Scottish Government

CHAPTER SIX: EVALUATIONS OF PUBLIC SERVICES

Chapter aims

This chapter addresses four key questions:

• How do people rate the standard of the health service, quality of education, the general standard of living, public transport and the economy over the previous year?
• How do recent evaluations compare to the judgements people gave in previous rounds of the survey?
• What factors are associated with people's evaluations?
• Who do people credit - or blame - for performance in these areas: the UK Government, the Scottish Executive or someone else?

Introduction

6.1 This chapter looks at people's evaluations in 2004 of:

• the standard of the health service
• the quality of education
• the general standard of living
• public transport
• the economy

It then looks at the pattern over time for the first three of these (health service, quality of education and living standards) and compares the proportions who said standards had increased. This is followed by a detailed examination of people's evaluations of each area in 2004 and looks at differences in opinion across a number of groups within the population.

6.2 The 2001 and 2003 Scottish Social Attitudes surveys asked people to evaluate the standard of the health service, the quality of education, and general living standards. These were initially designed to be asked with reference to election cycles so in 2001 people were asked to think back to the previous general election in 1997 and make their assessment, in 2003 they were asked to think back to 1999 (the time of the first Scottish Parliament elections). In 2004 two new areas were added, transport and the economy (the latter had been asked about once before in 1999 though in a slightly different format). The question wording was also altered and people were asked to think about performance over the past twelve months with the intention that these would now be repeated annually. Taking the example of the question about the health service, the following question was asked:

Thinking back over the last twelve months, that is since (month) 2003, would you say that since then the standard of the health service in Scotland has increased or fallen?
Increased a lot
Increased a little
Stayed the same
Fallen a little
Fallen a lot

The same format was used for the other areas with the exception of the economy where the answer categories ranged from "a lot stronger" to "a lot weaker".

6.3 Evaluations of performance are just one half of the story - Scotland's political context means that it is also necessary to ask people to whom they apportion credit or blame for performance. A follow-up question was asked for each area:

What do you think this has been mainly the result of?
Mainly the result of the UK government's policies at Westminster
Mainly the result of the Scottish Executive's policies
For some other reason

The final part of the chapter looks at the trends over time in who people credit and blame for performance.

Performance over the past year

6.4 Figure 6.1 presents the proportions in 2004 who said that standards have either increased or fallen. The first point to note is that none of the areas were judged by anywhere near a majority to have increased their standards. Three in ten (31%) said that their living standards had gone up and just under one in five (18%) said the standard of the health service had increased. The second point to note is that, with the exception of the health service, two common patterns emerge. The most common answer given for every other area was that things had stayed the same while, on balance, the proportion of people who said standards had fallen was never any higher than the proportion who said they had increased. True, the largest 'net increase', for living standards, is only seven percentage points while for the others the balance is often only just on the increase side. In this respect the health service stands out as quite distinct from the other areas. More than twice as many said standards had fallen (46%) as said they had increased (18%).

Figure 6.1 Evaluations of public services over past twelve months, 2004

Evaluations over time

6.5 But how do the 2004 results compare with results from previous years? Figure 6.2 looks at the proportions who said standards had increased in 2001, 2003 and 2004 to illustrate the trends ¹². The first point to note is that the shortening of the recall period in 2004 (as discussed in the introduction) does not appear to have altered judgements enormously. In fact, each year's readings are remarkably similar, though there has been a five percentage point decline in the proportion saying that health service standards increased (from 23% to 18%).

Figure 6.2 Evaluations of the health service, quality of education and the standard of living, 2001, 2003 and 2004

The Health Service

6.6 Table 6.1 explores the relationship between evaluations of the health service and a number of key factors. Its fifth column shows the overall balance of opinion by subtracting the percent who said standards had fallen from the percent who said they had increased. This makes it easier to quickly identify the groups most and least likely to have passed a favourable judgement and gives a sense of the strength of their opinion. Positive numbers indicate that more people within a group said standards had increased than had fallen whilst a negative number shows the opposite. In this instance all of the numbers in this column are negative, but the size is a useful guide to how strongly people felt.

