Rishi Sunak doesn’t speak much about his five priorities these days, apart from inflation, which ‘halved’ as promised. On NHS waiting lists, small boats, the economy and the public finances, the news hasn’t been nearly as positive – and people have noticed. Satisfaction with the National Health Service has hit its lowest point since records began, according to this morning’s British Social Attitudes survey, which reveals that fewer than one in four respondents were happy with their experience of accessing and receiving healthcare.

The main gripe is those sky-high waitlists that the government promised would be falling by now: 71 per cent cited the struggle to get both GP and hospital appointments as their main reason for plummeting opinions of the health service. Of the 3,374 people who took part in the survey, only 24 per cent said they were ‘satisfied’ with NHS care in 2023: a new record low, down from the 29 per cent reported in 2022. Notably, there was no major difference between how Tories and Labour supporters felt about the NHS: a 29 per cent satisfaction rate, compared to a 24 per cent rate. Frustration with lack of access to care goes beyond party politics.

This is all bad news for the government, which oversaw a rising NHS England waiting list throughout the majority of last year. It still sits at 7.6 million – up from 7.2 million, when the prime minister promised to get the waitlist falling. According to the survey, roughly half of respondents called for more money for the NHS. This doesn’t bode well either for the Tories, who have indeed been funnelling record levels of cash into the NHS (which will soon account for roughly 44 per cent of all day-to-day public service spending), including another £2.45 billion announced for the service earlier this month in the March Budget. Despite prioritising NHS spending above almost every other public service, they are failing to secure any kind of acknowledgement of it – let alone political credit.

But is all this dissatisfaction aimed at the Tories? Or is something else going on – possibly a genuine gripe with the health service itself? It’s easy to compare satisfaction levels at the start of the coalition years to now – 70 per cent in 2010 to 24 per cent in 2023 – and conclude the main problem is Tory mismanagement. But ten years after David Cameron entered Number 10, the majority of respondents were still reporting satisfaction with the NHS (60 per cent in January 2019 and 53 per cent in January 2020). The dramatic fall in satisfaction rates came during the pandemic, during which millions of people had their access to healthcare limited or suspended completely, as the NHS became, primarily, a Covid service.

Satisfaction has continued to fall as the Covid catch-up process continues to let people down. This is made worse by consistent strike action, which has led to over one million operations and appointments being cancelled since the end of 2022. All this, despite an additional £12 billion a year announced for NHS pandemic recovery for three years – which doesn’t include the additional funding top ups the health service seems to get in every in every fiscal statement.

The NHS is receiving record levels of funding

Demands for more cash are nothing new, but for the first time in over 20 years, the survey asked respondents if they would pay more tax for the NHS. The response was split: 48 per cent (notably higher earners) backed tax rises, while 42 per cent called for keeping tax and spending at current levels. It’s a different picture from the one painted by the YouGov poll at the start of the year which found that over 60 per cent of respondents preferred more public spending to tax cuts.

It’s also another sign of the public’s growing awareness of the ‘toxic relationship’ they have with the NHS – noted by the King’s Fund’s Dan Wellings this morning, as he recounted how a patient described the system to him. Not only is the NHS failing to deliver on its basic promise to care for the sick, but international comparisons suggest Britain should be getting far better results for the levels of cash now pouring into the system.

The NHS is receiving record levels of funding, yet patient satisfaction is at a record low: an indicator, if there ever was one, that reform can’t come soon enough.