Public trust in health care: the system or the doctor?

Abstract

Objectives: To examine how the public assess trust in health care in England and Wales. Design: Postal structured questionnaire in cross sectional survey. Setting: Random sample of people on the electoral register in England and Wales. Subjects: People aged 18 and over. Main outcome measures: General levels of trust and confidence in health care. Results: The response rate was 48% (n = 1187). The mean level of confidence (trust) in the healthcare system was 6.0 out of a score of 10. Levels of distrust appeared relatively high with at least 356 (30%) respondents reporting little or very little trust for 28 of 32 specific aspects of health care. The highest levels of distrust were found in relation to how the health service was run and financed, particularly waiting times and the implication of cost cutting for patients. Statistical analysis by univariable linear regression of the specific determinants of generic assessments of public trust (confidence) suggested that the key aspects were patient centred care and levels of professional expertise. Being covered by private health insurance was also a key determinant of levels of public trust. Conclusion: Public assessment of trust tends to address the views of care at the micro level. Policy makers concerned with the erosion of public trust need to target aspects associated with patient centred care and professional expertise.

Preferences of older patients and choice of treatment location in the UK: A binary choice experiment

“…Our finding also suggests an issue of public trust in the healthcare system [38][39][40]. Having a consultant performing the operation is akin to having the best person doing the job, so ensuring the best medical outcome.…”

What does it mean to trust a health system?

“…The need to find ways to understand these interdependent relationships is of paramount importance [24,26,27], yet the idea of trust in large-scale institutions or health systems is daunting when the condition of trust-that the 'truster' know the 'trusted' cannot be fulfilled given the distance of government from its citizens or health plans from its members [25]. Moreover, evidence about how trust can be nurtured, whether it can be viewed as a performance indicator and what makes a health system trustworthy is even scarcer [4,7,20].…”

Biobanks and the phantom public

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