Participants were asked for their views on the NHS, the challenges it faces and how it is funded. They were then given information on the funding challenges and offered possible solutions – paying for some services, means-testing or reducing the standard of care. This paper outlines and analyses the responses.
- Participants strongly supported the founding principles of the NHS – that access is based on need rather than the ability to pay, that it is available to all, and of high quality – and wished these to endure.
- Participants understood how the NHS is currently funded, but welcomed more information about how the money is spent.
- If user charges were to be introduced, there was support for applying them to ‘not clinically necessary’ procedures and for needs resulting from inappropriate lifestyle choices or misuse of the system.
- Means-testing was unpopular both in principle and for practical reasons. However, there was some support for the very rich paying for some services and for voluntary insurance.
- Reduction in the quality of care was seen as unacceptable, and paying to secure preferential treatment was strongly resisted, but there was support for optional payment to enhance non-clinical aspects of care (eg, ‘hotel’ facilities).
- Overall, many understood that the NHS is under pressure, but few accepted that this is on a scale to justify changing the fundamental principles on which the NHS is based.
- People want to be involved in decision-making about NHS funding; proposals for future change will need to be accompanied by detailed explanation and a public debate.
- People’s attachment to the founding principles of the NHS and reluctance to amend the current funding model suggest that an incremental approach to change is likely to be more acceptable to the public.
More on NHS funding
- Read our press release: Public remain wedded to NHS funding model says new research by The King’s Fund and Ipsos MORI
- Watch our videos with the public involved in this work
- Listen to Anna Dixon's introductory notes on funding the NHS
- Catch up with John Appleby's paper: Spending on health and social care over the next 50 years