Research shows that the worst off find it harder than the rich to access NHS care

Poor people find it much harder to access NHS care than the well-off and have a worse experience when they do get it, according to research from the healthcare consumer watchdog.

According to a study by Healthwatch England, those on the lowest incomes have much more difficulty getting a GP appointment, dental care or help with mental health problems.

They are also more likely to feel that they are not being listened to by a healthcare provider and that they are not involved in important decisions about their care, compared to those who feel financially comfortable.

The link between poverty and poor health is well known, but Healthwatch’s findings show that the poorest people also face the disadvantage the watchdog cites as barriers to getting healthcare when they need it.

The findings have raised fears that the NHS is too often a ‘dual service’, with access closely linked to wealth, and calls for more to be done to make services more accessible to all.

Healthwatch’s survey of 2,018 people aged 16 and over in England, a representative sample of the population, found that:

• 42% of those who described their financial situation as “really difficult” said they struggled to see a GP, double the 21% of those who felt “very comfortable”.

• 38% of the poorest found it difficult to get dental care from the NHS, compared to 20% of the better off.

• 28% of the very poor had difficulty accessing mental health care, while only 9% of the very comfortable did so.

There was also a gap, albeit much smaller, in emergency care, with 26% of poorer people saying they found it difficult to obtain this, compared with 19% of the better off.

Overall, 19% of people on very low incomes reported difficulty accessing NHS care, compared with 8% of the well-off.

Healthwatch also found a socio-economic divide in people’s experiences of NHS care: 21% of people who were ‘really struggling’ felt they were not listened to by the last healthcare provider they saw, while only 7% of the wealthy said so. Twice as many poorer people (18%) as richer people (9%) felt that the person they last saw did not involve them in decisions about their care.

“Our findings are really worrying because they show that poorer people in our society find it much more difficult than the better off to access essential NHS care when they need it, such as a GP appointment or mental health care, and that they also are more likely to feel like they have had a worse experience when seen,” says Louise Ansari, CEO of Healthwatch.

“I am concerned because the problem of the NHS becoming a two-tiered service already exists in some parts of the service, such as dentistry, and is (also) emerging in elective care, where people who can afford it to get diagnostics so they don’t have to wait so long.”

She urged ministers to take steps to improve access to healthcare for the poorest, including freezing dental costs, improving the reimbursement scheme for healthcare travel costs and expanding statutory sick pay for all those on health insurance. NHS waiting list status.

Saoirse Mallorie, senior health inequality analyst at the King’s Fund think tank, said: “These findings are particularly worrying when we have a healthcare system that is largely free at the point of need. Poverty and wealth should have nothing to do with a person’s ability to access NHS services.

“These survey data should prompt national leaders to examine whether health care is living up to its core principle of universal access. Poverty has a significant impact on people’s health and on how people access and use the NHS. There are a multitude of reasons behind these large gaps in polling data, from difficulties taking unpaid leave, the cost of traveling to appointments and the stigmatization of poverty, which can lead to poorer healthcare experiences.”

President of the Royal College of GPs, Prof Kamila Hawthorne, said poorer people were disproportionately affected by the difficulties many people faced in accessing GP services, struggling with rising workloads and an NHS-wide shortage of general practitioners.

People from disadvantaged backgrounds often needed longer than the standard 10-minute GP appointment due to the impact of poverty on their physical and mental health, she added.

A spokesperson for the Department of Health and Social Care said: “The Government is working to ensure that everyone across the country has access to the highest quality healthcare, where and when they need it.”

They cited the recent Dental Recovery Plan’s aim to create an additional 2.5 million appointments per year, a growing number of GP appointments and the increasing use of pharmacists to diagnose and treat conditions as evidence of the government’s commitment to improving access for improve patients.