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The NHS at the heart of the election What do politicians have to say? Jonathan Nicholls Head of Health Research, Ipsos MORI Public Affairs.

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Presentation on theme: "The NHS at the heart of the election What do politicians have to say? Jonathan Nicholls Head of Health Research, Ipsos MORI Public Affairs."— Presentation transcript:

1 The NHS at the heart of the election What do politicians have to say? Jonathan Nicholls Head of Health Research, Ipsos MORI Public Affairs

2 Who’s going to be running the show?

3 Voting Intention: all giving an opinion vs. those “certain to vote” How would you vote if there were a General Election tomorrow? Base: All giving a voting intention = 777 unweighted, All certain to vote = 519 unweighted; data collected among 1,001 British adults 18+, 26th-28th January 2010 All giving a voting intention (78%) All certain to vote (52%) Con LD Lab Other Con LD Lab Other Source: Ipsos MORI Political Monitor Conservative lead = +4Conservative lead = +8

4 Voting Intentions Jan 03 – January 10 (all certain to vote) Base: c. 1,000 British adults each month through June 2008; c. 500 British adults thereafter 40% 16% How would you vote if there were a General Election tomorrow? Howard elected (Nov 03) 2005 General Election Cameron elected (Dec 05) Brown as PM (Jun 07) Source: Ipsos MORI Political Monitor 32%

5 December 2005 August 2006 Who do you think would make the most capable Prime Minister …? Most Capable Prime Minster – Trends September 2009 June 2001 March 1992 April 1997 June 2007 September 2003 July/August 2004 Source: Ipsos MORI Political Monitor Base: 1,003 British adults 18+, 25th-27th September 2009 Kinnock Blair Brown Major Hague Duncan Smith Howard Cameron Ashdown Kennedy Campbell Clegg None/Don’t know

6 Which leader do you think … Gordon Brown, David Cameron or Nick Clegg? Comparing Leaders …is more honest than most politicians …best understands world problems? …would be best in a crisis? …is most out of touch with ordinary people? …best understands the problems facing Britain? Source: Ipsos MORI Political Monitor Base: 1,003 British adults 18+, 25th-27th September 2009 Don’t knowBrownCameron Neither Clegg  

7 Labour Conservative Source: Ipsos MORI Base: 1,004 British adults, 19-21 June 2009 Source: Ipsos MORI The Conservatives now have a clear lead in getting value for public money Do you think a Labour or Conservative Government would be most effective in getting good value for the public money it spends?

8 Net satisfied HAGUE (1997-2001) DUNCAN SMITH (2001-2003) HOWARD (2003-2005) Net satisfaction with Opposition Leaders (1994 – 2009) Number of months from becoming leader CAMERON (2005-?) How satisfied or dissatisfied are you with the way … is doing his job as leader of the … Party? BLAIR (1994-1997) Base: c.1,000 British adults interviewed 3 rd week of the month Source: Ipsos MORI Political Monitor Note: Data collected prior to May 2008 was collected via face-to-face methodology; data collected from June 2008 was via telephone Note: methods change for Cameron; see below

9 So what does all this mean – good news for Lib Dems? Conservative lead Labour lead General Election ’05 (Labour majority of 66 seats) Est. Labour lead required for a Labour overall majority Est. Cons’ve lead required for a Cons’ve overall majority Base: c. 1,000 British adults each month Source: Ipsos MORI Political Monitor How would you vote if there were a General Election tomorrow?

10 What about views on the NHS?

11 Highest levels of satisfaction with the NHS Q Overall, how satisfied or dissatisfied are you with the running of the National Health Service nowadays? Base: English adults aged 16+ (c.1,000 per wave) Source: Ipsos MORI Perceptions of the NHS Tracker % Satisfied Satisfied Dissatisfied

12 % satisfied Base: English adults age 16+ (c.1,000 per wave) Source: Ipsos MORI Perceptions of the NHS Tracker Outpatients 86% A&E 74% GPs 91% Inpatients 85% NHS overall 67% * Small base size means comparison of figures and trends is indicative only General upward trend in satisfaction…

13 Even if doubts about national standards, local NHS seen as good Q To what extent, if at all, do you agree or disagree with the following statements? % Agree The government has the right policies for the NHS The NHS is providing a good service nationally My local NHS is providing me with a good service Base: English adults aged 16+ (c. 1,000 per wave) Source: Ipsos MORI Perceptions of the NHS Tracker

