The BBC have quite a Ipsos MORI have quite a detailed poll on public attitudes towards funding the NHS. So far I think the BBC’s coverage has only briefly mentioned it in relation to (predictable) public support for increasing the charges on foriegn visitors who use the NHS, but the full tables have a lot of interesting things.

MORI asked people if they thought it was acceptable or unacceptable to increase funding for the NHS in various ways. The least popular method was – obviously – a move to an insurance model of NHS funded. The defining feature of the NHS is that we don’t have to worry about insurance and suchlike, people are free to go to the doctors without worrying about money. Nevertheless, a surprisingly high 33% of people thought this would be acceptable. People also rejected (by 51% to 37%) the idea of charging for services that are currently free. Asked about specific charges, 43% of people say they would be willing to pay for a guaranteed GP appointment within 24 hours, 51% would not (the average amount was £11).

Increasing income tax to fund the NHS was rejected by 40% to 50%. This is in contrast to a recent YouGov poll that asked a similar question and found slightly more people supported paying more income tax for the NHS than opposed it. I think this difference is down to wording – YouGov asked specifically about increasing income tax from 20% to 21% while the MORI poll did not specify the size of the increase – indeed, a later question in MORI’s poll asks more specifically about an increase in the basic rate from 20% to 21%, and this bumps support up to 50%. It looks like people are happy to pay more income tax for the NHS… so long as its only a modest rise. Support for increasing the higher rate of income tax (which most people wouldn’t have to pay themselves) is more popular, with 61% support.

As with the YouGov poll MORI also found a higher level of support (53%) when it asked about funding the NHS by increasing National Insurance. For the majority of respondents a 1p increase in income tax would be functionally identical to a 1p increase in national insurance, yet the NI increase is always more popular. Part of this difference may be down to the responses of over 65s, who do not have to pay national insurance, but looking at MORI’s breakdown the increase is across all age groups, so it is presumably also down to the fact that people are less aware of how National Insurance payments work. For what it’s worth, the MORI question did not specify employees NI contributions, so some respondents may have been thinking about employer’s NI.

MORI also asked about the potential for charging people for illnesses that are “caused by their lifestyle” or for missing appointments. These are similar in a way – the logic behind both is presumably that people are, through their behaviour, costing the NHS money. Public attitudes are completely different though – 71% think it is acceptable to charge the public for missing appointments, only 44% think it would be acceptable to charge for lifestyle related illnesses. Perhaps they view it as different levels of moral culpability, different potential costs, different likelihoods of being personally affected by it, or just infringing too much on the principle of being free at the point of delivery. When MORI asked about two specific cases later on in the survey people were far less forgiving: only 33% think liver transplants should always be available for free for alcoholics, only 27% think weight loss surgery should be freely available for obese patients (25% think it shouldn’t be available at all). That said, both these are quite unsympathetic examples.

So what can we conclude from all that? Well, around about half the population say they would support an increase in general taxation to pay for the NHS, depending on the level of the increase, which tax it was or which tax band. Only a minority (though perhaps a larger minority than you’d expect) would consider a change to the funding basis of the NHS acceptable. Asked in general, only a minority of people would support charges for treatment for conditions that are seen as “self-inflicted”, but shown some specific examples most people would support restrictions on treatment for some specific examples like transplants for alcoholics or weight loss operations for the obese.


134 Responses to “BBC/Ipsos MORI poll on NHS funding”

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  1. What a strange decision in the tables to conflate the responses from those in the three NHS systems that aren’t in England, to produce a sample big enough to pretend that it has “significance”

    The only thing in common is that they “aren’t in England”.

    Judging by the answers from the NI respondents, they are all elders in Ian Paisley’s Kirk!

    Probably more sensible just to look at the figures for those in England, rather than this silly pretence that a “UK” response is meaningful.

  2. “Perhaps they view it as different levels of moral culpability, different potential costs, different likelihoods of being personally affected by it, or just infringing too much on the principle of being free at the point of delivery.”

    ————

    I know there are limitations, but one does sometimes long for pollsters to do a bit more to try and find out the reasons for peeps’ choices.

