"Universal Healthcare Systems Are Better"

A fascinating review of public attitudes to healthcare systems has recently been released by Gallup, and it provides good news for both universal healthcare systems generally and the NHS specifically.

Gallup compared public attitudes to healthcare among those OECD countries with a universal healthcare system and those without. They found that the average satisfaction with the availability of quality healthcare in one's own area was 79% in the 22 universal healthcare system countries, but only 66% in the 8 non-universal healthcare countries. In addition, on average, the public in the former are more likely to have confidence in their national medical or healthcare systems (73% confident vs. 60%).

The cross country analysis also finds that in most countries people are more positive about their local healthcare system than their perceptions of the national system. This has been a widely recognised feature in England for some time - and not just in healthcare. According to the Gallup analysis this "perceptions gap" is highest in Germany and the US. However, there are exceptions, for example in Finland the public are more likely to be positive about their national rather than their local system. These findings of course beg several questions, including what sort of gap is desired or should we aim for no real gap in perceptions, as is the case in countries such as France, Sweden and Ireland? And to what extent are the differences (or lack of differences) due to differing levels of service delivery, media coverage, public scepticism about how their own personal experience reflects national reality, or the effectiveness of nationwide branding strategies?

In the UK, 73% of the public have confidence in the NHS nationally - same as the average of all 22 universal healthcare countries in the OECD. In total, 18 of the 30 OECD countries have lower ratings for their national systems than in the UK. In terms of satisfaction with the availability of local care the NHS does even better - 22 OECD countries have the same or lower ratings than the 85% satisfaction in the UK.

UKOnline - is it transforming how we deal with government or just helping us become better shoppers?

For over a decade now the UK Government has pursued policies to increase citizens use of the Internet in order to usher in the Information Revolution and in the words of Tony Blair not only to benefit the private sector and wider economy but also for public services to use information technology to help create fundamental improvement in the efficiency, convenience and quality of our services.

A major survey for the European Commission provides some insights into how far this has been achieved, at least from the perspective of the general public.

How Many Online?

The UK has done well in terms of public use of the Internet, with one of the highest levels of take-up across the EU. Four in five (80%) UK adults use the Internet at least every three months; only in Sweden (85%) and DenmarK (91%) are the levels statistically higher. The EU27 average is 68%.

However, with just 30% of UK adults using the net "several times a day" we are in line with the EU27 average (31%) and half the level found in Denmark (61%).

What Do We Do Online?

The chart above shows the activities of Internet users in the UK and for the EU27 average. Brits are similar to other Europeans in mostly using the net to search for information, email or send instant messaging (more than nine in ten Internet users do this). In many ways, UK Internet users lead other Europeans - almost four in five online Brits (78%) buy products or services online (the highest level of any European country), use Internet banking (56% in UK vs 51% in EU27) or use social network sites (39% in UK vs. 32% in EU27).

However, online Britons are no different from the European average in terms of using the Internet for "filling out and sending forms electronically to the public administrations" (46% in UK vs. 45% in EU27). France (63%) and Denmark (61%) head up this league table and a further seven European countries beat the UK on this measure.

And What Impact Has the Internet Had On Our Lives?

It seems the Internet has helped the UK become ever more addicted to shopping. Almost two in five (37%) online Brits strongly agree that the Internet has improved the way they shop (this is twice the EU27 average), though even more strongly agree the net has improved how they keep informed about current issues (53%), improved opportunities to learn (48%) and improved access th health-related issues (42%) - the latter perhaps a sign of the success of NHSDirect, especially given the EU27 average for this factor is just 28%.

It's not just about shopping and getting health information where more online Brits believe the Internet has improved what they do. They are also more likely than other online Europeans to strongly agree that the Internet has improved opportunities to learn and help manage finances (both 12 points higher), improved relationships with family and friends (8 points higher) and improved pursuit of hobbies (6 points higher).

Yet this has not translated into more online Brits strongly agreeing that the Internet has improved "the way you deal with public authorities" as just 16% in the UK say it has (the average in the EU27 is 15%). In Estonia, Malta, Austria and Hungary around three in ten of their online citizens strongly agree the Internet has improved access to their public authorities.

The question for the UK Government then is how much can it learn from other European countries which have been more successful at using the Internet to improve how citizens interact with it; as well as what more can be learnt from Tesco and other retailers where online Brits have been among the most enthusiasitc converts to the benefits of transacting online...

