The British public is the unhappiest it has ever been with the NHS, but still supports it in principle, a new survey has found.
The overall satisfaction with the NHS now stands at 29% – a fall of seven percentage points and the fourth-largest drop ever recorded in a single year. In 2010, satisfaction with the NHS was 71%.
The British Social Attitudes survey has tracked public opinion consistently since 1983.
Some 51% of people are unhappy with the healthcare service, a rise of 10 percentage points in a single year, and the highest levels of dissatisfaction since the survey began.
The 40th annual survey took place in September and October last year and asked 3,362 people from England, Wales and Scotland their opinions on health and social care.
The findings paint a worrying picture of how people perceive the NHS.
Over two-thirds of respondents (69%) chose long waiting times for GP and hospital appointments as one of the top reasons for dissatisfaction.
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Accident and emergency departments have seen a sharp increase in the percentage of dissatisfied respondents, with a record 40% saying they are unhappy, according to analysis by the Nuffield Trust and The King’s Fund.
General practice (GPs), dentistry and inpatient hospital services were among the other areas reaching record levels of dissatisfaction, with the findings consistent across all ages, income groups, genders and political persuasions.
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Of those who were satisfied with the NHS, the top reason was because NHS care is free at the point of use (74%), followed by the quality of NHS care (55%) and that it has a good range of services and treatments available (49%).
Matthew Taylor, chief executive of the NHS Confederation, said the survey results should be a “red flag to the government”.
The results “should not be seen as a judgement of the efforts of frontline staff to recover services in the wake of the pandemic but rather, a sign that the NHS is not being given what it needs to fully deliver for its local communities”.
“With there being around 124,000 reported vacancies across the NHS in England and a maintenance backlog stretching over £10bn this is hardly surprising,” he added.
Almost 80% of NHS staff consider quitting
Unhappiness within the NHS is not restricted to members of the public, with a separate survey finding 75.5% of workers are considering leaving the service altogether.
The survey of 2,500 NHS employees by Organise found more than half are taking days off due to stress, anxiety or burnout.
The majority also said patients are experiencing medication errors, delays in procedures and compromised quality of care as a result.
Anabela De Barros, a recovery nurse working in London, told Sky News the pandemic left many NHS staff deeply traumatised.
“I have never seen so many dead patients in my life,” she said, speaking about her work during COVID.
“And it was nice that everyone was clapping for us. But I know nurses that are now going to food banks, so it’s not enough.”
Image: Striking NHS junior doctors on the picket line
Ms De Barros has just voted to reject the latest pay deal offered to nurses.
“We’ve had Brexit, COVID and now the war in Ukraine has made the cost of living so high. We are just tired. We are exhausted. And it doesn’t seem like it is going to get better any time soon.”
Nat Whalley, CEO and co-founder of Organise – a worker-led network for fixing employment – called it a “ticking time bomb at the heart of our healthcare system”.
“We don’t need empty promises; we need tangible investments in the NHS that allow workers to thrive in their roles, without suffering from stress, anxiety, and burnout,” said Ms Whalley.
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Despite being unhappy, Brits still support the NHS
Despite the high levels of dissatisfaction with how services are operating, the public continues to show strong support for the principles underpinning the NHS.
Nine in 10 people backed the idea that the NHS should be free of charge when people need it.
But more than eight in 10 believe there is a major or severe funding problem for the service.
While taxation remains the favoured source of funding, more people believe the service should live within its budget.
Jessica Morris, report author and fellow at the Nuffield Trust, said: “It is clear that the level of unhappiness amongst the British public over the way the NHS is running is going to take many years to recover.”
A Department of Health and Social Care spokesperson said the government was “hugely grateful” to NHS and social care staff for their working during the pandemic and dealing with the subsequent backlog.
“Cutting waiting lists is one of the prime minister’s five priorities and so far, we have virtually eliminated waits of over two years for treatment and latest figures show the number of patients waiting over 18 months has reduced by 80% from the peak,” they added.
A spokesperson for NHS England said: “The NHS is taking significant steps to further improve patient experience, including our recently-launched blueprint to recover urgent and emergency care alongside continuing to slash the long waits for elective treatment which inevitably built up during the pandemic, and we are working on new plans to boost primary care for patients as well as publishing a long-term workforce strategy shortly.”
They also highlighted the government’s £14.1bn investment in health and social care over the next two years.
Wes Streeting MP, Labour’s shadow health secretary, said: “Support for the values that the NHS was built upon are unshakable. It will fall to the next Labour government to reform and rebuild the NHS, so it once again delivers quality care for patients, free at the point of use.”