  3. @oldnat

    Do Scots peeps have a different funding model or summat?Can you enlighten as to in what way does any difference in the Scottish system make a question about moving to an insurance-based funding model unusable?

  4. I mean like, if they already had an insurance model, that would make that question a bit redundant…

  5. @carfew

    “I know there are limitations, but one does sometimes long for pollsters to do a bit more to try and find out the reasons for peeps’ choices.”

    I think that’s probably where qualitative research can be more helpful than quantitative, in the first instance at least.

  6. Carfrew

    The samples for the 3 devolved nations are “small” or “very small”. Conflating them is pointless nonsense.

    As far as I know, no serious politician in any of them has suggested a change to an insurance based system, while that suggestion has been made by numerous English Tories (Jeremy Hunt for one!) as well as UKIP, so the issue is one that is live within the English polity, but not elsewhere.

    While the Barnett system would produce consequences elsewhere, NHS England is an EVEL area, so the views of the representatives of those living in the devolved nations won’t affect what the Tories in England ultimately decided to do.

  7. @OLDNAT

    This is getting a bit ridiculous. We are on the UKPollingReport site. Most of the polls are UK wide. This constant stream of saying everything is not relevant to Scotland as if it is an alien country even on these basic questions of NHS funding just does not hold water.

  8. Sea Change

    Few polls are UK wide. The vast majority are GB only.

    The NHS is a devolved area. There is no “NHS UK”. Why would anyone want to pretend there is?

  9. if the point is that is does not relate to scotland and is therefore not interesting then dont bother posting on a UK wide site.

    If there is a poll of staff nurses at Inverness General Hospital i shall refrain from posting about it in return.

  10. I reject your assertion that Scottish opinions on health insurance are not relevant in a UK context. Funding for devolved administrations comes through UK wide Taxation and redistribution.

  11. @ OldNat is perfectly reasonable. it is a devolved matter, moreover, completely different organisational solutions.

    Social care is part of the NHS in Scotland and NI, but not in England (I don’t know Wales). In Scotland there are no trusts, but boards, the same in Wales, except for two trusts. In Wales you have the community councils, there is none in England. There is no prescription charges in Wales, Scotland or the NI.

    You can continue it, but … yes, OldNat is right.

    It is frightening when politicians and civil,servants (and the new citizenship test book) doesn’t know of these massive differences.

  12. Oh, by the way, Manchester NHS is completely, utterly, absolutely (ran out of adjectives) is different from the rest of England.

  13. And Merseyside may follow Manchester, so two of the N English cities will have a different NHS from the rest of England.

    I’m not saying it is right, but it is the reality.

  14. @Laszlo

    This is NHS funding question and how the NHS is funded is a UK wide question as the tax base is UK wide. This insurance based funding has implications for the whole of the UK. Whether a devolved administration decides to charge for prescriptions or not is just dividing up its pie in a different way.

    How the actually pie gets delivered in the first place is thus germane at a Westminster level.

  15. Laszlo

    Thanks. For a while, it looked like this was going to be a repeat of tonight’s Brexit debate!

    But my post was a polling one.

    Firstly, what on earth is the point of creating a crossbreak of those whose only connection on the points being polled are that “they don’t live in England”

    and

    What is the point of polling those outside the polity where a question is a live one (and where their votes will have zero effect)?

    It makes sense to poll in Scotland about Land Rights and Responsibilities, or in Wales about Reforming local government or in Northern Ireland about Speed limits, but why would those in England be so desperate to have UK polling on issues that don’t affect them, just because we share the same state?

  16. @Oldnat

    “As far as I know, no serious politician in any of them has suggested a change to an insurance based system, while that suggestion has been made by numerous English Tories (Jeremy Hunt for one!) as well as UKIP, so the issue is one that is live within the English polity, but not elsewhere.
    While the Barnett system would produce consequences elsewhere, NHS England is an EVEL area, so the views of the representatives of those living in the devolved nations won’t affect what the Tories in England ultimately decided to do.”

