend the service they had received to their friends and family.

When asked how good or bad they thought NHS services were in the country as a whole, the proportion awarding a good score fell to 30%. This was higher in Scotland (61%) than in England (56%) or Wales (53%).

There was almost equal agreement that “the NHS is one of the greatest health services in the world” (74%) and that “the NHS is very much under strain. Waiting times for elective care are going up, the four-hour A&E target is deteriorating and hospitals’ ability to get patients through properly is being affected (75%). It was notable that 80% of those aged 55  and over agreed that the NHS is one of the greatest health services in the world, compared with 64%  18 to 24 year-olds.  69% agreed with Andy Burnham (though without knowing he had said it) that the NHS “is heading for the rocks and we urgently need a plan to turn things around”, but only 45% agreed with Unite the Union that “David Cameron is wrecking our NHS” and 30% agreed with Dr Dai Samuel, Chair of the BMA Welsh Junior Doctors Committee who said “Looking at how bad the health service is, I would  not want to be a patient”. The lowest levels of agreement, however, were for statements suggesting the NHS had never been  better. Only 22% agreed that “the NHS has more doctors and more nurses than ever before” or that “fewer people than ever are waiting long periods for their operations” –both extracts from Jeremy Hunt’s Conservative Conference speech in October 2014, though respondents were not told this.

How big a problem do you think each of the following is for the NHS today?

(0 = not a problem at all, 10 = a very big problem indeed)

  • Too much being spent on management and bureaucracy: 8.21
  • Patients being denied drugs or treatments that could help them, because of cost: 7.60
  • Shortages of doctors, nurses and other clinical staff: 7.48
  • Variation in standards of care and treatment between different hospitals and areas of the country: 7.45
  • Hospital closures and other cuts: 7.40
  • Waiting times between diagnosis and treatment: 7.15
  • Low pay for NHS staff: 7.05
  • Trouble getting GP or other appointments at a convenient time: 6.87
  • Standards of cleanliness of hospitals: 6.45
  • Patients not being informed or involved in decisions about their own treatment: 6.26
  • The quality of nursing care provided in the NHS hospitals: 6.00

How much do you trust the following to tell you the truth about how the NHS is performing?

(0 = not at all, 10 = completely)

  • Your own personal experience: 8.10
  • Friends or relatives who work in the NHS: 7.64
  • Family and friends who have recently used the NHS services: 7.50
  • Your GP: 6.84
  • Organisations like the Royal College of Surgeons or the Royal Collage of Nursing: 6.76
  • Local TV or radio news: 5.52
  • National TV or radio news: 5.39
  • Local newspapers: 5.35
  • Unions like UNISON and Unite: 5.21
  • National newspapers: 4.85
  • Your local MP: 4.71
  • Andy Burnham, the Labour Shadow Health Secretary: 4.55
  • David Cameron: 4.09
  • Jeremy Hunt, the Conservative Health Secretary: 4.01

The full report – well worth reading – is here.

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2 Comments

  1. George Nieman says:

    The NHS is likely to fall under the present Government. Andy Burnham is the only person who can save it. We all know how to bring that about

  2. roehamster says:

    Amazed that ‘Belsen’ Burnham scored above 0. something. It is a monopoly provider: anyone who has been treated by it will feel grateful.

    I call it Stockholm Syndrome.

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