Scottish Social Attitudes Survey 2023 - Attitudes to Government, the Economy, and the Health Service

2. Context

The SSAS 2023 fieldwork period was 12^th September 2023 to the 31^st September 2023. This section provides relevant context for this period of time for the public attitudes presented in this SSAS report.

Economic context

The cost of living has risen across the world as well as in the UK since 2022. In this period, food and energy prices in particular rose markedly, partly in response to the conflict in Ukraine, and global recovery from the COVID-19 pandemic put further pressure on prices.^[iii] Inflation was at its highest in October 2022, when the Consumer Prices Index was at 11.1%.^[iv] By the time of the fieldwork period for SSAS 2023, inflation had fallen and was continuing to fall during the fieldwork. CPI was at 6.7% in the 12 months to September 2023, falling to 3.9% in the 12 months to November 2023.^[v]

In 2023, Scotland’s economy was estimated to have grown by 0.1%. This indicated a plateauing after initial recovery growth of 5.9% in 2022 and 9.2% in 2021, the immediate years following the onset of the Covid-19 pandemic where the Scottish GDP fell by 12%.^[vi] Pre-pandemic, the Scottish economy had an estimated growth of 0.6% in 2019, relative to a growth rate of 0.4% in 2018.^[vii]

Since 2010, Scotland’s employment rate had typically been increasing over time before falling in 2020 as a result of the COVID-19 pandemic, but had returned to pre-pandemic rates during early 2022. Considering the period in which the fieldwork for the Scottish Social Attitudes Survey took place, Scotland’s employment rate was estimated at 73.6% in September to November 2023, down from 75.6% in same period in 2022. Scotland’s unemployment rate was estimated at 4.5% in September to November 2023 compared to 3.4% in same period in 2022.^[viii] Despite this, labour market conditions have generally been resilient in the face of subdued GDP growth and inflationary pressures, and has been characterised by low unemployment, strong demand for labour with elevated vacancy rates, and some companies reporting staffing shortages.^[ix]

The National Health Service (NHS) in Scotland

The NHS in Scotland has experienced extreme pressures from dealing with the COVID-19 pandemic and the rising demand, operational challenges, and increasing costs have added to the financial pressures. The NHS has struggled to meet the growing demand for health services and Audit Scotland found this pressure was creating operational challenges throughout the whole system, having a direct impact on patients.^[x]

These issues are reflected in decreased patient satisfaction with the NHS. The proportion of people responding positively when asked to rate the overall care provided by their GP practice has declined from 79% in 2019/20 to 69% in 2023/24. While the 2023/24 figure is a slight increase from 67% in 2021/22, this is still 10 percentage points lower than the pre-COVID-19 level.^[xi]

The pressure on the NHS has also meant a challenging landscape in which to meet waiting time targets.

In Scotland, 95% of patients should be seen at a new outpatient appointment within 12 weeks of referral. Treatment Time Guarantee (TTG) states that following the decision to treat, all eligible patients should wait no longer than 12 weeks for treatment as an inpatient or day case.

At the end of September 2023, there were around 535,000 ongoing waits for a new outpatient appointment. Of those waiting for a new outpatient appointment, 58% waited over twelve weeks. At the end of September 2023, there were around 153,000 ongoing waits for an inpatient or day case appointment. Of those waiting for an inpatient or day case appointment, 67% were waiting over 12 weeks, with a median wait of 163 days.^[xii]

In July 2022, the Scottish Government announced new targets to eradicate long waiting times in the NHS, including eradicating waits over two years in most specialities by the end of August and September 2022 for new outpatient and inpatient or day cases respectively. By the end of September 2023, there were over 1,000 waits lasting over two years for a new outpatient appointment and almost 7,000 ongoing waits lasting over two years for an inpatient or day case appointment.^[xiii]