    ————-

    None of that alters the idea that it might be of some interest and have some validity to include Scots peeps in a consideration of whether people in the UK would prefer an insurance model.

    Lots of things are polled upon that are not currently ‘live’ politically. It can still be interesting to find out what peeps think.

  17. @Lazslo

    “@ OldNat is perfectly reasonable. it is a devolved matter, moreover, completely different organisational solutions.”

    ———-

    There are many different organisational solutions, but you can still ask people if they’d like an insurance solution. Like there are many energy solutions, but you could still ask peeps if they’d like summat else.

    We have a different currency solution to the eurozone but you could still ask people if they’d like to join the Euro. Etc. etc…

  18. @Dom

    “I think that’s probably where qualitative research can be more helpful than quantitative, in the first instance at least.”

    ————

    You could be right. But can’t help thinking in some cases they could fit some quantitative questions in there to elicit the reasons. Be really useful for stuff like Brexit, for eggers, and spaceports…

  19. “It makes sense to poll in Scotland about Land Rights and Responsibilities, or in Wales about Reforming local government or in Northern Ireland about Speed limits, but why would those in England be so desperate to have UK polling on issues that don’t affect them, just because we share the same state?”

    ————

    Because we’re not just interested in what people in England think. It’s of interest to know what everyone in the UK thinks.

  20. I mean they complain if they think we don’t show interest in what Scots think or do, and they complain if we do. Utterly bizarre…

  21. Sea Change

    “This is NHS funding question and how the NHS is funded is a UK wide question as the tax base is UK wide.”

    There were a number of questions about “the NHS” in this poll – not just a proposal for insurance-based funding.

    For example, one was “Charging patients for missed appointments (for example GP or hospital appointments)”

    Such an administrative charge is nothing to do with UK wide taxation, but a measure open to all four NHS systems.

    If we look at the polling on this as to the percentage finding the idea acceptable –

    UK – 71%
    Eng – 72% (Engl makes up most of UK so not surprising)
    non-Eng – 65%
    Sco – 63% (Sco makes up largest part of non-Eng so not surprising – but a small sample which isn’t significant result))
    Wal – 59% (very small sample)
    NI – 81% (very small sample, and probably rather odd!)

    If any of the 4 governments (plus the new systems in parts of England that Laszlo refers to) want to suggest that approach, then a consultation (and meaningful polling within their polity) would be appropriate.

    It may be that you are getting upset because you would prefer all decisions to be made at Westminster, but that’s not how the UK currently works (although polling companies don’t seem to have realised it yet!)

    To go back to my original point, what conceivable point is there in the BBC wanting the non-England data be conflated into a single crossbreak?

  22. Carfrew
    It’s called being Scottish.

  23. Carfrew

    Why aren’t you interested in the views of the non-UK folk in the Isle of Man and the Channel Islands, who do use NHS England, but those in NI, who generally don’t?

    Why aren’t “we” (presumably meaning English people) not equally interested in the views of the French or the Irish?

    Those should be just as relevant (or irrelevant), but if NHS England (or any of the other systems) wants to charge for missed appointments, then the views of their patients would seem to matter – as opposed to the theoretical interest of those in other systems.

  24. Pete B

    “It’s called being Scottish.”

    Nope. According to this poll it’s being labelled as “non-English”.

    What purpose (if any) do you see in the conflated “non-English” crossbreak?

  25. @oldnat

    Well presumably the French have their own polling and we can use that. We frequently ask opinions on things even if Westminster has little say, because then can track changes over time and try and figure stuff out. We poll on Independence even in England, because it’s of interest to track how opinion changes, regardless of whether peeps have much say on the matter.

    You’re thinking in terms of political utility, it’s almost like you’re an activist or summat. Others just like to have the info. to consider. Even if things aren’t live issues now, they might be in the future and interesting to know when a move for change started, and why etc.

    Don’t forget polling can make summat become a live issue. Now, it maybe the poll wasn’t conducted in an ideal format to get the most useful data, but in terms of the principle of polling to get the info., It has its merits…

    Independence wasn’t very popular before the oil discoveries. Detailed polling charging the rise has its utility…

  26. Charting the rise…

  27. I’m not getting involved in yet another debate about which add-on bits of England should or should not have been polled. G’night all.

