London School of Hygiene & Tropical Medicine

UK doctors think Britain’s exit from the European Union (EU), also known as Brexit, will be very bad for the NHS, according to new research published in the Journal of Epidemiology & Community Health.

Led by the London School of Hygiene & Tropical Medicine (LSHTM) in partnership with University College London and Queen Mary University of London, the study anonymously surveyed UK doctors asking questions about their political beliefs and voting patterns. It is the first large scale study to look at the political opinions of UK doctors.

The results show that as a group, doctors are predominantly left-wing and liberal-minded. However, high earners tend to lean more to the right of the political spectrum, while surgeons are twice as likely as other specialties to express right-wing views.

Against a backdrop of major upheavals in health and social care as well as the political landscape in the UK, the research team wanted to find out about the political beliefs and voting behaviours of this publicly trusted and highly influential group of professionals.

To reach as representative a sample of the UK medical workforce as possible, the researchers collaborated with the online professional network, Doctors.net.uk, and validated proportionality of respondents against records from the professional regulator, the General Medical Council.

Those logging on to their Doctors.net accounts were directed to the survey link, which was open for a week following the 2017 UK general election.  This link was also sent to a wide range of specialty associations and relevant Facebook groups.

In total, 1172 respondents, representing 0.4% of the 282,304 doctors licensed to practice in the UK in 2016, were included in the final analysis. Nearly half (45%) were women. Most respondents had qualified in the UK, lived in England, and worked in the NHS.

One in three (36%) was a consultant and around one in five was a GP. Just under 30% were junior doctors.

When respondents rated their political beliefs on a scale of 0 (extremely left wing) to 10 (extremely right wing), the average score was 4. But the higher the income bracket, the more likely was the respondent to lean to the right.

Surgeons were twice as likely to register a right wing score, while psychiatrists and public health doctors were half as likely to do so. Junior doctors at specialty training entry level (ST3) and above were less likely to express right wing views relative to all other grades.

Nearly two thirds (just over 62%) of respondents described themselves as liberal while nearly one in four (23.6%) said they were conservative.

There was a shift to the left between the 2015 and 2017 elections, with the proportion of doctors voting Labour rising from just over 29% to just over 46%, while the proportion voting Conservative fell from just over 26% to just under 20%.

Among those who were ineligible/unable to vote in 2017, nearly a third (just under 30%) said they would have opted for a Labour candidate. Voter turnout among doctors for both elections was significantly higher than among the electorate.

Doctors overwhelmingly backed staying in the EU, with nearly eight out of 10 voting to remain in the 2016 referendum. Among those ineligible/unable to vote, more than 85% said they would have voted to remain in the bloc. Only 2% of respondents didn’t vote compared with nearly 28% of the electorate.

Virtually all respondents agreed that EU nationals working in the NHS should be allowed to stay in the UK after Brexit. Most also thought Brexit would be very bad for the NHS, irrespective of grade, income, or specialty, giving it an average score of 2 on a 0 (worst outcome) to 10 (best) scale. Nearly 83% scored it below 5.

In terms of their views on health policy, most backed minimum unit pricing for alcohol (74%); charging patients not eligible for NHS treatment for non-urgent care (71%); and protected funding for the NHS (87%). Two thirds (just under 66%) also thought there was too much private sector care funded by the NHS: only surgeons were half as likely to agree.

Dr Kate Mandeville, lead author from LSHTM, said: “This research comes at an important juncture in UK politics. Doctors are amongst the best-placed people to understand the impact of political decisions on the NHS. On Brexit their opinion is very clear: Brexit is bad for the nation’s health.

“We found that the current government lost support among doctors between the 2015 and 2017 general elections compared to an increase in support among the general public. This suggests that doctors in particular are very concerned about the government’s handling of the NHS.”

The authors acknowledge limitations of the study, including that despite their best efforts, the sample may not be fully representative, so should be taken only as an indication of the views of the UK medical workforce.

Further work is essential to obtain a better understanding of UK doctors’ political identities, particularly the economic and societal differences. This is important as the political ideology of doctors has been shown to influence clinical decisions on contentious issues in other contexts.

Publication

Kate L Mandeville, Rosie-Marie Satherley, Jennifer Hall, Shailen Sutaria, Chris Willott, Kielan Yarrow, Keerthi Mohan, Ingrid Wolfe, Delan Devakumar. The political views of doctors in the United Kingdom: a cross-sectional study. The Journal of Epidemiology & Community Health. DOI: 10.1136/jech-2018-210801