NHS backlog is a crisis for Conservatives, but a chance for Labour | Health policy

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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