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Three in 10 people in England have little or no confidence that the NHS will give them high-quality treatment this winter, a poll claims today.

The survey, by Ipsos MORI with the Evening Standard, discloses the damage to public faith in the health service after a winter crisis in accident and emergency departments.

A total of 29 per cent of people questioned said they were not very or not at all confident of receiving high-quality care — up from 25 per cent in November, before the current crisis began.

After weeks of major delays suffered by A&E units and ambulance services, just 18 per cent feel “very confident” of getting top-notch treatment, with 52 per cent “fairly” confident.

Affection for the NHS is high, with 68 per cent seeing it as “a symbol of what is great” about the country that should be maintained. But 29 per cent think the health service may be difficult to sustain in its current form, saying it was “a great project for its time” that probably cannot stay the same.

With health at the top of voter concerns for the general election, there are big differences in the way the public thinks David Cameron and Ed Miliband would run the NHS. Some 31 per cent believe the Tories would cut spending, despite Mr Cameron’s pledge to protect the budget. Only nine per cent think Labour would do so, while 48 per cent think they would spend more.

But asked who they blame for the problems in the NHS, people were divided. In unprompted answers, the biggest number — three in 10 — blamed underfunding or cuts. Almost a quarter pointed the finger at people using A&E units for minor ailments instead of going to a family doctor or pharmacist. Some 23 per cent said it was down to staff being overworked or underpaid.

Only five per cent said the Conservative Party was to blame, while six per cent named the Coalition and 12 per cent blamed governments in general. Other responses included the ageing population (six per cent), immigration (eight) and NHS managers (12).

Gideon Skinner, head of political research for Ipsos MORI said: “The NHS remains a great source of pride to many Britons, and confidence in normal circumstances remains high. But this affection also means the winter crisis in A&E is worrying the public and shooting the NHS up the election agenda, with underlying concerns about underfunding and lack of staff, as we have seen for many years, and perhaps a recognition that some of us need to change our habits too."

Today new figures showed that, in the week to last Sunday, only two of London’s 19 NHS trusts with A&Es — Chelsea and Westminster, and Guy’s and St Thomas’ — hit the target of treating 95 per cent of patients within four hours.

London North West Healthcare, which runs Northwick Park and Ealing hospitals, was joint worst in the country for A&E performance, with just 62 per cent of patients treated in four hours.

Across England, the figure was 89.9 per cent, compared with 94.5 per cent for the same week last year. There were 389,377 A&E attendances (up 5,811) and 75,546 admissions to hospital (up 2,441). Anne Rainsberry, regional director of NHS England in the capital, told the London Assembly that she had ordered an investigation into the “spike” in winter pressure in London.