Mine has a full size hole and a half size wheel, which I'm planning to change for a full size one when I can find one, for a number of reasons:
It becomes part of the replacement strategy. It has a new tyre, you replace one old one and put the spare on so you have two new tyres and one worn one as spare. At a convenient time, you put a new one on the spare.
Not sure if I can run with a space saver while towing the caravan.
If I need to use the small wheel, I'm forced to get a replacement quickly. That's not always possible (although acknowledging that the alternative is no spare if it's flat).
Newer models have run-flat tyres, but they're limited to 50miles or similar meaning you have to break your journey to get a replacement quickly. On the other hand it does cover the (unlikely) eventuality of two punctures. I did once lose 6 inches of the sidewall of my wife's car after running over something on the motorway. Not sure how they'd cope with that.
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