A healthy system: what’s the patients’ view on dealing with NHS cost pressures?
24 January 2017
This January, the financial and demand pressures that NHS is facing have made many a newspaper headline. This is set to continue for the long haul, as the need for health services grows significantly and patterns of need change, as the population ages, on the one hand, and as budgets tighten, on the other.
Commissioners and providers across the UK are having to make difficult decisions every day about what services can be delivered and how the future NHS can be paid for. With this in mind, we recently polled the public on their feelings towards the NHS, to find out how patients feel it should be funded and what changes are needed to ease cost pressures. So what’s the public’s view?
The research found quality of care is of key importance to the public. An increasing majority think that the quality of health services should take priority over balancing the books for hospitals. This amounts to over three quarters (76%), and this has increased from 68% - when we last asked the question in April 2016.
This finding reflects what we found in our recent report, Redrawing the health and social architecture, which looked at NHS professionals in England’s perspectives, where 71% of NHS staff in England said they wanted the healthcare system reformed.
There is also limited recognition from the public of the efficiency savings the service has made in response to financial pressures – only 16% agreed that the NHS has become more efficient over the past five years and 45% disagreed.
In terms of raising additional funding, 50% of the public are supportive of additional national insurance to improve NHS services nationally, while 31% are supportive of paying an additional local tax to improve NHS services in their local area.
This view chimes with previous surveys from ComRes in 2014 and 2015 where around half of those polled would be prepared to pay more tax to help fund the NHS. But also raises the question, are the public clear how taxation is raised and spent?
We know from PwC’s Paying for Tomorrow Citizens’ Jury that National Insurance is seen by the public as a contributory scheme, rather than a tax and it was felt more clarity was needed in the tax system, including the role and purpose of National Insurance.
The public were also provided with suggestions for how to ease financial pressure on the NHS - measures that aimed to prevent illness were popular. For example, 66% support immunisation being compulsory where it is known to prevent illness (except where the person is allergic to immunisation). And 52% said that people who are given advice to lose weight to help their condition should not receive any other treatment for that condition until they lose weight. But that this should not impact on the principle of ‘free at the point of use’. Only 26% supported the idea that conditions which are predominantly caused by lifestyle choices should be funded in part by the patient.
What’s clear from this polling is that the public wants a better health service and things have to change if the NHS is to close its £22bn funding gap. There is no silver bullet and the public seems prepared to entertain paying more if that’s what it takes. But what’s unknown is whether this would be borne out at the ballot box. And with low visibility of efficiency measures, a continued sharp focus on driving more from the service must remain a priority.
We will be bringing the patient’s voice to the heart of the debate in the months ahead. Find out more.