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IPPR - Revealed: Disruption to NHS healthcare costing Brits their ‘lives and livelihoods’, report finds

  • One in three British adults have faced difficulty to access NHS healthcare services since 2020, equivalent to over 17 million people  

  • Disrupted healthcare leads to worse social and economic outcomes – from financial insecurity to lost jobs 

  • One in six turn to private healthcare as emerging ‘two-tier’ system leaves people on lower incomes more exposed to cost of NHS disruption 

As the NHS reaches its 75th birthday under tremendous strain, new IPPR research shows a large number of people are unable to get the care they need, with a direct adverse impact on millions of lives.  

New research shows that a third of British adults (34 per cent) have found it difficult to get the healthcare services they need through the NHS, since the pandemic began. This rises to 51 per cent of people with a life-limiting health condition. 

This healthcare disruption is costing lives and livelihoods, polling for IPPR by YouGov found. Some 71 per cent of those with a life limiting health condition who experienced difficulty getting the NHS healthcare they need said this lack of access had directly undermined their wellbeing and economic prospects. This includes:  

  • One in two who said it reduced their ability to maintain hobbies and interests (50 per cent) 

  • One in three who said it impacted on their social relationships (33 per cent) 

  • Over one in four who said it increased their financial insecurity (26 per cent) 

  • Around one in six who said it made it more difficult to find work, or stay in work (16 per cent) 

  • Nearly one in five who said it reduced their ability to work the number of hours they'd like (19 per cent) 

The human and economic risks of poor access to healthcare are disproportionately borne by people with fewer financial resources, the report argues. Twice as many people in social grades ABC1 said they had used some form of non-dental private healthcare since January 2020 (23 per cent), compared to people in grades C2DE (10 per cent). 

Overall, one in six people (17 per cent) said they had paid for some form of non-dental private healthcare since 2020. The most common reason given for this was to avoid waiting lists (41 per cent of those who used private healthcare). This threatens to embed a two-tier system – where healthcare quality, and therefore life chances, depend on what you can afford – the report warns. 

Meanwhile one in four (27 per cent) had used private dental care, bringing the total who had used private healthcare of any kind since the Covid-19 pandemic to nearly 40 per cent (37 per cent). 

While some have argued for a shift towards a more contributory healthcare system – or a shift to a social insurance funding model – the report finds the public still overwhelmingly back the NHS’s founding principles. 

The vast majority believe the NHS should remain free at the point of delivery (89 per cent) and primarily funded through taxation (83 per cent). This support extends across political parties, leave/remain voters and all age groups. 

Almost half of society (45 per cent) support increased taxes in order to pay for at least the current level of care and services, three times as many as support reducing government spending elsewhere to fund the NHS (15 per cent), and over seven times as many as those who support reducing NHS spend to facilitate tax cuts (6 per cent).  

Moreover, the public actively support extending these principles to adult social care with 68 per cent saying that social care should be fully or mostly funded by the government, and just 4 per cent in favour of predominantly funding social care through service user charges. The majority want social care to be free at the point of use (78 per cent), comprehensive (80 per cent) and primarily tax funded (72 per cent) like the NHS – with consensus extending across parties. 

IPPR argues that the NHS founding principles and universal model can be maintained in the 21st century. However, this will require a fundamental shift from an ‘illness service’ – focused on reactively treating sickness – to a wellness service, that proactively focuses on preventing illness and promoting health.  

Chris Thomas, head of IPPR’s Commission on Health and Prosperity, said:  

“We should celebrate the NHS on its anniversary: since its founding year, it has treated millions and earned its position as the jewel of the crown in the British welfare state. 

“But we must also acknowledge that it is rather worse for wear. After a decade of austerity, a global pandemic and historic winter crises, too many people are struggling to access the care they need. This is costing people their lives and their livelihoods. 

“The idea that we need to change the NHS’ funding model or core principles is for the birds. Instead, we need to adapt it to 21st century health realities: it’s not 1948 anymore, and a reactive healthcare model focused on acute need and hospital care simply won’t work.  

“On the NHS’ birthday, we urgently need to transition it from an illness to a wellness service – focused on prevention, proactivity, and personalised long-term condition management. This is the only way to deliver on the public’s priority of a universal, comprehensive and free NHS, that flourishes in the 21st century.” 

Chris Thomas is available for interview   


  1. The IPPR briefing paper Chris Thomas, head of the Commission on Health and Prosperity, will be published at 0001 on Wednesday June 5. 

  2. All figures unless otherwise stated are from YouGov plc. Total sample size was 2014 adults. Fieldwork was undertaken between 7th and 8th of June 2023. The survey was carried out online. The figures have been weighted and are representative of all GB adults aged 18+. 

  3. Life limiting condition was established through two screening questions: one asking if participants had a physical or mental health condition that had lasted, or could be expected to last, over 12 months. The second asking if that condition impacts ability to carry out day-to-day activities. We include those who reported a condition that impacted day-to-day activities at least a little. N = 800 reported a health condition (38 per cent of the population) and n = 543 reported it impacted on ability to carry out day to day activities. 

  4. The Commission on Health and Prosperity (CHP) is a landmark IPPR initiative, exploring the case that a fairer country is a healthier country, and that a healthier country is a more prosperous country. The cross-party commission is co-chaired by Professor Dame Sally Davies, former chief medical officer for England and master of Trinity College Cambridge, and Lord Ara Darzi, leading surgeon, former health minister and Paul Hamlyn Chair of Surgery at Imperial College London  

  5. Previous reports from IPPR’s Commission on Health and Prosperity include: 
    - Healthy people, prosperous lives: The first interim report of the IPPR Commission on Health and Prosperity - available at: 
    - Getting Better? Health and the UK labour market – available at:  
    - Health and prosperity: Introducing the Commission on Health and Prosperity - available at: 

  6. IPPR is the UK’s pre-eminent progressive think tank. With more than 40 staff in offices in London, Manchester, Newcastle and Edinburgh, IPPR is Britain’s only national think tank with a truly national presence. 

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