Public satisfaction with the NHS has fallen to the lowest level ever recorded, particularly for GP and dentistry services, according to analysis of the latest British Social Attitudes survey (BSA) published today by The King’s Fund and the Nuffield Trust.
Dissatisfaction was also at an all-time high, with more than half (52%) of respondents saying they were dissatisfied with the NHS.
The analysis shows that for the first time in the 41-year history of the survey, less than a quarter of people are satisfied with the way the NHS is running.
Satisfaction levels previously peaked in 2010, when seven in 10 people reported being satisfied with the health service.
Overall public satisfaction with how the NHS runs now stands at 24% – down 5% from the previous year.
Since 2020, satisfaction levels have fallen by 29 percentage points.
The National Centre for Social Research (NatCen) survey conducted in September-October 2023 found that long wait times were the top complaint among those dissatisfied with the NHS. Nearly three-quarters (71%) of the respondents cited delays in GP and hospital appointments as a major concern.
Staffing shortages (54%) and perceived underfunding (47%) were also significant contributors to dissatisfaction.
Since the 2015 survey, the vast majority of respondents have consistently expressed the view that the NHS has a major or severe funding problem, with 84% of respondents to the 2023 survey now sharing this view.
Support for tax increases
But a new question added to the 2023 survey, found nearly half (48%) of the public would support the government increasing taxes and spending more on the NHS.
Highest earners were more likely to choose this option.
Despite the record low levels of satisfaction with the NHS, public support for the founding principles of the NHS, which marked its 75th anniversary in 2023, was found to be as strong as ever.
The overwhelming majority of respondents expressed high levels of support for the principles when asked if they should still apply in 2023: that it is free of charge when you need it (91), primarily funded through taxation (82%) and available to everyone (82%).
Of those who were satisfied with the NHS, the top reason given was because NHS care is free at the point of use (66%), followed by the NHS having a good range of services and treatments available (53%) and the quality of NHS care (52%).
As with previous years’ surveys, when asked what the most important priorities for the NHS should be, the top two cited by respondents were making it easier to get a GP appointment (52%) and increasing the number of staff in the NHS (51%).
Improving waiting times for planned operations and in A&E were chosen by 47% and 45% of respondents respectively.
Turning to government choices on tax and spending on the NHS, 48% chose ‘increase taxes and spend more on the NHS’, 42% chose ‘keep taxes and spending the same’, and 6% chose ‘reduce taxes and spend less on the NHS’.
Those in the highest monthly household income quartile were more likely to choose ‘increase taxes and spend more on the NHS’.
GP and dentistry services satisfaction levels decline
The survey also measured public opinion on specific NHS services. The think tanks’ analysis revealed that public satisfaction with GP services – historically the service with the highest levels of public satisfaction – now stands at 34%, marking the lowest level recorded since the survey began.
Since 2019, satisfaction with GP services has declined by 34 percentage points.
While satisfaction with NHS dentistry plummeted to a record low of 24%, public satisfaction with inpatient services was also at a historically low level (35%) as was satisfaction with outpatient services (44%). A total of 31% said they were satisfied with A&E services, up by one percentage point on the previous year.
Depressing but not surprising
Dan Wellings, senior fellow at The King’s Fund, said: “These results are depressing but sadly not surprising. The NHS has seen no respite from the issues that have led to an unprecedented downward spiral in public satisfaction in recent years.
“With the health service increasingly unable to meet the expectations and needs of those who rely on it, public satisfaction with the NHS is now in uncharted territory.
“The size of the challenge to recover it is growing more difficult with each passing year.
“Ahead of the upcoming general election, political leaders should take note of just how far satisfaction with this celebrated public institution has fallen.
“The public are clear that they want shorter waits for care, better staffing levels and more funding. Despite the challenging economic circumstances, our analysis suggests that one in two people may be prepared to pay more for the NHS through taxation, especially those with the deepest pockets.”
Need to be frank and realistic
Jessica Morris, fellow at The Nuffield Trust, said: “The next government will inherit an NHS with a record low level of satisfaction with the way in which it’s running.
“It is worrying how consistent this is across different NHS services, with inpatient, outpatient, dentistry and GP services reporting record low levels of satisfaction.
“As we approach a general election, political parties should be frank and realistic about the challenges ahead of them if they are to turn this situation around.
“Despite such low levels of satisfaction, the public continue to back the principles underpinning the NHS.
“The public has not fallen out of love with the idea of a publicly funded, free at the point of use NHS, but they are losing confidence that it will support them and their loved ones in the best possible way when they need it.”
Private sector commitment to support NHS is as strong as ever
David Furness, director of policy at the Independent Healthcare Providers Network (IHPN), added: “Today’s figures, which show the lowest levels of public satisfaction with the NHS on record, are not easy reading and are testament to the enormous challenges currently facing the health service.
“For decades now, the independent sector has worked with the NHS to deliver high quality, universal care which is free at the point of use for patients.
“This commitment to supporting the NHS is stronger than ever, and independent providers are ready and willing to play are part in delivering what really matters to the public – tackling the NHS backlogs and providing high quality and accessible patient care.”