Voters are losing faith in the NHS amid record waiting lists and ambulance delays, new research reveals today, as The Times launches a ground-breaking year-long inquiry into the future of health and social care.
The YouGov survey found a dramatic breakdown in public trust in the health service, with more than two-thirds of people saying they think provision is “bad” and 80 per cent saying the NHS has deteriorated over the past five years.
The Times commission, which will report before the next election, will take evidence from across the health service and draw up a radical plan for wide-ranging reform.
It follows the Times Education Commission which reported last summer and whose findings were endorsed by both Rishi Sunak and Sir Keir Starmer.
The health commission has hit out at deteriorating performance across a number of indicators following the Covid pandemic and funding crisis.
An analysis by The Times last week found that 50,000 more people than normal died in the past 12 months, with NHS delays believed to be one of the deadliest years on record. There were 1,600 more deaths in the Christmas week as long waits for ambulances, cold weather and rising flu infections saw the death rate rise by a fifth.
The public appetite for reform is highlighted by the poll, which found that just 22 per cent of people thought NHS services were ‘good’ and 67 per cent said they were ‘bad’.
Just 15 per cent say the health service is currently working ‘well’ against 78 per cent saying it is working ‘poorly’.
Voters were pessimistic about the future of the NHS, with 58 per cent saying they thought it would get worse over the next few years. Although the majority are still confident that they will be there for them in an emergency, 39 per cent are not and 63 per cent doubt that the NHS will provide them with good quality and timely treatment if they have a less serious medical condition.
The survey also found that 85 per cent of voters thought the government was doing a “bad” job with the NHS. Only 10 per cent of people think the government is doing well and only 18 per cent of people who voted Conservative in the last election.
The commission will include a group of leading medical professionals, business leaders and political experts who will serve as commissioners. They include Lord Rose of Monywood, the chairman of Asda; Lord Darzey of Denham, the surgeon and ex-minister; Dame Jane Daker, former President of the Royal College of Physicians and Sir John Bell, Professor of Medicine at Oxford University.
The ongoing crises affecting the NHS, illustrated by streams of ambulances waiting to discharge patients, have eroded public confidence in the service.
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Bell compared the NHS crisis to the First World War. “They seem intent on following the strategy of the Battle of the Somme, recruiting… doctors and nurses and sending them into battle. It creates no measurable forward progress and costs a fortune.” Dacre describes a “bottomless pit of need” as a result of demographic change and societal expectations.
Matthew Taylor, chief executive of the NHS Confederation, who is also on the committee, said a shift in priorities was needed. “The system is unavailable as currently configured,” he said. “You can get to the point where health and care is no longer consuming an ever-increasing proportion of GDP, but only through transformative change. We need to minimize the time people spend in hospital. We need to stop seeing health as this huge hole into which we pour resources and realize that a healthier population is a more productive, economically active population.
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Lord Rose said the “pipeline” was as important in a hospital as a supermarket, but it was now disrupted by the lack of social care and GP appointments. “You’re making sure the right goods are going in and you’re getting them out as quickly as possible. There should be no time for delay. We currently have a machine in the NHS that is not fit for purpose.
On Sunday, Starmer warned that the NHS must be reformed if it is to survive. He said it would always be free at the point of use, but that he wanted to make more use of the private sector and that he supported plans to allow patients to self-refer for things like routine tests and physiotherapy without going through GPs.
Meanwhile, the Royal College of Nursing has warned it will dramatically escalate strike action, asking all eligible nurses to strike early next month if there is no progress in pay talks with the government.
Lord O’Neill of Gatley, a former Goldman Sachs banker and Chancellor of the Exchequer, another commissioner, said: “We need to step back from the crisis of waiting lists, ambulance times, cancer and say, ‘Wait a minute, what are we doing as country?’ How is it possible that we spend so much on health compared to education? It’s crazy that we seem perfectly happy to spend more and more of the taxpayers’ money on seemingly very ineffective things. Unless we invest properly in preventative health, the rest of it is just very wasteful.
Millions of Britons now doubt that they can rely on the NHS for good quality and timely treatment, even in emergencies.
Senior NHS leaders fear that a lack of trust could mean a repeat of the problems caused at the start of the pandemic, when people did not seek NHS care because they were afraid or did not want to strain services.
One expert said of the current NHS: “The timeliness and experience of accessing care is clearly deteriorating for a very significant number of people.”
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Private health services report a growing interest in both insurance and self-funded treatment.
Sally Warren, director of policy at the King’s Fund think tank and a Timers commissioner, said: “This is the most challenging and strained health and care system in all the time I’ve worked on health and care policy.” She said, that it feels like “there is no break anywhere in the system.”
Although the majority of those polled by YouGov said they were still confident the health service would be there for them in an emergency, 39 per cent were not.
Some 41 per cent doubt the NHS will provide them with good quality, timely treatment if they have a serious medical condition, rising to 63 per cent who are not confident of its care if they have a less serious medical condition.
Patient groups have called for better communication with the public about plans to improve services. Jacob Lunt, head of policy at patient champion Healthwatch England, said: “The timeliness and experience of accessing care is clearly deteriorating for a very significant number of people.”
He said the NHS needed to reassure the public “by presenting a clear and understandable action plan and outlining how quickly we should expect to see improvements”.
Rachel Power, chief executive of the Patients’ Association, said the health secretary should declare a national emergency, adding: “The Government must show leadership during this crisis.”
GP and Times columnist Mark Porter said people’s experiences varied widely depending on their condition. “If you have meningitis, you’re still looked after, but if you have a child with ADHD, it’s like putting a camel through the eye of a needle right now,” he said.
The survey found a fairly even split between 35 per cent of people who found it easy to access NHS services in the past year and 38 per cent who found it difficult.
But those who used health services were much more likely to be satisfied with the level of care they received than dissatisfied, at 63 percent versus 32 percent.
Some, including the Labor Party, have proposed improving access by allowing the public to go directly to specialists without going through GPs.
Porter said: “That perception of the goalie at the moment is quite academic because whether I was standing at the goal or not, you’re stuck in this huge snaking queue.”
NHS chiefs believe resolving the current industrial dispute is key to restoring confidence.
Interim chief executive of NHS Providers, Saffron Corddry, said the figures were “a real concern” reflecting pressures including Covid-19, flu, staff shortages, crumbling buildings, outdated equipment “and the long-term neglect of social care”.
She said trusts were working hard “to find new, better ways of delivering care” but restoring trust levels would take time.
She suggested: “A very important first step would be for the government and the unions to come together and find a way to pay staff. It will help everyone.”
Her call was backed by Matthew Taylor, chief executive of the NHS Confederation and a member of the Times’ health committee.
He warned: “No one working in the NHS wants to go back to how things were at the start of the pandemic, when too many people didn’t reach out for support.”
The survey found that 78 percent of people thought the government had handled the recent dispute over wages and strike action badly, while only 14 percent said it had handled unions well.
The number of people on the NHS waiting list for planned care fell for the first time since the pandemic in November, reaching 7.19 million, down from 7.21 million in October. Before the pandemic, the total was 4.4 million.
However, A&E performance is the worst ever, including average waits of over an hour and a half for stroke and heart attack patients calling ambulances.
Private medical insurer Aviva said it now covers 1.1 million people, up from 0.9 million in 2020. HCA Healthcare UK says the number of people choosing to pay direct for treatment has increased by almost a fifth.
Porter said he now actively asks patients if they have…
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