  28. Carfrew

    You are right. I am thinking in terms of political utility for polls.

    If they have none, then they are just populist froth, like asking folk about the half-time performance at the Super Bowl – and if it could have been improved by more synths.

  29. For the few who are actually interested in politics in the UK, this is a useful article on STV voting in NI.

    http://www.northernslant.com/which-parties-will-pass-the-transfer-test/

  30. @Oldnat

    I didn’t say polls never have any political utility. Indeed I gave an example when they might, e.g. when an issue polls so strongly politicians react with policy.

    But I am saying this doesn’t HAVE to happen for there to be utility of another kind, of an explanatory nature. Tracking shifts in opinion and trying to to divine why they occur etc., or indeed don’t occur etc….

  31. Really worried by that missed appointments figure. I have had to miss three appointments in the last year as I hear voices and woke up unable to do anything. If they start charging me for when this happens I will probably choose to not get any medical help at all.

  32. Thanks for the summary AW.

    Looking at the polls mentioned above it seem apparent to me that the voters want a better functioning system of health and social care, know it needs a lot more money, and are happy for extra money to be raised as long as they personally don’t pay it. So nothing has changed then.

    If you want good health care you have to pay for it, I use the NHS when I can but also pay a small fortune in insurance to cover my wife and my needs when the NHS cannot provide what we need in a timely and efficient fashion.

  33. Oldnat

    The NI piece is interesting. It seems to suggest that the increasing need to garner transfer votes to get elected will lead to a softening of extremism, since appealing strongly to the biggest chunk of the electorate while ignoring the rest will increasingly not get you elected.

    I’d have thought that’s quite a positive development in terms of the tenor of political discourse. But quite what effect it’s likely to have on the election outcome in terms of party numbers is another matter. I don’t understand the implications well. The general view seems to be that any changes will be minor, but maybe that is to underestimate the scope for real change, propelled also by the post-RHI loosening of automatic allegiance to the DUP. As I’ve said before, we need a NI Oldnat! (Oldprod? Oldsinn?)to

  34. Alec

    It seems PwC have a similar vision to the PM and some who support Brexit. I offer this as an alternative to the gloomy view many take on the UK economy going forward.

    ‘UK could be fastest-growing G7 economy if it gets trade deals right’PwC says developing successful trade links with faster-growing emerging economies such as China is ‘critical’ to the UK.
    The UK could shake off the near-term impact of Brexit to become the fastest-growing economy in the G7 group of rich countries between now and 2050, according to a report that paints a bright outlook for the country’s prospects outside the EU.

    Consultants PwC say the UK economy will not escape entirely unscathed from the decision to leave the bloc and that it will dampen growth prospects in the short term. But the brunt of the impact would be felt by 2020 and in the years that follow the UK would outperform its peers thanks to its relatively large working age population and its flexible economy.

    PwC sets out the UK’s prospects in its latest report into how the world economy will look in 2050. Using models that analyse population trends, investment, education and technological progress, PwC economists expect six of the seven largest economies by 2050 will be emerging markets, led by China.
    They see the UK economy remaining in the top 10, slipping down one spot from ninth place now to 10th in purchasing power parity (PPP) terms, which adjusts for price differences between countries to provide a measure of the volume of goods and services produced by an economy.

    France is forecast to drop out of the top 10, to 12th place in 2050, while Germany is forecast to fall from fifth place to ninth. Mexico is the only newcomer to the top 10 in 2050.

    “Our relatively positive long-term growth projection for the UK is due to favourable demographic factors and a relatively flexible economy by European standards,” said John Hawksworth, chief economist at PwC.

    “However, developing successful trade and investment links with faster-growing emerging economies will be critical to achieving this, offsetting probable weaker trade links with the EU after Brexit.”

    With annual average growth of about 1.9% over the period to 2050, the UK is projected to be the fastest-growing economy of the G7, which comprises it, the US, Canada, France, Germany, Italy and Japan.

