Europe’s Satisfaction With Healthcare Systems Continues to Decline
Amidst the stellar advancements of modern medicine and healthcare, and its resilience in the face of global health crises, resentment simmers beneath the surface. Frustration with access to healthcare appointments, the standard provided in healthcare institutions, staff shortages and a general mistrust of those making political decisions about health echoes across the European continent. Never before in the 10-year history of the STADA Health Report have Europeans felt so let down by their healthcare systems. However, their pessimism is accompanied by a contrary trend: a growing trust in conventional medicine. This is an interesting contradiction as much as a wake-up call. But it is also an expression of hope for the future of Europe’s current healthcare landscape.
Healthcare Satisfaction Drops for Fourth Consecutive Year
Since 2021, the STADA Health Report has logged a continuous decline in satisfaction with public healthcare systems in Europe – and the trend continues. In 2020, just before the pandemic broke out, overall satisfaction was at 74 percent, dropping to 71 percent in 2021. By 2022, it was as low as 64 percent, and fell to 61 percent in 2023. Today, as few as 56 percent of Europeans are satisfied with the healthcare system in their country. And while some first-time participants are bringing up the rear, average satisfaction among repeat participants has also decreased by an average of 3 percentage points compared to 2023.
Satisfaction dropped most notably in the UK, forfeiting 11 percentage points, with discontentment likely fuelled by post-pandemic pressure on the National Health Service; Kazakhstan, where satisfaction dropped by 10 percent; and Germany, with a loss of 8 percent. In those three countries, difficulties to book appointments (69 and 68 in the UK and Germany, respectively) and the standard of care (Kazakhstan, 61) were cited as the main reasons for discontent.
Lack of appointments, poor standards of care and distrust drive dissatisfaction
Overall, people in Hungary are the most dissatisfied with their healthcare system: 72 percent of them find it insufficient, followed by Kazakhstan (67) and Serbia (65). Across Europe, the main arguments for dissatisfaction are struggling to get an appointment in the first place (54), which seems to be particularly difficult in Hungary (73), and personally having or knowing someone who has received inadequate care (47), which was most often reported in Sweden (63). Additionally, almost 1 in 2 Europeans (46) say they have a general lack of trust in those responsible for health policy, which is most common in the Czech Republic (66). Other reasons for dissatisfaction with healthcare systems include a lack of sustainability (39), privatisation which negatively impacts healthcare services (30), no access to preventive services and lack of medical staff in hospitals (28 each). While 42 percent of Europeans could imagine paying for better-quality healthcare, especially in Uzbekistan (75), this is not a majority option, mainly because 1 in 3 Europeans say they could not afford to pay more for healthcare.
Europeans appreciate healthcare professionals and availability of medicines
Belgium (85), Switzerland (81) and the Netherlands (77) remain the most satisfied with their healthcare systems – mainly due to doctors or pharmacists giving good advice (56, all), and being able to obtain medicines when needed (64 Belgium, 63 Netherlands and Switzerland). Interestingly, good availability of medication is also the main reason for satisfaction with the German healthcare system (66 vs 56 European average) despite supply shortages for certain products, especially for children’s medication. Other satisfaction drivers are affordability of medication (43), which is rated especially high in Belgium (59), and good access to preventive health services (41), which is particularly valued by the Czech population (62). In the STADA Health Report 2023, the Czechs were also among the countries with the highest number of regular preventive healthcare visits.
A general observation: satisfaction with healthcare systems could be linked to regular self-care. People who regularly engage in self-care are more likely to be happy with the healthcare system (57) than those who reportedly do little to support their own health (47).