You can download the full report here.

We Love the NHS

The Conservative MEP, Daniel Hannan's, criticism of the NHS seems to have unleashed a bout of patriotism in the UK, at least if we judge it by the media reporting of the massive "twittering" response. But relatively few people use twitter so is this really a good measure of public opinion, or is it more a reflection of how the media can hype up the impact of new technology?

Representative opinion polls, which capture the opinions of those offline and online, shows unequivocaly the strong public support for the NHS. A poll by Ipsos MORI for Unison, released this week, shows that more than three quarters of the British public (77%) believe that "the NHS is crucial to British society and we must do everything to maintain it" in comparison to thinking that "the NHS was a great project but we probably can't maintain it in its current form (22% of the public agree). Few institutions, in Brtain at least, enjoy such widespread public support. Even support for the Monarchy trails that of the NHS, as this trend data shows (around seven in ten people wish Britain to remain as a Monarchy).

Indeed, a survey conducted in 1999 found that the NHS was seen by far the most important achievement of the 20th century by the British public - more so than the establishment of the welfare state, winning the 2nd world war or even the introduction of universal suffrage. It would take a brave - or in David Cameron's words an "eccentric" British politician - to argue the NHS was a mistake and a relic of the past.

Yet despite the widespread support for the NHS now and the evident pride in its achievements over the past 60 years, almost half (47%) the public do not think it will exist in 50 year's time. Two in five people (40%) also don't expect Britain to have a Monarchy in 50 year's time... if they are right the Britain of the 21st century could be very different from the last one....

A Greek Tragedy! Banning Pre Election Opinion Polls

As a keen member of the World Association of Public Opinion Research (WAPOR) and as someone who believes pre election opinion polls help to keep politicians honest (...help...) and stops journalists just sticking their finger in the wind or relying on "a focus group of one person", I wholeheartedly agree with WAPOR's reaction to the Greek government's decision to ban the publication of election polls in the final 15 days of the election. Click here to read the press release.

Afghanistan – an unwinnable war?

July saw a large increase in British military deaths in Afghanistan and the highly publicised row between the Government and the Opposition (and the military top brass) about the adequacy of equipment for soldiers on the frontline. It is no surprise then that several polling firms were commissioned to ask the public about their views on Afghanistan. Overall the surveys provide us some clear insights into public attitudes. They show how the public is divided on Britain’s continual involvement in the war and suggest there is strong public scepticism about what can be achieved there.

Two polls conducted in the first half of July, by ICM (for the Guardian/BBC Newsnight) and by Populus (for ITN News) show that two thirds of the public (67%) say they feel they understand the purpose of Britain’s mission in Afghanistan and there is a strong consensus that the main reasons for being there are ‘as part of international fight against Al Qaeda terrorists’ (80% say that this is one of the main reasons) and ‘to help the Afghan Government to fight the Taliban’ (78%).

These surveys reveal, however, that the public is split down the middle in terms of its support for British military presence in Afghanistan. The ICM survey shows that 46% of the public supports the ‘British military operation in Afghanistan’ and 47% oppose it. Interestingly, further sub-group analysis reveals that the key opponents of British military presence is over-65 year olds, with more than half (53%) opposing the war.

Perhaps one of the explanations for the public opposition is the high level of concern about military equipment. According to the Populus poll, three quarters of the public (75%) believe that ‘British service personnel in Afghanistan are inadequately supplied or equipped’ and a ComRes poll (for The Independent), conducted towards the end of the month, also found that 75% of the public agree that ‘British troops do not have the equipment they need to perform their role safely in Afghanistan’. And adding further pressure to the Government is a YouGov poll, conducted 16 - 17 July, which found that 60% of the public believe Gordon Brown is ‘deliberately trying to fight the war on the cheap’ – three times the proportion who believe the Prime Minister ‘is doing his best to provide British troops with the equipment they need’, (20%).

Finally, perhaps the most troubling results for the Government are that three in five people (58%) who believe that war in Afghanistan is unwinnable (ComRes/The Independent) and approaching half the public in both the Populus and YouGov surveys felt the objective of stabilising Afghanistan and preventing it becoming a terrorist stronghold was a worthwhile objective but not at the cost of high levels of British casualties.