    PwC’s projections see the world economy doubling in size by 2042, growing at an average annual rate of 2.5% to 2050. But it adds a note of caution that the forecasts are based on some basic assumptions.

  35. Sommerjohn – Eoin might have a view if he is lurking?

  36. Guardian/ICM Poll:

    The latest Guardian/ICM poll is out this morning and there is more bad news for Labour. It continues to lag behind the Conservative party by a mile.

    Here are the state of the party figures.

    Conservatives: 42% (no change from Guardian/ICM two weeks ago)

    Labour: 27% (up 1)

    Ukip: 12% (down 1)

    Lib Dems: 10% (no change)

    Greens: 4% (down 1)

    Conservative lead: 15 points (down 1)

    https://www.theguardian.com/politics/blog/live/2017/feb/07/only-a-third-of-voters-think-labour-will-win-an-election-by-2025-poll-suggests-politics-live?

  37. The public is , ever so slowly, coming to realise that we have to fund the NHS differently if it is to keep pace with what the public want from it.
    I believe we will be having a huge debate on this once we have left the EU and these negotiations are behind us.
    And, OldNat, people think the same about the NHS whether in Aberystwyth, Aberdeen, Belfast or Brighton – it’s a British thing.

  38. Jim Jam

    Ah yes, I’d forgotten Eoin. It’s been quite a long time, if I’m not mistaken. His return would be welcome. Or maybe Conor Daly, who wrote the piece Oldnat linked to, could be tempted here?

  39. @TOH – I did wonder how long it would take for someone to float the highly spculative PwC report, gazing into the distant future some three and a hald decades from now.

    I also wondered if whoever posted this link was a Brexit supporter, and if they were, whether they would bother to mention that PwC were one of the ‘expert’ forecasters who the Leave campaign so roundly trashed a few short months ago for their apparently innaccurate forecasts of the post Brexit impacts.

    In the world of economic forecasts, you have to follow what has come to be known as Alec’s law;

    A forecsat that says what I believe = a good forecast.
    A forecast that says what I don’t believe = a bad forecast.

  40. https://www.theguardian.com/commentisfree/2017/feb/07/research-results-corbyn-labour-voters-soft-brexit

    Don’t know who this guy is, but he seems to have a vague idea of what he is talking about.

  41. @TOH – an alternative view here – https://www.theguardian.com/business/2017/feb/07/ifs-warns-steep-cuts-tax-rises-40bn-black-hole-uk

    My guess (and it really is only a guess) is that as the PwC analysis is based on bigger scale generic features of individual economies, like population and demographics, and doesn’t pay much heed to the more intricate mechanics of the economy, like the debt, deficit and public service issues, as the IFS does.

    The point is that we have chosen the worst possible time to exit the EU, which was a key reason in my decision to vote to remain, and with the potential global economic instability likely to arise from Trmp’s presindency, that just got a whole lot worse. Add to that the decision to go for a hard Brexit and I suspect PwC will be revising their forecasts pretty soon again.

    On the one hand, this helpd PwC to frame a longer term analysis, albeit containing some pretty heroic assumptions as they admit, while the IFS restricts their more detailed analysis to the next ten years.

    The IFS thus disagree with PwC about the depth and extent of the pain, which they think is much more likely to continue until 2025, not 2020.

    From where we are now, this seems far more likely. I’m really not remotely sure why on earth PwC think we can resolve the severe issues with basic health provision, mental health services and social care, to name but three services that are already at or beyond the point of collapse, by 2020, alongside the sharp Brexit related slowdown that everyone is predicting.

    I’m really struggling to understand why PwC see this sense of crisis lasting for less than three years, when we still haven’t got control of the deficit and we won’t have any or many new trade deals by 2020.

  42. Alec/ToH – this line caught my attention

    ”UK would outperform its peers thanks to its relatively large working age population and its flexible economy”

    Now the flexible economy is true but the same flexible economy that has arguably led to widespread disaffection and alienation; and, which is now being challenged by many.

