Satisfaction with the NHS is at an all time low, but private medical insurance is failing to benefit. Andrew Holt reports

Medical insurance faces a number of challenges if the public is to fully embrace it, according to new research. The study highlights two worrying trends for the insurance industry: the fact that people still expect the government to pay towards private medical insurance (PMI) and nearly half of those questioned knew little about health insurance on offer.

The study by medical insurance intermediary Private Health Partnership (PHP) reveals an increase of 8% from 55% to 63% of those who believe the government should pay towards the cost of private treatment, evidence there are major issues over Britain's healthcare.

The number of those people who believe the government should pay something towards the cost of private treatment increased the most in the 25-34 age and C2 groups both from 55% to 70%, even higher than the 67% of the 65+ respondents.

In the previous survey 52% of the 55-64 age group were against this notion, but this has now dropped to 38%.

The view that the government should make a contribution rose from 55% to 67% in the North. But there was little difference across the regions except for Scotland at 59%. Overall, the findings of a significant rise suggests a hardening of opinion across the country.

According to Jan Lawson, managing director of PHP: "There are clear concerns about the fairness of effective 'double charging' when paying for private treatment and this appears to be growing which may point the way forward to a closer partnership between the NHS and the insurance industry."

And this is coupled with the fact that half of the population is now less confident with the NHS as opposed to 42% since the turn of the year. And there is no region in the UK where those more confident in the NHS are a majority.

Fiona Harris, head of personal markets for Bupa Insurance, agrees with a partnership model. "Healthcare in the UK is not an 'either-/or' system - either private health insurance or public funding. It should be an 'and/and'
system, one that combines private or voluntary funding with public entitlement.

"There are lots of different systems ranging from social insurance through to duplicate and supplementary funding. It is important that there is more of a public debate about how public and private health funding could work better in combination.

"The focus needs to be on how we can build a better health system for the people of this country - using the best of both the public and private sectors together."

But the insurance industry also needs to communicate better. The survey shows that only 46% feel they were fairly knowledgeable about medical insurance.

When asked to what extent they feel knowledgeable about medical insurance, 46% feel they are knowledgeable, but the same percentage feel they are not. For women 48% consider themselves knowledgeable as opposed to 45% of men.

Unsurprisingly, 56% of the AB social group consider themselves knowledgeable dropping to 39% among C2s. The South East at 49% is highest and Scotland and northern England the lowest at 43%. The most extreme result was among the 18-24 age group where 57% feel they lack knowledge about medical insurance.

And despite the recent electoral focus on healthcare there has been a big negative attitude shift over NHS care in a very short time.

Confidence dipped worst in the 45-54 age group from 48% to 60%, and in the C2 and DE groups to 53% and 52% respectively from 50% and 43%. The Midlands, which had the highest confidence levels in December 2004 at 44% now records the lowest at 39%.

This indicates that despite increases in spending on the health service and more favourable waiting list figures the message is still not getting through.

Lawson adds: "On the face of it, these findings are predictable, but there is clearly a greater need for education about the types of medical insurance available and the costs.

"The value of educating the 18-24 age group at a time when the cost of medical insurance is likely to be much lower to them cannot be underestimated both for personal benefit and to remove some of the strain from the NHS."

Research for this ongoing six-monthly 'PHP thermometer' is an effort to gauge changes in the public's attitude towards 'going private' for medical treatment.

But Harris says that those who have taken the leap into PMI are, in fact, satisfied. "When we asked patients for their views, 80 % say they would keep their PMI even if the NHS met its 2008 target for reducing waiting lists, and 60% would maintain it even if NHS waiting lists disappeared.

"In a separate MORI poll, 62% of people said the current investment in the NHS was unlikely to produce the improvements they would like to see."