Analysis
NHS backlog is a crisis for Conservatives, but a
chance for Labour
Denis
Campbell
Health
policy editor
Only the
Blair/Brown government managed to reduce waiting times, but that strategy won’t
work for Rishi Sunak
Mon 12 Dec
2022 20.15 GMT
The
worrying and in some cases dangerously long waits for NHS care now being faced
by so many patients are a headache for the government, and a potential
opportunity for the opposition.
Stories
about delays in getting an operation, hospital bed, GP appointment, ambulance
or entry into an A&E unit from the back of an ambulance, make headlines
almost daily. Waits for non-urgent hospital treatment are not just the longest
on record, they also affect unprecedented numbers of patients – 7.2 million in
England alone and about another 2 million in Scotland, Wales and Northern
Ireland.
Last week
Steve Barclay got some rare positive publicity for the government’s efforts to
tackle the anxiety, misery and risk – both clinical and political – that that
7.2 million backlog represents. The health secretary launched a new “elective
recovery taskforce”, modelled on the expert group headed by Kate Bingham that
played such an important role in ensuring that the UK was the first country in
Europe to deploy Covid vaccines to its population. The taskforce will help to
“turbocharge our current plans to bust the backlog”, Barclay said.
Unusually
but revealingly, Rishi Sunak took it upon himself to attend the first meeting
of the new group – a clear sign that he knows that one in eight of the
population of England languishing on the waiting list is a problem he will need
to fix before the general election in 2024.
Labour also
had its own initiative on NHS waiting times last week. Wes Streeting, the
shadow heath secretary, promised to keep rather than scrap any of the array of
existing targets the party created in the 2000s. It came amid persistent
reports that ministers and NHS England bosses would like to scrap the supposed
guarantee – now often honoured in the breach – that 95% of those attending
A&E will be treated and then admitted, sent home or transferred within four
hours. The actual figure last month was just 69%.
Boldly,
Streeting also committed a Labour government to cutting waiting times, as Tony
Blair and Gordon Brown’s administration did 20 years ago.
But how can
governments banish a care backlog? The King’s Fund thinktank’s new report,
Strategies to reduce waiting times for elective care, provides an in-depth
tutorial. Given only one government has managed that trick – Blair/Brown – it
looks in detail at the measures it deployed.
Labour
controversially used private health providers to perform as much surgery as
they could. And it imposed a regime of “targets and terror” on NHS hospitals to
push them to improve waiting times. And, crucially, the NHS Plan in 2000 pumped
huge sums into the service, which in turn paid for a massive expansion of its
workforce.
Together,
that all worked. It is almost impossible to imagine now that in 2008, the NHS
was hitting the target, created in 2004, of treating 92% of people needing
planned hospital within 18 weeks. Today, more than 400,000 people have already
been waiting more than a year.
The trouble
for Sunak is that his government is throwing everything at the waiting times
problem, and is copying most of the Blair/Brown playbook, but it is having only
a limited effect. For example, while the number of people waiting more than two
years is down to just 1,907, the number of year-long waiters is still rising.
As is the size of the waiting list, which grew by 100,000 alone between
September and October.
Richard
Murray, the King’s Fund’s chief executive, who was a senior official in the
department of health during the 2000s, says that the “decade of neglect” by the
Conservatives from 2010 which did deep damage to the NHS has “hamstrung” the
government’s ability to repeat Labour’s successful backlog-busting.
When Labour
reminds voters in 2024 who is responsible for their long waits for care, Sunak
would be entitled to quietly curse David Cameron and Theresa May.
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