It’s a little over 300 days since a hot July morning saw Keir Starmer walk into No. 10 and Wes Streeting take the reins at the Department of Health and Social Care.
Labour’s headline health mission – to “build an NHS fit for the future that is there when people need it” – came at a critical time. In July 2024, the NHS backlog stood at 7.62 million appointments and procedures. So, has Streeting been effective in conveying his mission for change? How has the announcement of NHS England’s abolition been received? What do voters want to see more of?
We polled 1,021 adults living in Great Britain to zero in on these questions.
The NHS today: a mixed report card
Our polling paints a picture of cautious optimism.
Asked to rate the current performance of the NHS, 29% of the public considered it to be either ‘excellent’ or ‘good’. While a similar proportion (32%) said ‘poor’ or ‘very poor’, the most selected answer (36%) was a middling ‘fair’. In other words, the public are not yet convinced things are better, but they are not entirely sure they are worse either.
Since Labour took office, a quarter (24%) say services have improved, while 28% say services have worsened. Again, the largest share (40%) say things have remained about the same. For a government elected on a ‘change’ mandate, this will not exactly be happy reading for them.
However, there is a glimmer of optimism. Over two fifths (41%) expect NHS services to improve over the next five years – significantly more than the 24% who expect a decline. Labour’s success is not just critical for the public’s health – it is also crucial for the party’s own political health, with health and social care ranking as the third most important issue to voters.
NHS England reforms: some cut through, with limited understanding
In March, Streeting and Starmer announced the abolition of NHS England, folding it into the Department of Health and Social Care (DHSC) – a symbol of the wider Government’s desire to instil efficiency across public services. While the move took politicos and NHS managers by surprise, the public reaction was more engaged than expected with 63% hearing at least something about it.
As with all exploratory research, it is important to test claims rather than take them at face value. While 89% of people claimed to have seen or heard about “NHS England” before taking the survey, only 39% of the public correctly identified it as the body overseeing day-to-day NHS services and budgets. A quarter (25%) thought NHS England referred to the entire NHS and 11% believed the announcement meant the entire NHS was being abolished.
Even after a plain, balanced, explanation, two fifths (40%) were still unclear about the change in NHS structure.
Still, the government can take some comfort from the changes announced: 39% support the merger, compared to 13% who oppose. The main reasons people gave for supporting the changes were a reduction in duplication and bureaucracy (48%) and making NHS services work better (45%). Those opposed to the merger cited increased political interference (48%) as their chief concern.
Streeting has his work cut out in explaining the government’s ability to manage the NHS through DHSC, as only 39% are confident and 47% are not.
What the public wants: reforms, with guardrails
Looking forward, the public is clear in its desire for NHS change. Over three fifths (63%) want reform, with 44% saying it must be significant. However, there is not public appetite for reform at all costs, driven by politicians. Unsurprisingly, nearly half (46%) say doctors and nurses should be in day-to-day charge, with just under a third (30%) preferring NHS managers. Just 5% want civil servants in charge and only 4% say politicians.
The public is sold on the idea of pragmatism. They want solutions and delivery. Over half (51%) support private sector involvement in delivering NHS services, as long as they remain free at the point of use. Nearly seven in ten (68%) support charging for missed GP appointments. However, any proposal to charge for all GP appointments would be rejected strongly: 55% are opposed, compared to only 25% in support. Any private sector involvement would have to align with the NHS’s founding principle of free access.
One last thing. Delving into the cross-breaks shows that pragmatic NHS reform is popular with many people. But it is significantly more popular with older people and slightly more popular with people who say they’re currently planning to vote Reform or Conservative. With Labour badly needing these voters at the next general election, the political calculation starts to fall into place.
The NHS tomorrow: the devil’s in the delivery
Labour has made a pledge to treat 9 in 10 patients within 18 weeks by the end of this Parliament. Currently, confidence is low. Only a quarter (25%) believe they will succeed, while two fifths (42%) doubt they will.
Streeting is now one of the more visible Cabinet figures, with a 27pt uptick in his awareness since this time last year. However, his oratorical skills must be balanced with delivery if he is to truly transform the NHS.
The message from voters is clear: reform is needed, but it must be competently executed and anchored in public trust. Streeting’s real test has just begun.
