Intended for healthcare professionals

Analysis NHS at 60

How the NHS measures up

BMJ 2008; 336 doi: (Published 26 June 2008) Cite this as: BMJ 2008;336:1469
  1. Tony Delamothe, deputy editor
  1. 1BMJ, London WC1H 9JR
  1. tdelamothe{at}

In the fifth article in his series, Tony Delamothe examines two important factors in judging the success of the UK health system: the satisfaction of its users and how it rates compares with other countries

The previous four articles in this series have dealt with how the founding principles of the NHS have fared over the past 60 years.1 2 3 4 I have judged them against the utopian aspirations of 1940s Britain for a national health service that was universal, equitable, comprehensive, high quality, centrally funded, and free at the point of delivery. Much of my attention has therefore been directed backwards and inwards.

In this article, I want to look outwards. Firstly, I want to capture what the British public thinks of the NHS today. And secondly, I want to see how the NHS compares with other healthcare systems that share many of the NHS’s underlying principles.

What does the UK think of the NHS?

People seem happy with their NHS care, with more than 90% consistently rating their inpatient care as good, very good, or excellent (fig 1).5 In a 2006 survey for the Department of Health, 74% of those who attended a general practice or local healthcare centre were completely satisfied that their main reason for attending had been dealt with. Of the others, 22% were satisfied “to some extent” and only 4% were not satisfied at all.6

Fig 1 Adult patients’ ratings of inpatient care, England, 2002-75

Although the general public tends to have a somewhat lower opinion of the NHS than patients with recent experience of NHS care, British Social Attitudes surveys show net satisfaction with the NHS is at its highest for 20 years (fig 2).7 Net satisfaction varies—between 62% for general practice and 27% for hospitals. Nevertheless, these proportions obscure a …

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