    More interestingly was the line about relatively large working age population which I think encapsulates the immigration dilemma.
    Mr Bones made some remarks about productivity based on pure arithmetic in the short term and was challenged by some posters on the basis that his arithmetic failed to take account of changing dynamics resulting from said immigration in to the UK.

    One, perhaps biased, interpretation of the PWC line I re-quote is that we are in better shape due to the high level of inward migration of mainly young people many of whom will settle here.

    That there have been social consequences and that Governments have failed to plan and provide properly for is not doubted and there hangs the dillema which impinges on future judgements regarding immigration policy as well.

    NB) This is Economics with a social dimension and has anything to do with being PC or not which is a rather tired ah-hominen similar to liberal in the US or Neo-liberal or Trot thrown around in Labour circles at present.

  43. @japser22

    “And, OldNat, people think the same about the NHS whether in Aberystwyth, Aberdeen, Belfast or Brighton – it’s a British thing.”

    Can you link to any polling evidence to support that assertion?

  44. @Jim Jam – yes, I was thinking along the same lines. The UK economy is strengthened precisely by the one thing the government have chosen to reject as part of their Brexit stance.

    Already the UK agricultural sector is saying they are 75,000 workers short, directly as a result of EU migrants staying away. This and other influences have shown up already through a shrinking overall workforce.

    My other, somewhat cynical, thought on the PwC report is that they derive huge amounts of business from the government, whatever colour it is. When the government wants a positive report, PwC always seem to provide it, whatever it is the report needs to say.

  45. Alec

    Where is Christopher Robin when you need him?

    Hireton

    Where is your polling evidence to the contrary?no doubt your lepracauns have whispered into your ear whilst you were asleep

  46. NHS is under funded compared to other major economies health systems, but it could become more effective under current level of funding.

    Somehow Government working with healthcare professionals needs to reduce demand. They need to look at better management of resources and allow regional trials of different ways of working, to see what works.

    If you have elderly people staying in Hospital beds for too long, because there is insufficient care locally, then why does the NHS not work with local council authorities to build small residential care units. If NHS saves money this way and they end up owning property assets with local councils, then surely over the years, it will more than pay for itself.

    People having unhealthy lifestyles with poor diet, is costing the NHS billions every year. The demand for replacement knee and hip joints is incredible. It would interesting what the difference is between say France and UK. France has always been known for a healthier diet and people generally weighing less. Therefore less strain on joints and fewer operations needed ?

  47. Here is some polling evidence from GPs themselves, rather than the general public. It comes from this research paper: “Primary Care Physicians in Ten Countries Report Challenges Caring for Patients with Complex Health Needs”. It was done by The Commonwealth Fund of New York in December 2016.

    There are, in my opinion, interesting differences in the responses of the GPs across all the UK. Scottish GPs seem least stressed and most satisfied with practising medicine. There are interesting responses suggesting that too much is done to provide medical care from all providers.

    The link is to an analysis of the report.

    http://newsnet.scot/commentary/scottish-gps-satisfied-least-stressed-uk-possibly-world/

  48. Alec

    Very good reply, and I loved Alec’s Law which I generally agree with. We all do it including your goodself, as you did yesterday.

    If you think about it all I was doing is making the point that there are others out their, with economic credentials, who actually have a vision like my own and it would appear the PM’s.

    I actually take little real notice of economic forecasts when looking to my own affairs. It was my gut reaction at the look of the markets which made me dispose of most of my portfolio in 2006 so I was cash rich when the crash came. Obviouslyy since then I have reinvested and done very well. I didn’t believe any of the economic forecasts in the period 2010 to 2014 and I was right then as the real economic numbers proved.

  49. Alec

    “Very good reply, and I loved Alec’s Law which I generally agree with. We all do it including your goodself, as you did yesterday.”

    I should have added and you did it again today as well.

    :-)

  50. The ICM poll figures have been pretty stable for both Tories and Labour since May became PM. Unlike Yougov there is no sign of a further Labour decline – indeed given ICM’s historical tendency – going back to 1997 – to pitch Labour lower than other pollsters it might be argued that 27% is not too bad and perfectly compatible with Opinium giving them 30%.

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