14 Base: NHS satisfaction – c. 1,000 English adults aged 16+ interviewed face-to-face per wave, Government satisfaction – c. 1,000 GB adults aged 18+ interviewed by telephone per wave (N.B interviewed face-to-face until June 2008) Source: Ipsos MORI/DH Public Perceptions of the NHS Tracker, Ipsos MORI Political Monitor % Satisfied with current running of NHS % Satisfied with way government is running the country Since Autumn 2007 public attitudes towards the NHS appear to have moved away from more general opinions of government. This may suggest current high levels of satisfaction with the NHS reflect real improvements to its services. Q Overall, how satisfied or dissatisfied are you with the running of the National Health Service nowadays? QAre you satisfied or dissatisfied with the way the Government is running the country? Satisfaction with NHS less linked with attitudes towards government than in the past 73 25

15 NHS has fallen as an issue facing Britain NHS Crime/ Law & Order Race / immi- gration Economy Source: Ipsos MORI Issues Index What do you see as the most/other important issues facing Britain today? Unemployment Base: representative sample of c.1,000 British adults age 18+ each month, interviewed face-to-face in home

16 Issues Facing Britain: NHS / Hospitals / Healthcare Howard becomes Tory Leader Cameron becomes Tory Leader Brown Becomes PM General Election – “Battle of Margaret’s shoulder” London Bombs Hewitt heckled at UNISON conference – fears over NHS job cuts Blair tells doctors “not enough” has been done for the NHS – allocates extra £20 billion. Report says waiting lists have doubled under Labour Alan Milburn promises 35,000 more nurses, 40 new hospitals and development of foundation trusts as part of NHS plan Base: representative sample of c.1,000 British adults age 18+ each month, interviewed face-to-face in home Blair – “We have underfunded the NHS for years and we are paying the price for it” – BBC NHS day Lowest score since December 1985 What do you see as the most/other important issues facing Britain today? Source: Ipsos MORI Issues Index

17 Asylum/ immigration Unemployment Pensions Afghanistan Education Party leader/policies Managing the economy Protecting the environment Healthcare Defence Crime/ anti-soc. behaviour Looking ahead of the next General Election, which, if any, of these issues do you think will be very important to you in helping you decide which party to vote for? Change from August 2008* -4 n/a -4 -12 -8 +10 -5 -2 +4 Key election issue: the economy stupid … but health also important +2 Source: Ipsos MORI Political Monitor Base: 1,003 British adults 18+, 25th-27th September 2009 NOTE: Trend is from a face-to-face, prompted question. This year’s question is asked open-ended. Taxation All at 3% and above Europe 0

18 Managing the economy Unemployment Asylum/ immigration Healthcare Crime & anti-social behaviour Education Defence Taxation Which party has the best policies on … ? Source: Ipsos MORI Political Monitor Base: 1,003 British adults 18+, 25th-27th September 2009 +5 -15 -2 -5 +14 +11 +3 +2 Conservative lead over Labour LabourConservativesLib Dems 39 20 17 15 13 10 6 6 % who think issue is ‘very important’ in helping them decide how to vote NB. Figures exclude ‘don’t know’, ‘none’ and ‘other’ responses

19 The elephant in the room….

20

21 Green shoots? Employment levels, rebased* 12345678 Recession starting in *Quarter before start of recession = 100Source: ONS/Economist Years since start of recession !

22 Over the next three years…

23 The problem is that this isn’t registering….

24 People apprehensive about NHS over next few years – but its not about financial crunch Base: c.1,000 British Adults % net better Thinking about the NHS over the next few years do you expect it to get better/worse? Source: Ipsos MORI 2005 General Election (May 05) – Hewitt replaces Reid as Health Secretary Cameron elected (Dec 05) Brown as PM (Jun 07) – Johnson replaces Hewitt as Health Secretary 1p rise in National Insurance for NHS (Apr 02) Reid replaces Milburn as Health Secretary (Jun 03) Burnham replaces Johnson as Health Secretary (Jun 09)

25 The Ipsos MORI Economic Optimism Index Base: c. 1,000 British adults each month +28 -46 -4 -56 Source: Ipsos MORI Political Monitor Do you think that the general economic condition of the country will improve, stay the same or get worse over the next 12 months? +20 +23

26 A denial of seriousness of national debt… % Tend to disagree% Strongly disagree% Tend to agree% Strongly agree There is a real need to cut spending on public services in order to pay off the very high national debt we now have Making public services more efficient can save enough money to help cut government spending, without damaging services the public receive Base: 1,004 British adults, 19-21 June 2009 Source: Ipsos MORI Public Spending Index 40% To what extent do you agree or disagree with each of the following statements about public services in Britain?