6.7 Three groups stand out from this table as being much more likely to say that standards had fallen than increased: women, people who do not identify with any political party, and people living in small remote towns. It is not surprising that supporters of the two parties in government in Scotland (Labour and the Liberal Democrats) were less likely than supporters of the other parties to express that standards had fallen; a similar relationship between satisfaction with the NHS and political identification has long been identified in analyses of the British Social Attitudes survey (see, for example, Bromley and Hewson, 2005).

6.7 Table 6.1 also looks at personal experience of the NHS and evaluations and in fact finds that there is very little difference between the views of people who had used the NHS in the past year themselves and people who had not. This is in part due to the fact that only a very small proportion of the population have no contact with the NHS in any given year (in 2004 just 10% said this) so direct experience is not a hugely useful means of understanding attitudes to the NHS in general. Though it should be noted that when asked about specific services, such as General Practitioners ( GPs) or in-patients, users of these services generally rate them more highly than non-users (Bromley and Hewson, 2005).

6.8 The relationship between newspaper readership and evaluations of the health service was also explored but not found to be significant, nor were the views of people employed in the private sector any different to those in the public sector.

Table 6.1 Evaluations of health service standards, by sex, age, education, party identification, urban / rural residence, and recent experience of NHS services

Quality of Education

6.9 Table 6.2 looks at quality of education in more detail. It follows the same format as Table 6.1 and also includes a 'net balance of opinion' column. It compares the views of people who have a school aged child (4-15) in their household with those who do not as a proxy measure of use of education services ¹³. Looking back to Figure 6.1, one in six (16%) people said "don't know" to this question. In many instances, therefore, the differences found in views about education quality in part reflect the fact that some groups, most notably the over 65s and people without school aged children, simply did not offer an opinion here. However, when the analysis was carried out using only those people who gave an answer the patterns are very similar. Table 6.2 presents the views of all respondents.

Table 6.2 Evaluations of the quality of education, by age, education, party identification, urban / rural residence, and presence of school age child within household

6.10 In contrast to Table 6.1, the net balance of opinion is, in almost all cases, in a positive direction; more people said that quality had increased than had fallen. Young people, Labour party supporters, people in remote rural areas and those with a school-aged child in their household were the groups for which this is most commonly the case. Again views about public services are very much linked to party political identification. The only group amongst whom more people said the quality of education had fallen than had increased was Conservative Party supporters.

Public transport

6.11 Table 6.3 explores evaluations of public transport. As the proportion who did not know how to answer this question was also quite high (13%) the analysis was conducted twice, once with all respondents' views and then with just the views of people who expressed an opinion. In both instances the pattern was quite similar so Table 6.4 includes the views of all respondents.

6.12 Once more a fairly mixed picture emerges. Young people and daily public transport users were the most likely to say that standards had increased (38% and 36% respectively), but in neither case was the proportion who said this particularly large. Of course, there is some degree of overlap between these two groups, but not as much as might be expected - 34% of young people use public transport daily.

6.13 Other notable findings include the fact that the views of people in cities were, on balance, the most positive while people in small towns (and in particular, in small remote towns) were the least.

6.14 Party political identification was significantly associated with views about transport, as with the health service and education. SNP supporters stand out as being distinct - as a third (33%) said that the standard of transport had increased compared with between a fifth and a quarter of supporters of all the other parties. However, it is not clear from these results why this difference exists.

Table 6.3 Evaluations of the standard of public transport, by sex, age, urban / rural residence, party identification, and use of public transport

Living standards

6.15 Now looking at standards of living, Table 6.4 shows more varied patterns than either of the previous two. Once more the balance of opinion is positive for more groups than not, though here some key differences emerge. The most significant being in relation to people's self-rated economic hardship. People who say they are living comfortably were twice as likely to say that living standards in general had increased over the past year than people who say they are having difficulty coping on their income (42% and 19% respectively).

6.16 Men were more likely than women to say that standards of living had increased, while older people were more likely to say this than their younger counterparts. People with higher education were more likely to think the general standard of living had increased than people with no qualifications.

6.17 Unlike the heath service and education, the relationship between party political identification and evaluations of living standards was fairly weak so this is not shown in the table, though people with no party identification were on the whole less likely to believe that standards have improved compared to supporters of the four main parties.

