As the NHS prepares to celebrate its 75th anniversary, new polling data from Ipsos and the Health Foundation shows that despite the health service making people most proud to be British, the public are worried about its future.
Among those in Great Britain who identify as British citizens, the NHS ranks highest with 54% of the public saying this is what makes them most proud to be British, higher than our history (32%), our culture (26%) or our system of democracy (25%). Among members of the public who say the NHS is something that makes them proud to be British, the aspect that makes people most proud is it being free at the point of use, affordable and paid for via tax (55%), followed by being available to all and treating everyone equally (36%).
However, despite being the main source of pride, nearly 3 in 4 (71%) believe the NHS’s principle of ‘free at the point of delivery’ will be eroded to at least some extent over the next 10 years. Half (51%) expect to pay for some services currently free at point of use, while 13% think most services will need to be paid for upfront and 7% anticipate charges for all services.
The data revealed the public are also pessimistic about the NHS’s ability to meet key future challenges:
• 77% believe the NHS is not prepared to meet the increasing health demands of an ageing population
• 61% believe the NHS is not prepared to respond to the impacts of climate change
• 51% believe the NHS is not prepared to keep up with new technologies to improve patient care
The public are more confident in the NHS’s preparedness for future pandemics, with 47% who think it is well prepared compared to 46% who believe it is not prepared.
Nearly 3 in 4 of the public (72%) think the NHS is crucial to British society and that everything should be done to maintain it (as opposed to thinking we probably can’t maintain it in its current form – 26%). This represents a small but statistically significant change from 12 months ago (77%) and, while support remains stable among people intending to vote Labour (86%), there has been a significant decline among those planning to vote Conservative (50%), ‘Other’ (59%) and undecided voters (64%).
While the NHS’s founding principles command majority support across the party-political spectrum, the findings reveal that people intending to vote Labour are more than twice as likely to say the NHS makes them most proud to be British (71%) than Conservative voters (31%).
People intending to vote Conservative are also more likely to expect user charges for some services (66% vs 51% of Labour voters). But those planning to vote Labour are more likely to expect to pay for most1 or all services2 that are now free at point of use. There was also a political difference in the ideas on what was causing the strain on the NHS, with Conservative voters more likely to single out NHS management (43%) and inefficiency (32%), whereas Labour voters tend to point to lack of funding (58%) and government policy (52%).
The majority (80%) continue to think that the NHS needs an increase in funding, compared to just 17% who think that the NHS should operate within its current budget. While the public generally favours paying for this through tax rises rather than increasing borrowing or cutting spending elsewhere, people remain divided on what specific taxes they prefer. The most popular options are an additional tax earmarked specifically for the NHS (31%), an increase in National Insurance (22%), and an increase in Income Tax (21%).
Tim Gardner, Assistant Director for Policy at the Health Foundation, said:
‘After 75 years, the NHS remains fundamental to what it means to be British – but there is real concern among the public about whether the principles on which the health service was founded will endure.
‘People’s concern about the current state of the health service should not be interpreted as an appetite for radical change to its founding principles. Our polling consistently shows that the public wants a better health service, that can respond to changing health needs and continue to provide equitable access for all, and backs the investment and policy action needed to bring that about.
‘The government has chosen to mark the NHS’ anniversary by finally publishing the long overdue workforce strategy, but this should be just the start of a longer-term and sustained process of investment and improvement – not a one-off event.’