title: Public trust in health care: the system or the doctor?
abstract: OBJECTIVE
  To examine how the public assess trust in health care in England and Wales.
  
  
  METHODS
  Postal structured questionnaire in cross sectional survey.
  
  
  METHODS
  Random sample of people on the electoral register in England and Wales.
  
  
  METHODS
  People aged 18 and over.
  
  
  METHODS
  General levels of trust and confidence in health care.
  
  
  RESULTS
  The response rate was 48% (n = 1187). The mean level of confidence (trust) in the healthcare system was 6.0 out of a score of 10. Levels of distrust appeared relatively high with at least 356 (30%) respondents reporting little or very little trust for 28 of 32 specific aspects of health care. The highest levels of distrust were found in relation to how the health service was run and financed, particularly waiting times and the implication of cost cutting for patients. Statistical analysis by univariable linear regression of the specific determinants of generic assessments of public trust (confidence) suggested that the key aspects were patient centred care and levels of professional expertise. Being covered by private health insurance was also a key determinant of levels of public trust.
  
  
  CONCLUSIONS
  Public assessment of trust tends to address the views of care at the micro level. Policy makers concerned with the erosion of public trust need to target aspects associated with patient centred care and professional expertise.
authors.affiliation: Department of Social Medicine, University of Bristol, Bristol BS8 2PR, UK. m.w.calnan@bristol.ac.uk
authors.forename: M W
authors.initials: MW
authors.lastname: Calnan
authors.forename: E
authors.initials: E
authors.lastname: Sanford
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D004739:England; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D010820:Physicians; D011639:Public Opinion; D013222:State Medicine; D011795:Surveys and Questionnaires; D035502:Trust; D014852:Wales