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Public want government to prioritise primary care over hospitals

New research also finds strong support for raising taxes to increase NHS funding

A major new research project has found that the public wants the government to focus more on improving primary and community care than hospitals, and is willing to pay more taxes to improve NHS services.

In a new report published today, researchers from the Health Foundation and Ipsos UK combined nationwide polling with in-depth public deliberative workshops* to explore what the public thinks about the NHS in England and the critical decisions facing the next government. The workshops – each held over two days in King’s Lynn, Leeds and London – add up to one of the most extensive exercises of its kind ever carried out with the public in England about the future of the NHS.

The research highlights the public’s appetite for a shift in how NHS resources are distributed. If the NHS budget is not increased, 60% of people polled in England think the government should prioritise the NHS budget on improving access to community-based services like general practice and dentistry, twice those who would prioritise access to hospitals (29%). Workshop participants also largely supported a greater focus on primary and community care to reduce demand on hospitals, for example through earlier diagnosis and better management of conditions.

Successive governments have failed to realise ambitions to bring more services into the community, with the share of NHS spending on general practice currently at its lowest in almost a decade.**

The new findings follow recent Health Foundation analysis that projected an additional 2.6 million people are expected to have a major illness by 2040 with conditions, such as anxiety and depression, chronic pain and diabetes, that could be managed more effectively in primary care.***

Around half of the public (47%) would also prefer to see an increase in taxes to maintain the current levels of care and services provided by the NHS. This compares to just 11% who would like to reduce spending on other public services to maintain current levels of NHS care and 9% who would reduce the level of services provided by the NHS to avoid increasing tax and spending. The polling also found that those intending to vote for Labour (63%) and Liberal Democrat (61%) are more in favour of increasing taxes than those voting Conservative (41%).

In the workshops, despite concerns about the cost of living, participants overwhelmingly wanted improvements in NHS services and supported increases in taxes to achieve this. They also favoured earmarked taxes similar to the health and social care levy introduced by Boris Johnson’s government, and VAT, over income tax. However, participants had conditions around additional funding, including a need for the NHS to be more efficient and spend its budget well; a need to see improvements in services; and greater transparency and long-term planning to make the best use of the budget.

The public’s belief in the NHS’s founding principles remains as strong as ever, with survey respondents in England agreeing that it should continue being free at the point of delivery (88%), providing a comprehensive service available to everyone (84%) and being funded primarily through taxation (83%). This was again backed up in the workshops with the public, where participants strongly favoured the current NHS model over a system of social health insurance or additional user charges.

The research highlights a significant mistrust and lack of confidence in the government’s handling of the NHS – just 9% of those surveyed in England think that the government has the right policies for the NHS. And 54% believe that the standard of care provided by NHS services will worsen in the coming year.

Tim Gardner, Assistant Director of Policy at the Health Foundation, said,

“As we approach the general election, it is vital that the political parties have a deep understanding of what the public wants and expects. No issue is more crucial than the NHS, which is seen as a top priority among voters.

“The public clearly supports the need for greater investment in primary and community care to help our growing, ageing population to live healthier lives, as well as to help people manage illness better and ease the burden on stretched NHS hospitals.

“With such low confidence in the government’s handling of the NHS, the next administration must swiftly restore public confidence and be transparent about the challenges it faces. The good news is that the public fully supports the NHS, its funding model and its principles, which is a solid foundation for building a more resilient and sustainable health service.”


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