Public attitudes and general practice: a worrying diagnosis

4 September 2015

This week, there has been some media interest in the most recent British Social Attitudes (BSA) survey results. The BSA billed this installment as the “verdict on five years of coalition government”.

Some of the findings on health policy are in line with expectations. Overall satisfaction with the NHS is 65 per cent – up from a 2011 low of less than 60 per cent. The financial pressure the NHS is experiencing has translated into 9 in 10 agreeing that the NHS has a “funding problem”.

Other figures, however, are more surprising. For instance, 43 per cent of respondents reported no preference between hospital care provided by “an NHS service”, a “private service” and a “non-profit service”. The BSA report notes, “…it would appear that this issue does not concern prospective users of the NHS as much as both critics and advocates of ‘privatisation’ sometimes seem to presume”. Polling commissioned by Reform last year found the public to be similarly open-minded.

The most striking finding, however, relates to general practice. The BSA found 71 per cent of people are either “very satisfied” or “quite satisfied” with their “local doctor or GP”. Hardly a disastrous figure – indeed it’s higher than for the NHS as a whole and for hospital care. Yet, this is the joint lowest satisfaction figure recorded for general practice in the 30 years the BSA has run the survey.

The long-term trend helps to illustrate the problem. In the last 20 years, public satisfaction with the NHS as a whole has been transformed. In 1994 the BSA found only 44 per cent of people were satisfied with the NHS; today the figure is 65 per cent. In contrast, over the same period, satisfaction with general practice has actually fallen from 80 per cent to 71 per cent. Figure 1, below, shows the satisfaction figures over the 30 years of the BSA survey.

Fig. 1: GP and overall NHS satisfaction, 1983-2014
The 2015 GP Patient Survey, an annual survey conducted for NHS England, also shows ongoing, though small, deteriorations in satisfaction.Public attitudes are an imperfect measure of performance. Taken alone these figures show little. However, they are in line with a growing vein of commentary describing general practice as “in crisis” and news stories about looming GP workforce shortages and lengthening waiting times at surgeries.Since taking office, the Government has made clear that changes to general practice will form a key plank of its NHS reform programme. The Prime Minister, in his first speech after the election, talked of “rethinking what primary care can be”. Shortly afterwards, Jeremy Hunt, the Health Secretary, announced a “new deal” for general practice. The Government is right to target reform of general practice. They should be bold in embracing innovative new solutions. With this in mind, over the coming months, Reform will be developing proposals to support the transformation of general practice.
Leo Ewbank, Researcher, Reform



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