Research by the health services consumer watchdog found that poorer people find it much more difficult to access NHS care than wealthier people, and when they do access care, their experience is worse.
A HealthWatch UK survey revealed that people on the lowest incomes have far more difficulty getting appointments with their GPs, getting dental care or help with mental health issues.
They are also more likely than those who are financially better off to feel that health professionals are not listening to them and not involved in key decisions about their care.
The link between poverty and ill health is well known, but HealthWatch’s findings show that people who are worse off also face what the watchdog says are barriers to accessing healthcare when they need it.
The findings raise concerns that the NHS is often a “two-tiered service” closely linked to wealth, and call for it to do more to make services more accessible to everyone.
Healthwatch surveyed 2,018 people aged 16 and over in England – a representative sample of the population – and found:
Among those who described their financial situation as “very difficult”, 42% said it was difficult for them to see their GP, double the 21% of those who said they were “very comfortable”.
38% of the poorest people find it difficult to access NHS dental care, compared with 20% of the better-off.
28% of poor people have difficulty accessing mental health treatment, while only 9% of the better-off population have access to mental health treatment.
There is also a gap in A&E care, although the gap is much smaller: 26% of poor people say they have difficulty accessing A&E care, compared with 19% of wealthier people.
Overall, 19% of very low-income people said they had difficulty accessing NHS care, compared with 8% of better-off people.
Healthwatch also found there were socio-economic differences in people’s experience of NHS care: 21% of “really distressed” people felt the last medical professional they saw did not listen to them, compared with just 7% of better off people. . Twice as many poor people (18%) as rich people (9%) feel the last person they saw did not involve them in decisions about their care.
“Our findings are indeed worrying as they suggest that poor people in our society find it harder and more difficult to access vital NHS care when they need it, such as GP appointments or mental health help, than the rich. Maybe they’ll feel like they’ve been through something worse when they’re seen, said Louise Ansari, chief executive of Healthwatch.
“I’m concerned because the problem of the NHS becoming a two-tier service already exists in some services, such as dentistry, and [also] Elective care is on the rise, where people who can afford private care or diagnosis can pay so they don’t have to wait as long. “
She urged ministers to take steps to increase access to care for the poorest people, including freezing dental fees, improving the medical travel expense reimbursement scheme and extending statutory sick pay to include everyone on the NHS waiting list.
Saoirse Mallorie, senior analyst on health inequalities at the King’s Fund think tank, said: “These findings are particularly worrying when our health services are largely free when needed. Poverty and wealth should be linked to one It has nothing to do with people’s ability to access NHS services.
“This survey data should give national leaders reason to check whether the health service is delivering on its fundamental principle of universal access. Poverty has a significant impact on people’s health and how people access and use the NHS. These clear gaps in the polling data There are multiple reasons behind this, including the difficulty of taking unpaid time off, the cost of attending appointments, and the stigma of poverty, which can lead to a worse health care experience.”
Professor Camilla Hawthorne, chair of the Royal College of GPs, said poorer people were disproportionately affected as many faced difficulties accessing GP services, who were struggling to cope with increasing workloads and Shortage of GPs in the NHS.
She added that people from poorer backgrounds often need longer than a standard 10-minute GP appointment because poverty affects their physical and mental health.
A spokesman for the Department of Health and Social Care said: “The government is working hard to ensure everyone across the country has access to the highest quality healthcare when and where they need it.”
They cite the recent Dental Rehabilitation Programme, which targets 2.5 million more appointments per year, an increase in the number of GP appointments and an increase in the use of pharmacists to diagnose and treat disease, as evidence of the government’s commitment to improving patient access.
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