Public willing to fund NHS as GP satisfaction declines to 34%

Large numbers of the public are willing to pay higher taxes to fund the NHS, as satisfaction with GP services fell to a record low of 34%.

The latest British Social Attitudes Survey (BSA) found just 24% of the public is satisfied with the NHS as a whole – down from 29% last year and the lowest-ever level recorded since the survey began in 1983.

But the survey also found that 84% of the public agree the NHS has a funding problem and 48% would support the Government choosing to increase taxes to spend more on the NHS.

People with the highest income are ‘significantly’ more likely to say that they would support the Government increasing taxes to spend more on the NHS, analysis showed, with 62% of the highest income quartile agreeing.

At its peak, in 2010, seven in 10 members of the public were satisfied with the NHS.

The survey, seen as a gold-standard measure of public attitudes in Britain, was carried out by the National Centre for Social Research (NatCen) in September and October 2023, with the analysis carried out by the King’s Fund and Nuffield Trust.

The main reasons people give for being dissatisfied with the NHS are long waiting times for GP and hospital appointments (71%), staff shortages (54%), and a view that the Government does not spend enough on the health service (47%). 

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%).

Despite low satisfaction levels, the overwhelming majority of respondents expressed high levels of support for the principles of the health service, when asked if they should still apply in 2023:

• free at the point of use (91%),

• primarily funded through taxation (82%) and

• available to everyone (82%). 

The King’s Fund senior fellow Dan Wellings said: ‘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.’ 

Nuffield Trust fellow Jessica Morris warned that the next government will inherit an NHS with ‘a record low level of satisfaction’ with the way in which it is running.

She said: ‘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.’

BMA council chair Professor Phil Banfield said: ‘We know that across the country, patients are waiting far too long to see their GPs, and GPs are deeply frustrated about access issues. We’ve told the Government repeatedly what needs to be done to rectify this but instead of listening to us, it has starved general practice of resources.

‘The recent practice contract baseline funding uplift of only £179m in the face of crippling rising costs and expenses is frankly an insult to my GP colleagues. Across the country, GP practices are closing – permanently. This survey shows the kind of government attitude that got us to this sorry state.’

Adding that ‘money is a crucial issue’, Professor Banfield said ‘it would be unwise to overlook’ the ‘clear public appetite to adequately fund a better NHS’ revealed by the survey findings.

‘It is worth observing that there are many ways of increasing tax revenues without increasing the burden on individuals, but the principle of the more you earn, the more you should willingly contribute makes moral and ethical sense to us,’ he said.

RCGP vice chair for external affairs Dr Victoria Tzortziou-Brown said that the survey ‘clearly’ shows the public wants more investment in the NHS.

She said: ‘It is always distressing and disheartening to see patient satisfaction with general practice, and the NHS more widely, continue to fall.

‘We know how much our patients value the care and services GPs and our teams offer, and we share their frustration when they struggle to secure timely appointments. Unfortunately, we simply do not have enough GPs to keep up with the increasing need for our care. 

‘General practice has been severely neglected by years of underfunding and poor workforce planning.

‘Today’s survey clearly shows the public wants more investment in the NHS, and that’s what we want too.

‘General practice is the bedrock of the NHS, making the majority of patient contacts and keeping people out of hospital where care is more expensive – but it needs significant investment, and urgent efforts to both retain the existing GP workforce and recruit more GPs, or this situation will continue to get worse.’

Oxfordshire GP Dr Rachel Ward, speaking on behalf of the Rebuild General Practice campaign, said that it is ‘devastating’ to see public satisfaction with general practice and the whole NHS so low, but it is also not surprising.

She said: ‘GPs have been sounding the alarm for years, but successive governments have failed to act. We understand and share patients’ frustration, and we all want the same thing – for general practice to provide the best care it possibly can.

‘But without urgent intervention from Government, and despite our best efforts, patients’ exasperation will only escalate.’

Chris Hopson, chief strategy officer at NHS England, said: ‘Whilst these findings reflect the sustained pressure and disruption facing NHS services last Autumn, it is extremely welcome to once again see overwhelming public support for the founding principles of the NHS.

‘Over the last 12 months as the NHS has continued to recover from the pandemic, frontline services have responded to significant increases in demand, with October seeing the most A&E admissions since January 2020 and GP teams delivering 53 million more appointments last year compared to pre-pandemic levels. Coupled with the impacts of a year of strike action, this has affected the experiences of some patients, which we know has been very frustrating.’

He added: ‘While there is still much more to do, the NHS’s plans to recover access to emergency, primary and dental care and reduce cancer, ambulance and elective waiting times are helping the NHS to deliver improved care for patients.’

Labour’s shadow health secretary Wes Streeting said: ‘After 14 years of Conservative neglect, the NHS has never been in a worse state. Fewer than one in every four people say they are getting a good service, and who can blame them?

‘Patients are waiting 18 months for an operation, more than a month for GP appointments, and NHS dentistry barely exists anymore. The longer the Conservatives are in office, the longer patients wait.

‘The Conservatives have taken the NHS to breaking point, and if they are given five more years, they will finish the job.

‘The last Labour government achieved the highest patient satisfaction in the history of the NHS. We did it before and we will do it again. We will provide an extra two million operations and appointments at evenings and weekends, the first step in our plan to getting the NHS back on its feet.’