Healthcare systems require improvement
Beyond addressing the immediate causes of dissatisfaction mentioned above, Europeans have some broader ideas about what needs to be worked on to improve healthcare systems in the future. Almost 1 in 2 Europeans (48) believe it would make a difference if health policy-makers have a health-related background – a rather sensible suggestion, considering that a lack of trust in this group is a major driver for dissatisfaction. Increasing the wages of people working in medical professions is the second most popular measure, with 47 percent hoping this might motivate more people to pursue a career in healthcare. 43 percent also believe that increased production of medicines in their own country rather than relying on imported goods could help. More than 1 in 3 Europeans (35) would like to see the scope of their pharmacists’ responsibilities expanded to free up doctors’ capacities, and almost as many (31) would like to see alternative career paths to becoming a doctor offered to address shortages. On a similar note, 1 in 5 Europeans believe entry requirements for medical professions should be reduced to increase the number of people employed in the sector.
Trust in conventional medicine is on the rise
Almost 7 in 10 Europeans (69) say they trust conventional medicine completely or mostly while educating themselves independently on the internet – an increase by 7 percentage points compared to 2022. Men (35) are more likely to have no reservations whatsoever against conventional medicine than women (25). Looking at individual countries, returning participant Finland (84) takes the lead in terms of trust, followed by Spain (82), which has always been among the fiercest proponents of conventional medicine.
The main reasons for high levels of trust are health practitioners such as doctors and pharmacists: 48 percent expressly appreciate their advice, believing that healthcare professionals (HCPs) “know what’s best”. People in Belgium and Ireland hold their professionals’ opinions in particularly high regard (56). An additional 42 percent say they trust conventional medicine because it has proven effective – especially in Finland (57), the United Kingdom (UK) and Ireland (51). Another 41 percent base their trust on the decades-long research that has led to many breakthroughs in conventional medicine, and 39 percent are put at ease by high quality standards, regulatory processes and controls.
It seems that trust in conventional medicine coincides with a higher likelihood of healthcare satisfaction: 59 percent of people who say they trust conventional medicine are satisfied with their healthcare system, compared to only 28 percent of those who have reservations against conventional medicine. But still, improving confidence alone is not enough to compensate for the ever-growing discontent with healthcare systems – system deficiencies seem to be the root of the problem, not medicine itself.
Localised scepticism of conventional medicine prevails
People in Kazakhstan are most wary of conventional medicine (23). And Uzbekistan seems in two minds about the topic: it has the highest share of people saying they completely trust conventional medicine (56), as well as 22 percent who say the opposite. Across the continent, 44 percent are worried that people involved in conventional medicine are just trying to make money, and an equal share (43) are frustrated with conventional medicine’s focus on symptom management rather than addressing root causes. This point of view is more prominent among women (46) than men (39). Just over 1 in 3 (35) think that the pandemic brought to light the limitations of conventional medicine, an opinion shared most often by people in Serbia (49) and Romania (48). 17 percent have been disappointed in advice received from a GP or prefer to use alternative treatments, the latter being especially popular in Switzerland (34). For 16 percent, negative press about conventional medicine has been off-putting, and 15 percent complain that conventional medicines are often unavailable or in short supply.
More individualised care and better communication to further improve conventional medicine
To further improve confidence, 46 percent of Europeans believe that conventional medicine should focus more strongly on the individual patient case and their demands – and this sentiment comes primarily from Spain and Finland, the strongest advocates (59). Improved communication between HCPs and patients during consultations would also help to improve conventional medicine’s overall reputation. In Portugal, more than half of the population would approve of clearer, more layperson-friendly communication. In terms of performance, 41 percent of Europeans would like to see more breakthroughs in conventional medicine, especially in the treatment of serious diseases such as cancer, while 40 percent want to see a more holistic approach to medicine, taking into account both physical and mental health. To make conventional medicine even more accessible, 29 percent would like to see lists of doctors who specialise in treating specific diseases, easier access to appointments around work commitments (28), more comprehensive materials to help them learn about diseases and treatment options and more user-friendly medicines (25).
