The debate on the future development of the NHS continues with the Prime Minister speaking on the subject today.
What do the public think about the possibility of change?
The Department of Health’s own regular survey of public perceptions of the NHS was published on Friday and whilst only covers the period up to December 2010, nevertheless shows some changes in perception since the previous survey in March 2010, prior to the General Election.
What are the key points?
- The report has positives and negatives for the Government. People are broadly content about the NHS (70% satisfied to 14% dissatisfied) and think it has improved perhaps reflecting some recognition of the investment of the last government, whilst being more optimistic (as of December 2010) about the future of the NHS (pages 12-13)
- Because this is a publicly funded report, rather than a political one, it perhaps lacks for not detailing political affiliation. Previous research by the same Pollsters for the NHS Confederation shows that:
“experience of the NHS is not the most significant driver of general public satisfaction and that many other factors determine the public’s views about how the NHS is run at a national level. Political beliefs, support for the Government and age are much greater drivers.
Support for the Government seems to be tied to the public’s perception of the NHS so that disenchantment with the Government translates into scepticism about the NHS and vice versa. A range of opinion polling suggests that confidence in the Government’s conduct of public service reform and management of public services is currently not high and has declined markedly over the last few years.”
- From the above, one might therefore expect supporters of the new Government to have shifted from past negativity towards the NHS – perhaps over past media issues like hospital cleanliness – to a much greater optimism, whilst as of December 2010 – when the NHS debate was still very much a minority sport prior to the TUC March and the local election campaign issues – new opposition voters were still quite optimistic about the NHS. Thus we see the first increase in optimism towards the NHS since 2005 (pages 12-13). It might now be reasonable to expect this to decline in the next report?
- As of December there was a low level of understanding of the reforms with just 24% broadly aware and 73% unaware. This is likely to be significantly higher now after some of the public comments by the medical and nursing profession.
- It is interesting to note there is for the first time a gender difference in satisfaction with more women dissatisfied (page 8). This may reflect the impact of job fears on the NHS workforce, with a high percentage of women working for it.
- There was a widening gap between satisfaction of users compared to non-users (page 9). This may show the potential of using staff as advocates for explaining change issues.
- GP’s and outpatient services have the most satisfied patients, (page 10). This perhaps indicates that when services want to improve levels of satisfaction they should seek to personalise the nature of the relationship – ie between patient and GP, consultant and nurse rather than between patient and institution
- Commissioning by GP still seems the most popular aspect of the reforms as well as cutting bureaucracy. People who mention this tend to be more optimistic about the NHS (page 19). No doubt the government will continue to focus on them as positives. In terms of some of the reform issues, these were the percentages in who were positive compared to those who were negative (pages 20-26):
– GP commissioning – 47% to 20%
– GP understanding of patient needs – 79% to 15%
– Impact of community care – 64% to 15%
– Awareness of patient commitments to register with any GP and access to patient records – 42%-54% and 46% to 51%
– Involvement in treatment – 74% to 14%
– Choose treatment – 56% to 21%
– Wish to get involved in decisions over treatment 17% to 55% – as can be seen here patients seem very content to trust the professionals. This is much higher with Older people and DE’s demographically. In values terms one might also see a higher sustenance driven Settler percentage here.
- The NHS was still a low priority issue in December compared to the Economy (page 28) though one might expect it to have risen in the first few months of the year to now be the second most important issue
- An interesting table on page 30 on perceptions of the biggest issue. Cancer and Obesity top the poll relatively far ahead of smoking and heart disease. Public Health campaigning in future might need to address public perceptions as well as the issue itself?
- There are some minor negatives (page 33) with managing budgets (25% to 39%) seen to be poor (see also pages 36 and 37). Waiting Times (page 35) are seen as increasing and this could become a bigger political issue by next Winter?
- It is interesting to note that the proportion of people who know where to get information on the quality of local services in only 54% and this has declined from 59% in March 2010 (page 40). People’s motivation to access information is often impacted by their values and we have blogged on some of the differences here.
The future of the NHS is likely to remain a significant public policy issue for the rest of the year as there is speculation over whether the Government’s current pause is extended. More public surveying at PCT/Locality level as well as continued national polling might enable us all to understand what changes the public are really happy with and which are the ones that do require far more public and parliamentary debate.
Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.