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.