Analysis of British Social Attitudes survey data by the King’s Fund has revealed declining public support for three core principles underlying the NHS: that it is free to use, available to everyone, and tax-funded. The research examined attitudes across five generational cohorts and found backing for all three pillars dropped over the five-year period, with only a minor exception in millennials’ support for tax funding.
The most pronounced decline emerged in support for the principle that the NHS should be available to everyone. Among those born before World War II, this belief fell from 87.1% in 2021 to 73.2% in 2025, representing a 13.9 percentage point drop. Boomers showed a similar pattern, with support declining from 83.1% to 71.2%, a decrease of 11.9 percentage points. Support for free-at-point-of-use care also fell, though by smaller margins, and remains held by between 85% and 92% of the population.
The analysis identified what researchers termed a generational fault line in NHS funding attitudes. Generation Z showed the steepest decline in support for tax-funded healthcare, dropping 11.2 percentage points from 2021 to 2025. Fewer than four out of five members of Generation Z (74.1%) now support tax funding compared with at least 80% in other age groups. Experts attributed this shift to economic pressures facing younger adults, including high housing costs, student debt, wage stagnation, and limited access to services such as mental health support.
Think tank analysts noted that while absolute support for the NHS’s founding principles remains strong, the decline occurs against a backdrop of record low public satisfaction with the service and growing political divisions. Changing attitudes toward migration may also play a role in reduced support for the principle of universal availability. Officials cautioned that as the NHS consumes an increasing share of public spending amid an ageing population and competing demands from defence, social care, and special educational needs, declining public support could complicate future efforts to secure increased funding.
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