To mark the 70th anniversary of the NHS, the BBC asked the Health Foundation, Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust to look at five central issues currently facing the NHS. These issues are the relative strengths and weaknesses of the national health service, its funding, the state of social care, the public’s expectations of the NHS, and the potential of technology to change things in the future.

This is the fourth of five briefings intended to inform and encourage a national conversation about the past, present, and future of the NHS. The briefings are supported and informed by opinion polls that looked into these five issues that are currently relevant to the NHS.

Key points

  • Support for the founding principles of the NHS remains unwavering. Although public satisfaction with the service remains high, there is evidence that people are becoming less satisfied with NHS services.
  • With waiting times rising, there is evidence that people think the government is not delivering the resources the NHS needs to meet the standards expected of it, and that this is undermining the ‘contract’ of rights and responsibilities between the NHS and the public.
  • There is increasing evidence of NHS services being rationed as it become more difficult to balance public expectations with funding constraints. The public is reluctant to accept rationing, suggesting that politicians will need to be more honest about the hard choices facing the service.
  • People’s health is determined by a complex interaction between different factors, the most important of which is the economic, physical and social environment in which they live. Significant inequalities in these wider determinants of health help explain the yawning gaps in life expectancy between different parts of the UK.
  • The vast majority of people accept that they have a contribution to make to their own health and wellbeing. Polling also suggests that the public might be more receptive to government intervention to improve health through regulation and taxation than politicians sometimes suppose.

Further reading