27 3 months later, even fewer want to look at cuts To what extent do you agree or disagree with each of the following statements about public services in Britain? There is a real need to cut spending on public services in order to pay off the very high national debt we now have Making public services more efficient can save enough money to help cut government spending, without damaging services the public receive Base: 1,041 online British adults aged 16-64, 4-7 Sept 2009 % Disagree% Agree

28 Perhaps because most people don’t feel personally squeezed Base: 984 British adults, 15th May – 21st May 2009 Your personal finances The economy in your local area The British economy % Very good% Fairly good % Fairly poor % Very poor How would you describe the current state of… Source: Ipsos MORI

29 Why is this a problem for the NHS?

30 Consistent view it should be protected % Q10Which of the following statements best reflects your thinking about the NHS? Base: English adults age 16+ (c.1,000 per wave) The NHS is crucial to British society and we must do everything to maintain it The NHS was a great project but we probably can’t maintain it in its current form

31 The NHS should provide all drugs and treatments no matter what they cost Base: British public, 18+ (1,001) 12-17 January 2006 The NHS should provide the most effective drugs and treatments no matter what they cost The NHS should provide the most effective drugs and treatments provided they represent good value for money 72% expect NHS to provide drugs no matter what they cost no matter what they cost treatments no matter what they cost It will provide me with everything I need … = no limits on spending

32 % Agree% Disagree June 08 Base: English adults aged 16+ (c. 900 per wave) N.B arrows represent significant differences in agreement from June-Aug 08 The NHS will be there for me when I need it Britain’s National Health Service is one of the best in the world QPlease tell me whether on the whole you agree or disagree with each of the following statements? July 08 August 08 June 08 July 08 August 08 June 08 July 08 August 08 Source: Ipsos MORI NHS 60th awareness tracking August 2008 My local NHS helps improve the health and wellbeing of me and my family The psychological contract

33 … and public want NHS protected The NHS/health care Schools The Police Defence Local authority services Benefit payments Social services Care for the elderly Overseas aid Which TWO or THREE, if any, of the following main areas of public spending do you think should be protected from any cuts? None of these Don’t know Base: All who think some services should be protected (773), 19-21 June 2009 Source: Ipsos MORI Public Spending Index

34 As well as funding challenges…. - we're older and we're more expensive to treat - we expect services to give us what we want - we're all expert in what's wrong with us and what the NHS should be doing about it - we expect it of right and we're more vocal in demanding it - and we don't trust you if you say we can't have it Which means... We have a much stronger sense of being denied (by the NHS) Huge expectations pose real challenge to the NHS…

35 Unrealistic public expectations likely to do reputational damage to NHS – and undermine public support Which brings with it real risks… The sentimentality we attach to the NHS will disappear as a new generation realises the financial implications. The IPOD (Insecure, Pressurised, Overtaxed and Debt-ridden) Generation, now in their thirties, will simply rebel by voting out politicians who want to maintain the current system Prof Karol Sikora, Sunday Times, 31 August 2008

36 A backlash? Early signals….

37 Becoming a less compassionate society? Source: British Social Attitudes Survey 2010 The state has a duty to provide a decent standard of living for the unemployed 1985 Now Government should redistribute wealth to help the poor 1994 Now

38 Fewer now support extending services Tax cut/reduce services Things left as are Don’t know Tax increase/extend services People have different views about whether it is more important to reduce taxes or keep up government spending. How about you? Which of these statements comes closest to your own view? Source: Ipsos MORI Base: c.1,000 British Adults % Taxes should be cut, even if it means some reduction in government services, such as health, education and welfare % Don't know % Things should be left as they are % Government services such as health, education and welfare should be extended, even if it means some increases in taxes 46% 33% 18% 2%

39 So what do politicians have to say?

40 An ageing society, technological advances and public expectations are placing demands that all countries are struggling to meet. Countries do not have infinite sums of money to spend on health. … The debate is not about whether - but how - healthcare budgets can be most fairly shared out among a country's citizenry. Sir Michael Rawlins, Chairman of NICE, 18 August 2008 A debate is needed…

41 As a society we have to make some hard choices for the NHS - what it should deliver, what it shouldn ’ t - how it decides what ’ s “ fair ” - should NHS rewards personal responsibility? This is about determining a new psychological contract between public, clinicians and the NHS about what the NHS can and can ’ t do … Need to lead a fundamental debate with the public and clinicians…

42 Thank you – any questions? For further information contact jonathan.nicholls@ipsos.com 020 7347 3110 © 2010 Ipsos MORI – all rights reserved


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