Healthcare professionals are vital to keeping the system alive
Health professionals such as general practitioners (GPs) and pharmacists are also the most important sources of information when it comes to buying over-the-counter (OTC) medicines and dietary supplements. GPs are the most trustworthy sources for recommendations (63), closely followed by pharmacists (54) and other healthcare professionals (49). In Ireland and Finland, especially, people are highly likely to trust their GP’s and pharmacist’s opinion (72/71 and 70/65, respectively). Looking at age groups, Europeans above the age of 55 are most likely to trust their GP’s recommendation, while first-hand accounts from friends or family tend to sway 18 to 34-year-olds. And: GPs (26), pharmacists and other HCPs (21 each) are not only the most trustworthy but also most influential forces when consumers purchase medication. By comparison, recommendations stemming from AI (7), online-advertising (11), social media (12) or Google search results (11) are significantly less vital when deciding what mediation to purchase.
Thinking about the future of their brick-and-mortar pharmacies, 46 percent of Europeans would like to see more affordable treatment options and medication, especially in Finland (62) and the Czech Republic (61). Roughly 1 in 3 (32) would appreciate the opportunity to have their prescriptions or other medications delivered to their home, an idea that is particularly popular in Germany (42). An additional third (31) would like to see other health-related services like eye or hearing tests merged into pharmacy services, and 31 percent would appreciate more information on the specifics of their prescription or medication in terms of use or application.
Artifical intelligence: an open box
Europeans are wary of AI use in health contexts
The use of AI in personal healthcare, whether this is for booking appointments, getting a diagnosis or keeping informed about recovery, makes the majority of Europeans feel uneasy – and women more so than men. An interesting take, especially since AI could potentially help practices become more efficient in scheduling appointments and giving diagnoses and treatment recommendations, which could benefit patients significantly.
64 percent of Europeans worry about possible misuse, especially in Uzbekistan (81), 57 percent have reservations about data security, mainly in Ireland and Kazakhstan (68 each). The possible loss of human interaction with AI entering the healthcare sector concerns 59 percent of Europeans, most notably in Ireland (72) and the UK (69), as well as prospective implications for people working in healthcare. 56 percent of Europeans worry that technology might replace human actors in the sector – and again, people in Ireland (71) and the UK (66) worry most about this. Informed consent and autonomy as well as the ability to refuse treatment could be at risk in the eyes of 42 percent. Europeans are also apprehensive about potential issues with biases in terms of cultural sensitivities (34) and a general loss of control (53). Remarkably, Uzbekistan harbours both the highest number of people concerned and unconcerned about possible ramifications of introducing AI into personal healthcare. So, while AI will surely continue to be adopted across different fields of practice in healthcare, Europe’s citizens are clear: this should be a complement to, and not a replacement for, personal interaction with qualified professionals. And any moves to use this emerging technology must be handled transparently to dispel concerns about security.
There are digital healthcare solutions Europeans can get on board with
Electronic prescriptions (59) are most appreciated in the Czech Republic (78) – where they have been mandatory since 2018, and Finland (77), which has also been using them for some time. Digitised patient records would be welcomed by 54 percent, as well as more virtual consultations with doctors or pharmacists (48) – which are in particular demand in Bulgaria (59) and Portugal (58), health apps on prescription (40) and electronic package leaflets (38).
Europeans share a rather optimistic outlook on future of medicine, further fortifying their belief in conventional medicine
The most unifying opinion shared by 46 percent of Europeans: within the next ten years, we will have developed more vaccines against common diseases. Portugal, Spain, Finland and Sweden (57) are most optimistic about this prospect. In Hungary (53), Austria (51) and Germany (50), people believe that robots will pay an integral part in performing medical procedures like surgeries (41 European average). For better or worse, 38 percent see AI becoming a central tool in diagnosing most diseases – especially in Romania (46), where reservations against such technology are currently running high.
Other forecasts include the majority of cancers being non-fatal (30), consulting medical experts and doctors from around the world for a virtual diagnosis (29), growing replacement organs from cells taken from our own bodies (26) and taking individually created nutritional supplements tailored to individual needs (24).
Remarkably: Europeans deem all of the aforementioned scenarios more plausible than scientists finding a cure for the common cold or flu – only 1 in 5 Europeans consider this a likely reality.