Table 6.4 Evaluations of the general standard of living, by sex, age, education, urban / rural residence, and self-rated hardship

The economy

6.18 The final area considered was the strength of the economy. As shown in Figure 6.1, exactly the same proportion of people said that the economy had grown as said it had weakened and Table 6.5 illustrates the extent to which views on this matter varied. Starting with party identification a familiar pattern is repeated once more. Supporters of the parties in government in Scotland were, on balance, more likely to say the economy had grown stronger than say it had weakened while the reverse is true for all other party supporters. In fact the views of Conservative supporters had almost the exact opposite views of those of Labour and Liberal Democrat supporters.

6.19 Younger people were also more likely to judge the economy to have grown stronger than older people, and were much less likely to say it had weakened. Unsurprisingly, people's own perceptions of their economic standing was clearly linked to their views on the economy as a whole. A third (33%) of people living comfortably said the economy had grown stronger compared to almost a quarter (23%) of people struggling on their income.

6.20 People in urban areas were more likely to feel that the economy had grown than people in remote or rural parts of Scotland. Over half of Scotland's Gross Domestic Product is made in Edinburgh, Glasgow and the surrounding areas that feed into the two cities so it is unsurprising that residents of large urban areas are more likely to perceive growth in the economy than people living in more remote and less economically productive areas (Glaeser, 2004).

Table 6.5 Evaluations of the strength of the economy, by sex, age, urban / rural residence, party identification, and use of public transport

Evaluations and responsibility

6.21 Part of the reason for looking at perceptions of public services and factors such as the economy and living standards is to assess the extent to which people feel the apparatus of devolved government is making a difference. However, as mentioned in the introduction, the fact that a number of the items asked about are largely the Scottish Executive's responsibility does not necessarily mean that either credit or blame for performance in these areas will automatically be directed to that institution.

6.22 Table 6.6 looks at those people who said that standards had increased and where they place the credit for this. It is quite a mixed picture. The Scottish Executive was given the credit for improvements to education, transport and the economy (even though the latter is, to a very large extent, arguably the UK Treasury's domain). In contrast, the UK Government was given the credit for improvements to the health service, despite this being the Scottish Executive's single largest area of expenditure. One in five (21%) credited the Scottish Executive for their increased living standards, the smallest proportion to do so for any item. One in three credited the UK Government or attributed this to some other reason (35% and 33% respectively).

Table 6.6 Credit for increased standards, 2004

6.23 Table 6.7 shows that the UK Government was mainly held responsible for falling standards in each area except public transport, where falling standards were most commonly attributed to some other reason. The highest responsibility for decreasing standards attributed to the Scottish Executive was for the economy (30%). Again, it is surprising that so few people believe the Scottish Executive is responsible for perceived falls in standards of the health service or the quality of education given that these are such major components of the Scottish Executive's remit.

Table 6.7 Responsibility for falling standards, 2004

Changing responsibilities over time

6.24 Given that awareness levels of the way different responsibilities are shared between the Scottish Executive and UK Government are, on the whole, quite low ( see Chapter Two for a more detailed discussion of this) it is worth exploring the extent to which people's readiness to apportion responsibility to what on the surface might seem the "wrong" body has changed over the past few years. This section discusses the trends in how people have apportioned responsibility for the performance of the NHS, education and living standards since 2001 when this question was first asked. That is not to say that everyone who blames the UK Government for a fall in the standards of the NHS in Scotland does so out of ignorance - it is entirely possible that they could, for example, be passing judgement on the size of the budget allocated to Scotland from Westminster.

6.25 Table 6.8 shows that the proportion who credited the UK Government for increased standards of the health service has varied over time. In 2001, over half (54%) gave credit to the UK Government for increasing NHS standards, by 2003 this dropped to 30% while in the same time the proportion crediting the Scottish Executive almost doubled. In 2004, however, this pattern reversed and once again the credit was more likely to land at the door of the UK Government. Interestingly, this change is only found amongst those who think standards have increased, and while the proportions in both years who said standards had increased were quite small the change is statistically significant. In contrast, the proportion who blamed the UK Government or Scottish Executive for falling standards was much the same in 2003 as in 2004. Quite why this shift might have occurred is unclear, particularly because this pattern is not evident for either education or standard of living assessments.