“I don’t remember feeling this unsafe ever before,” says 76-year-old devout Sikh Resham Kaur who moved to the UK from India when she was 18.
She’s waiting for two men to walk her home from the gurdwara – a Sikh place of worship – at a time of rising fears over physical and verbal racial abuse.
Resham reaches for her walking stick and puts on her shoes.
Image: Sarbjit Singh and Mangat Singh walking Resham Kaur home from the gurdwara
Image: Monty Singh says they are ‘not vigilantes’
“When I came to this country, I didn’t fear for my safety. But now I do – every day. It’s a lot worse now,” she says.
It’s a disturbing admission at a time when some fear Britain’s communities are more fragmented than ever.
Two volunteers arrive, opening the exit door for Resham at the gurdwara in Smethwick in the West Midlands.
Sarbjit Singh – who works in a bakery – and Mangat Singh – who works at a salad farm – are part of the congregation and walk people to and from the gurdwara on their days off to keep them safe.
With attendance numbers at the gurdwara falling because of safety fears, Sarbjit says it’s something they need to do “until we get a bit of peace and tranquillity back in society and the community”.
“We have to do something. We can’t just sit in silence. And we can’t let the congregation just stay at home,” Sarbjit says.
Image: The Oldbury patrol
Other groups of Sikh men are also taking action – joining patrols along a road in nearby Oldbury where a young Sikh woman was allegedly raped a few weeks ago.
That alleged attack – and an assault on two taxi drivers in Wolverhampton in August – have horrified the Sikh community. Police are treating both incidents as racially aggravated.
Image: Two Sikh taxi drivers were allegedly assaulted in Wolverhampton in August
Monty Singh, who is taking part in the patrols, says they are “not vigilantes”.
“We need to make it crystal clear that we’re good people, we’re just trying to do the right thing and support our community,” Monty adds.
Pervinder Kaur is the vice president of the gurdwara.
Image: Pervinder Kaur said before the summer people felt safe, but racial abuse is being emboldened
She believes racial abuse is being emboldened after a summer of demonstrations outside hotels housing asylum seekers and renewed debate about immigration.
“People are more verbal about it now. They are not scared of the consequences,” she said.
A sense of vulnerability is common among minority communities and security measures have also been stepped up at mosques around the country.
Image: Iman Adam Kantar said ‘the Union Jack is our flag’
Image: Friday prayers at the Rumi Mosque in Edmonton, north London
Imam Adam Kantar from the Rumi Mosque in Edmonton, north London, said: “Many people are now telling their children not to be outside after certain hours.
“Their [husbands], they prefer to go shopping instead of their hijab [wearing] wives and spouses.
“We have to engage with the wider community and prove that we love this country and its people. The Union Jack is our flag.”
What Britain’s fragmented society has in common is fear among minority communities – even if the causes are different.
Rabbi Josh Levy, the co-lead of Progressive Judaism, has spent years trying to advance interfaith dialogue.
He said: “Single individual(s) or small groups can cause a huge amount of pain and distress.
“There are lots of really great examples of community cohesion around the country. But generally, there is definitely a sense of fragmentation. And whether it’s driven by political concerns or what’s happening internationally.
“We’ve got huge work to do in taking the work that happens on a national level and bringing it into local communities.”
Rachel Reeves has been warned that firms face a “make-or-break moment” at next month’s budget.
The British Chamber of Commerce (BCC) urged the chancellor, who is widely expected to announce tax hikes in November’s budget to fill a gap in the public finances, to steer clear of increasing levies on businesses.
Ms Reeves raised taxes by £40bn last year and the BCC said business confidence had not recovered since.
“Last year’s budget took the wind from their sails, and they have been struggling to find momentum ever since,” BCC director-general Shevaun Haviland said.
She said firms felt “drained” and could not plan ahead as they expected “further tax demands to be laid at their feet” when the budget is delivered on 26 November.
“The chancellor must seize this moment and use her budget to deliver a pro-growth agenda that can restore optimism and belief amongst business leaders,” Ms Haviland added.
“This year’s budget will be a make-or-break moment for many firms.”
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The BCC also called for a reform of business rates and the removal of the windfall tax on gas and oil introduced by the last government.
In its submission, the industry body outlined more than 60 recommendations, including the proposal of further infrastructure investment, cuts to customs barriers and action on skill shortages.
Earlier this year, Prime Minister Sir Keir Starmer announced Labour would aim to approve 150 major infrastructure projects by the next election, with Labour already pledging to support expansions of both Heathrow and Gatwick airports – another of the BCC’s requests.
While the Treasury would not comment on budget speculation, a spokesperson insisted Ms Reeves would “strike the right balance” between ensuring funding for public services and securing economic growth.
