Public support for the NHS’s founding principles – that it is free to use, available to everyone, and tax-funded – has fallen over the last five years, research has shown. Experts suggest that a rise in economic hardship and changes in attitudes towards migration could explain this decline.

Declining Support for NHS Principles

Backing for all three pillars of the NHS dropped between 2021 and 2025 across the UK population, with the exception of a slight increase in millennials’ support for NHS funding through taxation. The King’s Fund think tank analyzed data from the British Social Attitudes survey, focusing on attitudes towards the NHS among five age groups: Gen Z (born 1997-2012), millennials (1981-1996), Gen X (1965-1980), boomers (1946-1964), and those born pre-war.

Support for the NHS being free of charge and available to everyone has fallen in recent years across all five groups. While large majorities still agree that it should be available to everyone, the decline in that belief is particularly striking:

  • The proportion of those born before the Second World War who believe in universal availability dropped from 87.1% in 2021 to 73.2% last year – a 13.9 percentage point fall.
  • Among boomers, support fell from 83.1% to 71.2% – down by 11.9 percentage points.

Support for the NHS being free of charge also decreased, but by smaller proportions, remaining a belief shared by between 85% and 92% of the population.

Generational Differences in Attitudes

The analysis revealed a generational fault line in attitudes towards NHS funding, with Gen Z holding different views compared to other age groups. Support among Gen Z for the NHS remaining tax-funded fell by 11.2 percentage points from 2021 to 2025, a larger drop than seen in Gen X, boomers, and the pre-war cohort. Fewer than four out of five Gen Z (74.1%) support this principle, compared to at least 80% in other age groups.