Table 6.8 Responsibility for changes in the standard of the health service, 2001, 2003, 2004

6.26 Table 6.9 shows that between 2001 and 2003 the proportion who gave credit to the UK Government for an increase in the quality of education fell from 45% to 30%, while the proportion crediting the Executive increased from 35% to 43%. This is similar to perceptions about responsibility for health service standards between 2001 and 2003. In 2004 views about education were very similar to those found in 2003, for example 46% in 2004 credited the Executive compared with 43% in 2003. So, whereas the credit for increased health service standards switched from Executive to the UK Government between 2003 and 2004, this was not the case for education quality where views remained fairly consistent. Views as to who is to blame for a decline in education quality saw little consistent variation between 2001 and 2004.

Table 6.9 Responsibility for changes in education quality, 2001, 2003, and 2004

6.27 When it comes to living standards, however, there has been quite a large shift towards people saying that any increases were due to reasons outwith either the Executive's or the UK Government's control. Table 6.10 shows that in both 2001 and 2003 fewer than one in five said that some other reason accounted for increased standards whereas in 2004 as many as one in three said this. There was also a twelve percentage point decline in the proportion holding the UK Government responsible for falling living standards and an increased number of people place responsibility for this with either the Scottish Executive or some other reason than did so previously. When the question has been asked once more in 2005 it should be possible to see whether these changes represent a consistent pattern.

Table 6.10 Responsibility for changes in the standard of living, 2001, 2003, 2004

Key points from this chapter

• Evaluations of standards of the health service were not as favourable as those for the quality of education, the general standard of living, public transport or the economy.
• 18% said health service standards has increased over the past year and 41% said they had fallen.
• For each of the other four areas more people, on balance, said standards had increased than said they had fallen, though in many cases the margin was very small. In fact, the most common answer given in relation to these four areas was that standards had stayed the same.
• There was little notable change in people's evaluations of the health service, education, and the general standard of living between 2001, 2003 and 2004.
• The only difference was that the proportion saying health service standards had increased fell from 23% in 2001 to 18% in 2004.
• 52% of women said health service standards had fallen compared with 39% of men, while 46% of people over 65 said this compared with 32% of 18-24 year olds.
• The views of people with recent experience of using the NHS were no different to those who did not have any experience.
• The groups most likely to have given a favourable evaluation of education quality were: young people, Labour supporters, people in remote rural areas and those with a child aged 4-15 living in their household.
• 42% of people who said they were living comfortably said the general standard of living had increased compared with 19% of people having difficulty coping on their income.
• The other groups more likely to think living standards had increased were: men, people over 65, and people with higher education.
• Transport standards were most likely to be judged to have increased by young people and those who use public transport on most days. People in urban areas were also more likely to say this while people in small remote towns were the group most likely to say standards had fallen as opposed to increased.
• The economy was more commonly judged to have grown stronger by Labour and Liberal Democrat supporters, and by young people. Once again personal hardship shaped views: people having difficulty coping on their income were much more likely to say the economy had weakened than people living comfortably.
• In 2004 people credited the Scottish Executive for increases in the quality of education, transport and for a stronger economy. The UK Government was given the credit for increased health service standards while a rise in the general standard of living was credited equally to the UK Government or some other reason.
• Declining standards were all blamed on the UK Government, with the exception of the economy where the Scottish Executive was blamed for its weakening.
• Between 2001 and 2003 the proportion crediting the UK Government for increased health service standards fell from 54% to 30%, while those crediting the Scottish Executive grew. This changed in 2004 when the UK Government was once again more likely to be credited.
• For education the pattern was consistent across the years: fewer people credited the UK Government in 2003 than in 2001, while the figures for 2004 were very similar to 2003's.
• The proportion crediting some other reason for increased living standards more than doubled between 2001 and 2004 (from 15% to 33%).
• Between 2003 and 2004 the proportion holding the UK Government responsible for falling living standards fell from 60% to 48%. The Scottish Executive or some other reason appear to have been held responsible in equal measure.