She has vowed to stick to Labour’s manifesto pledges not to raise taxes on “working people”.
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Household spending on the wane
The BCC’s plea to halt further tax rises on businesses comes as retail sales growth slowed in September.
“With the budget looming large, and households facing higher bills, retail spending rose more slowly than in recent months,” Helen Dickinson, chief executive of the British Retail Consortium (BRC), said.
“Rising inflation and a potentially taxing budget is weighing on the minds of many households planning their Christmas spending.”
Total retail sales in the UK increased by 2.3% year-on-year in September, against growth of 2% in September 2024 and above the 12-month average growth of 2.1%, according to BRC and KPMG data.
While food sales were up by 4.3% year-on-year, this was largely driven by inflation rather than volume growth.
Non-food sales growth slowed to 0.7% against the growth of 1.7% last September, making it below the 12-month average growth of 0.9%.
Image: Total retail sales in the UK increased in September compared to the year before. File pic: PA
Online non-food sales only increased by 1% against last September’s growth of 3.4%, which was below the 12-month average growth of 1.8%.
“The future of many large anchor stores and thousands of jobs remains in jeopardy while the Treasury keeps the risk of a new business rates surtax on the table,” Ms Dickinson said.
“By exempting these shops when the budget announcements are made, the chancellor can reduce the inflationary pressures hammering businesses and households alike.”
Thousands of homes fitted with insulation under a flagship government scheme now need major remedial work, or risk damp and mould, the public spending watchdog has warned.
A damning report by the National Audit Office (NAO) said “clear failures” in the Energy Company Obligation (ECO) scheme to tackle fuel poverty and pollution had led to low quality installations and even potential fraud.
It blamed incompetent subcontractors and weak monitoring and government oversight for the issues, which in extreme cases could cause fires.
Fuel poverty campaigners warned the system had “let cowboys through the front door”, saying it must be fixed to bring down energy bills and keep people warm.
Almost all homes – some 98%, affecting 22,000 to 23,000 properties – fitted with external wall insulation under the ECO are affected, the NAO said.
A further 29% of homes with internal wall insulation – around 9,000 to 13,000 dwellings – also face major issues that need fixing.
A small percentage of homes – 6% with external insulation and 2% with internal – put people in immediate danger, such as poor ventilation that could cause carbon monoxide poisoning, and electrical safety issues that could start fires.
ECO is a scheme that obliges energy companies to pay for energy efficiency measures in vulnerable households out of consumer bills.
Gareth Davies, head of the NAO, said ECO is “important to help reduce fuel poverty and meet the government’s ambitions for energy efficiency”.
But “clear failures in the design and set-up” had led to “poor-quality installations, as well as suspected fraud”, he added.
‘Gaming the system’
The report says the reason things had gone so badly wrong could be down to work being subcontracted to individuals and firms who are not competent or certified, uncertainty over standards, and businesses “cutting corners” or “gaming the system”.
The energy regulator Ofgem last year estimated businesses had falsified claims for ECO installations in between 5,600 and 16,500 homes.
That means they could have claimed between £56m and £165m from energy suppliers – ultimately paid for by bill-payers.
Image: More than 20,000 homes are said to be affected. File pic: iStock
Martin McCluskey, the government minister for energy consumers, criticised the “unacceptable, systemic failings” that had affected thousands of families.
He added: “We are fixing the broken system the last government left by introducing comprehensive reforms to make this process clear and straightforward, and in the rare cases where things go wrong, there will be clear lines of accountability, so consumers are guaranteed to get any problems fixed quickly.”
The government urged households to take up the free audit that will be offered in a forthcoming letter, and said installers would be forced to remedy the issues free of charge.
However, insulation has the potential to vastly improve homes, analysts pointed out.
Jess Ralston from energy think tank ECIU said: “The majority of households that have benefitted from insulation schemes have lower bills and warmer, healthy homes, particularly during the early years of the gas crisis when the UK’s poor quality housing stock was one of the reasons we were so badly hit compared to other European countries.”
Simon Francis, co-ordinator of the End Fuel Poverty Coalition, said: “Insulation and ventilation, when done properly, are among the safest and most effective ways to bring down energy bills and keep people warm.”
But the report had revealed a “system that has let cowboys through the front door, leaving thousands of victims living in misery and undermining public trust”.
Sue Davies, Which? head of consumer protection policy, called it “a damning indictment of a failed scheme, where poor oversight has allowed rogue traders to cause huge damage to people’s homes and lives”.
She said the government must take swift action to rectify the damage, as well as ensuring “there is no repeat of this scandal by putting in place robust consumer protections and effective oversight”.