Public satisfaction with the NHS is now at its highest level and has increased across the population, but satisfaction levels differ considerably by service, according to the latest findings of an annual survey.
When the Labour Party came to power in 1997, only a third of people (34%) were satisfied with the NHS, and this was the lowest level since the National Centre for Social Research (NatCen) began its annual British Social Attitudes survey in 1983. But by 2009, satisfaction stood at 64%, the highest since the survey began, says NatCen.
Only one in five people (19%) now are “very dissatisfied” or “quite dissatisfied” with the NHS, down 31 percentage points since 1997, when 50% were dissatisfied, it adds.
Moreover, the survey finds that satisfaction levels have increased across the population, and that the largest increases have been among those with traditionally low levels of satisfaction. These include 18-34 year olds (up 32 percentage points since 1996, compared with an increase of 24 points among those aged 65 and over) and better-off households in the top two income quartiles (up 31 and 36 percentage points respectively since 1996, compared with an increase of 25 points among the lowest income quartile).
While satisfaction with the NHS among Conservative supporters fell initially when Labour came to power, it rose 12 percentage points between 1996 and 2009, reaching a high of 61% in 2009.
Increased satisfaction partly reflects the fact that people recognise and value the improvements that have taken place within the NHS, particularly in relation to waiting times, but the promotion of patient choice (within England at least) has not led to higher levels of satisfaction with NHS services, says NatCen.
It also finds that levels of satisfaction with the NHS differ considerably by service. For example, satisfaction with GPs is traditionally high and, although levels declined after 1993, they recovered in 2005 and stood at 80% in 2009, possibly mirroring the introduction of maximum waiting time targets for appointments.
At 67%, public satisfaction with outpatient services is now at its highest-ever level and, overall, outpatient services have seen the biggest increase in satisfaction levels, with a 15-point increase between 1996 and 2009. For inpatient services, increases in satisfaction levels only really began in 2006, reaching 59% in 2009, the survey finds.
Conversely, satisfaction levels with dentists steadily declined since 1983, halting only in 2004, since when they have remained stable. In 2009, less than half of people (48%) said they were satisfied with NHS dentists.
“Voters may have rejected Labour at the ballot box but this hides a huge increase in satisfaction with core public services over the lifetime of Labour’s government. The coalition government should bear this in mind as it grapples with reform and reducing public spending in services like health and education,” says NatCen.
Adds co-author John Appleby: “the new government’s health policy (in England) is now laying even greater emphasis on patient choice and more disaggregated purchasing of care by GPs as the main mechanisms for improving the NHS, but against a virtual zero real growth in funding for the next four years and the rejection (at least overtly) of the target regime that has been instrumental in improving waiting times. If these policies fail to deliver improvements in the things the public cares about, it will be hard to see a continuation in these upward trends in satisfaction with the NHS,” says Prof Appleby, who is chief economist, health policy at The King’s Fund.