A stark and growing generational rift lies at the heart of public attitudes towards the National Health Service, with younger adults expressing significantly less satisfaction and optimism than their older counterparts, according to the authoritative British Social Attitudes survey.
The latest data, compiled by the National Centre for Social Research (NatCen), reveals that while just 20% of people under 35 said they were satisfied with the NHS, that figure rose to 35% among those aged 65 and over. Experts describe this as a “longstanding trend” that requires urgent attention from ministers and health service leaders.
The reasons behind the generational gap
Analysts suggest several factors are driving this wedge. Younger people are more likely to interact with services that have faced extreme strain, such as GP access and dentistry, where satisfaction remains persistently and particularly low. Their expectations, shaped by digital-age convenience, may clash with the reality of navigating a complex, backlogged system.
Furthermore, a separate NHS Staff Survey from 2025 hints at a mirrored discontent within the health service’s own workforce, where younger staff aged 21-30 were more likely to report burnout, work-related stress, and intentions to leave. This internal morale crisis may indirectly affect the service experienced by younger patients. The broader context is also one of decline from a higher baseline; satisfaction among the under-65s plummeted to 19% in 2024 before a slight recovery, while it has remained more stable among the over-65s.
Bea Taylor, a fellow at the Nuffield Trust, urged the government to focus on “figuring out what could improve younger people’s perceptions of the service,” noting that older people remain the most optimistic.
A fragile uptick in overall satisfaction
The survey of over 3,400 people across Great Britain did record the first rise in overall public satisfaction since before the COVID-19 pandemic. In 2025, 26% reported being satisfied, a significant increase from the record low of 21% in 2024. Correspondingly, dissatisfaction fell by 8 percentage points to 51%, the largest annual decline since 1998.
Health Secretary Wes Streeting seized on the figures, stating patients were “beginning to feel the change” and attributing it to government investment and modernisation. He highlighted reductions in waiting lists to a three-year low, improvements in A&E four-hour waits, and faster ambulance response times. Sir James Mackey, chief executive of NHS England, called the findings “really encouraging and testimony” to staff efforts.
However, health think tanks warn the recovery is fragile. Mark Dayan of the Nuffield Trust pointed out that a 26% satisfaction rate is “still worse than it was even during the ’90s” and indicates a public that remains “very unhappy.” This caution is underscored by stagnation in satisfaction with specific services; there were no significant improvements year-on-year for A&E, GP, or dental care, with combined satisfaction for A&E and dentistry stuck at just 22%.
The public’s priorities for improvement are clear: making it easier to get a GP appointment and improving A&E waiting times rank above reducing routine hospital waiting lists. Two-thirds of respondents believe the government spends too little on the NHS, though opinions are divided on solving this through higher taxes.
Sharp political and ideological divisions
The survey lays bare pronounced political differences. Satisfaction is markedly higher among Labour (33%) and Liberal Democrat (35%) supporters than among those backing Reform UK (20%). This divide extends to core principles. While 74% of all adults agree the NHS should be available to everyone, only 30% of Reform UK supporters concur, compared to 68% of Labour voters.
There is, however, enduring cross-party support for the NHS’s founding tenets. Large majorities believe it should be free at the point of use (89%) and funded primarily through taxation (81%), despite a slight decrease in the intensity of this belief since 2021. Analysis from the Nuffield Trust also found an association between believing immigration is bad for the economy and doubting the NHS should be available to all.
Perceptions of efficiency also split along political and age lines. Some 66% of the public believe the NHS often wastes money, a view more prevalent among older individuals and those intending to vote for Reform UK or the Conservatives.
Regional differences persist, with people in Wales reporting lower-than-average satisfaction at 18%, following a period in 2024 when Welsh dissatisfaction was the highest in Britain at 72%.
The government has outlined a reforming agenda titled “Fit for the Future: 10 Year Health Plan for England,” aiming to shift care into the community, focus on prevention, and increase technology use. Specific plans include establishing Neighbourhood Health Centres, reforming dental contracts, and a new workforce plan due in autumn 2025. Controversially, ministers plan to abolish approximately 18,000 backroom NHS jobs in England to redirect £1bn annually to frontline care, though upfront implementation costs are estimated to match that saving.
Satisfaction with social care remains in a far deeper crisis, with only 14% satisfied and 49% dissatisfied. The overall picture, while showing tentative green shoots, confirms an NHS and a public navigating a long and difficult road to recovery.