Public confidence in the National Health Service has plummeted to its lowest level since records began, with only 21% of Britons expressing satisfaction with the state of the NHS according to the latest British Social Attitudes survey. The findings have sent shockwaves through the healthcare community and prompted urgent warnings from senior NHS leaders about the service's relationship with the public.
A Damaged Relationship With the Public
Jim Mackey, chief executive of NHS England, delivered a stark assessment at this week's King's Fund annual conference, stating that the health service has "damaged our relationship with the population and it's their service." He emphasised that public satisfaction represents one of the most critical targets for the NHS, alongside staff satisfaction surveys that reveal only 64% of employees would recommend their own service to family members.
The conference presentations painted a gloomy picture, with graphs tracking public attitudes showing consistent decline. Access to services emerged as the primary public concern, spanning GP appointments, hospital treatments, and A&E departments. Social care received even lower approval ratings than the NHS overall, with just 13% of respondents expressing satisfaction.
Contradictory Public Attitudes Revealed
The survey uncovered several contradictions in public opinion. While nearly three-quarters of respondents believe the NHS receives insufficient funding and requires more staff, the population remains evenly divided on whether to pay higher taxes to support the service. A significant 51% of Britons claim the NHS doesn't spend its money efficiently, often citing individual incidents or administrative inefficiencies as evidence.
Younger generations demonstrated greater dissatisfaction than older citizens, raising concerns about the future of public support for the health service. Perhaps most worryingly, when presented with a list of NHS priorities, respondents ranked "improving the health of the disadvantaged" as their lowest concern, suggesting a potential erosion of the service's founding principles.
Staff Face Increasing Hostility
Conference speakers reported growing disrespect toward NHS workers, with one ambulance service leader warning about escalating racist violence against paramedics. Several NHS representatives pointed to increasing political discourse around race and illegal migration as contributing factors to the rising racism faced by healthcare staff.
Despite these challenges, core support for NHS principles remains robust. An overwhelming 91% of respondents believe the service should remain free at the point of use for everyone, funded through general taxation (80%). However, researchers noted a concerning decline in the number of people who "definitely" support universal access, which fell from 67% to 56% in just one year.
Political Pressures and Public Expectations
The NHS continues to serve as the primary benchmark by which voters judge all public services. According to More in Common research, Labour switchers have indicated they will base their decision to return to the party on improvements in the health service. Voters appear remarkably impatient, with 65% of these switchers giving Labour just one year to demonstrate progress, while 10% expected immediate improvements.
Analysts highlighted a persistent disconnect between personal experiences and overall perceptions of the NHS. Care Quality Commission surveys consistently show that patients leaving hospital typically report good treatment, and 75% express satisfaction with their GP experiences. Yet even highly satisfied patients often maintain negative views about the NHS overall, assuming their positive experience was exceptional.
Dan Wellings of the King's Fund pointed to this perception gap as a perennial problem, noting that "even highly satisfied patients still believe the worst of the NHS."
Glimmers of Hope Amid the Gloom
The Health Foundation's latest polling suggests some positive developments. Referrals to waiting lists have increased by 1.5%, while removals from waiting lists have risen by 2.3% - nearly sufficient to meet the parliamentary target of 92% of patients beginning treatment within 18 weeks.
Researchers also found that people's experiences of local NHS services are notably more positive than their views of the health service overall. Local services received net positive ratings, with 46% of respondents reporting good service from their local NHS compared to 28% who disagreed. Consistent with previous surveys, those who use the NHS most frequently tend to be the most positive about its performance.
As the NHS faces one of its most challenging periods, health leaders emphasise the need to remind citizens that the health service represents a collective endeavour that belongs to and is shared by everyone. The research suggests that while most Britons maintain a sense of social solidarity, emerging cracks - particularly among Reform party supporters who show the lowest satisfaction levels at 13% - require urgent attention to preserve the service's founding principles.
