The NHS is back in the headlines as the winter takes its toll. There isn't yet any new NHS polling since the news cycle started, but I thought it would be interesting to look at the long-term trends in NHS satisfaction and its importance as an issue.
Starting with importance, the NHS has been among the most (if not the most) important issues in the MORI index for the last 30 years. Prior to that it generally didn’t register particularly highly, but in 1987, public concerns about waiting lists and health authority finances (and declining concerns about other issues, like the economy) pushed it up the agenda.
It fell again to its lowest levels since the 1980s during the financial crisis and its aftermath, though the fall had actually started earlier as satisfaction levels improved – I’ll return to that in a moment. In general the importance of the NHS tends to move inversely to importance of the economy, despite respondents being able to choose as many issues as they like.
Interestingly there doesn’t seem to be be a strong seasonal pattern – on average the NHS is given about the same importance as an issue in winter months as its annual average. Right now that percentage mentioning it in the monthly poll is close to its 30 year average.
But how satisfied are the public? One stat doing the rounds on social media is that NHS satisfaction levels are higher now than they were when Labour were in government. Technically, this is true, but it should be caveated.
The statistics come from NatCen’s British Social Attitudes Survey, the underlying data used by the annual Kings Fund report. But as with many things in survey data, interpretation is key, even if when the data itself is highly reliable.
As the second chart shows, general satisfaction (both gross and net) rose during Labour’s time in government, and has stayed at similar levels since. So Labour might be expected to claim a lot of credit for the improvement, but talking up the party’s record in government doesn’t seek to be the leadership’s prefered strategy.
The other question is what are people saying they’re satisfied with? Is it with doctors and nurses, or the concept of the NHS, or the government’s handling of the health service? Supplementary questions suggest that the latter isn’t a particularly strong driver (although that seems to be the case whichever party is in power).
There may also be lags in the data, because most people use the NHS relatively infrequently, so their opinions may not change rapidly, or they could be based on second-hand information.
As for the current situation, it’s notable that satisfaction with A&E specifically did not rise as sharply over the time that overall satisfaction did, though it is higher than when the question was first asked.
It remains to be seen what impact this story has. The NHS is rarely the decisive issue in elections – the party that’s ahead on leadership and economic competence nearly always wins. But voters in recent decades have rated the NHS as a very important issue, and that shows no sign of changing.