The public’s views on the future of the NHS in England Findings from deliberative research and polling with the public and what it means for the next government
May 2024
Key points
- A general election is approaching and the NHS will be at the heart of the debate. The next government will need to address fundamental questions about the future of the NHS in England, grounded in an understanding of what the public wants and expects.
- This report summarises the findings from deliberative research with the public in England, alongside the findings from our latest public polling, both conducted by Ipsos in Autumn 2023. It identifies implications for the government that will shape the policy agenda for the NHS in England after the upcoming election.
- The public is dissatisfied with how the NHS is currently working and is concerned about its future, but maintains a deep appreciation for the health service and strong attachment to its founding principles. A wide range of factors is understood to be causing strain on the NHS and supporting the workforce is a top priority for the public.
- On balance, the public wants primary and community care to be a higher priority for NHS resources than hospital services. While participants in the deliberative research would not accept a decline in access to hospital care for those who need it, there was support for a steady rebalancing of funding over time.
- Participants in the deliberative research mostly supported improving NHS service levels, which they said they would be willing to pay additional taxes to achieve, even when confronted with the illustrative financial consequences for people like them.
- If taxes are to increase, participants wanted the extra revenue to be raised from a combination of taxes – though an additional tax earmarked for the NHS and increasing VAT were generally preferred over raising income tax. Concerns around the cost of living led participants to want assurance that any additional funding would be used effectively and for the burden to be shared across society, including with business and employers.
- Support for the NHS’s founding principles remains solid. Despite high-profile calls to introduce additional patient charges or move to a system of social health insurance, participants overwhelmingly preferred keeping the current NHS funding model over these alternatives.
- Confidence in the government’s policies for the NHS is low. The next government will need to address the lack of public trust in politicians to manage the NHS well. The deliberative research suggests giving the NHS more independence from politics, taking a longer-term perspective in policy decisions and building in more independent scrutiny and public engagement could help.
As a general election looms, the NHS looks to be at the centre of the debate and a top issue for people in deciding how they vote. The NHS is struggling, with long waits for care, staff shortages and unprecedented strike action – but what does the public think about the future of the NHS? And what does this mean for the next government’s priorities?
This report brings together findings from public perceptions polling and deliberative research with the public, carried out by the Health Foundation in partnership with Ipsos, providing greater insight into what people really think and their priorities for improving the health service. The report covers perceptions of the NHS and the challenges it faces; the balance between primary and community care, and hospital care; funding levels; the funding model; and how to build confidence in government planning.
The report concludes with implications for the next government, including the case for wider changes to ministers' relationship with the NHS to ensure more independence from politics, taking a longer-term perspective in policy decisions and building in more independent scrutiny and public engagement.
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