Clap for carers now feels like ancient history. Public satisfaction with the NHS is at its lowest since 1997, according to a new study out today. The British Social Attitudes Survey finds overall satisfaction with the health service at just 36 per cent, a record-breaking fall of 17 points since 2020.

People often relate to the health service through GPs and their experience of A&E. The latter has experienced a record-breaking 15 point fall, now at 39 per cent satisfaction, its lowest level since the BSA started asking questions about A&E in 1999.

It’s worth remembering that in 1997, when public satisfaction with the NHS as a whole was at just 34 per cent, politicians and senior health figures were worried about an existential threat to the health service. They could see the public giving up on the concept and the model, and turning, unwillingly, to private medicine in order to beat the mounting waiting lists. That dynamic seems to be repeating itself, with the number of patients going private growing by 35 per cent since the start of the pandemic. Back in 1997, it led to New Labour’s NHS plan which included a lot more money for the health service, performance targets and targets for training more doctors and nurses, followed by big reforms including the creation of foundation trusts.

Now, some of those reforms have turned out to have flaws: targets, for instance, were in some cases gamed and the way they were enforced fostered a culture of bullying in the health service. But there was a relentless focus on getting the health service back into shape in order to ensure its survival.

Can the current government’s approach be described as relentless? It’s arguable that this crisis is worse than that tackled by the Blair government in the late 1990s and early 2000s: the waiting lists are longer, for one thing. There is an elective recovery plan, and ministers will point to more money for the NHS, but there is a glaring refusal to do anything at all about one of the key factors in the health service’s struggles: the workforce. After waiting times for GP and hospital appointments, which were cited by 65 per cent of respondents, concern over staff shortages are the second biggest worry, at 46 per cent. Meanwhile, some 40 per cent agree that the government does not spend enough money on the NHS.

I’ve been writing a book on the history of the NHS. What has struck me most about public feeling towards the NHS, often dubbed the national religion, is that much of the love stems from a recognition that staff are constantly going above and beyond, holding the health service together in spite of government failings. The gaps in the workforce stem as much from the global shortage of doctors as from government inaction, but there is little prospect of change while the Treasury continues to resist calls for proper workforce planning. The risk for the government is that the public continues to applaud carers while blaming ministers for failing the NHS.