David Hare is Chief Executive of the Independent Healthcare Providers Network
Amidst the heat and light of the leadership campaign, and the dominance of Brexit, the two candidates vying to be our next Prime Minister would do well to avoid neglecting the re-emergence of one of the most toxic issues British politics has ever known: NHS waiting times.
They are now at their highest levels for a decade. Hundreds of thousands of patients were added to the list in 2018/19 alone. And by the time the next Conservative leader is due to face the electorate in 2022, the number of people on NHS waiting lists is expected to have exceeded 5.3 million.
No Prime Minister will want to explain at an election why an extra 1.5 million people have been added to waiting lists in the current Parliament. To do so would represent a major risk to confidence in the Government’s handling of one of the public’s main priorities, and would represent a real failure to demonstrate that patients can expect to access vital treatment in timeframes they see as acceptable.
And as a previous Conservative Prime Minister found out, this can be politically fatal.
This political toxicity is not just driven by the headline-grabbing national numbers. People around the country are now experiencing a postcode lottery in their NHS services, with more than half of hospitals failing to deliver on patients’ rights to receive treatment within 18 weeks. And the national numbers overlook the harm to patients caused by lengthening waiting times – about whom the Public Accounts Committee recently accused the NHS’s headquarters of ‘lacking curiosity’.
What will concern our incoming Prime Minister most is the complete absence of a plan to address this situation. And although those leading the NHS do have an important part to play in articulating what the NHS is able to achieve with the resources it has, the new Prime Minister must help to balance the NHS’s own wishes with the rights to speedy treatment that the patients it serves deserve.
In balancing these asks, our new Prime Minister will know too that there is nothing inevitable about long waiting times. Although they were the norm until the early 2000s, the investment in and protection for the NHS budget since then have allowed waiting times to fall, and should now allow them to stay low. Indeed, last year the Government committed an extra £20 billion of taxpayers’ money to deliver precisely this.
But with patients themselves now noticing problems with accessing NHS care, the new Prime Minister faces a choice over whether to permit waiting lists to continue rising, or to take action to bring them under control. And if he chooses the latter, all parts of the NHS should respond. With NHS being increasingly squeezed, the use of private hospital capacity will need to be ramped up to improve patient access, an approach which was key in reducing waiting times under the last Labour Government.
The private sector’s role may unsettle today’s ministers having to deal with an opposition more focused on raising the spectre of NHS privatisation than actual operational performance. But opinion polls have consistently shown that whilst this may be a concern of an obsessed minority, the public at large have little time for phony arguments about whether the public or private sectors should deliver NHS services, so long as the NHS services provided are high quality, delivered at NHS prices, and available to all free-of-charge. Sarah Wollaston’s Health and Social Care Committee has even called for the NHS to take “proactive steps to dispel misleading assertions about the privatisation and Americanisation of NHS”.
Many people think NHS waiting lists fell to their lowest levels under the last Labour Government. But it’s a little-known fact that the lowest ever waits on record were not during the Blair/Brown Governments but just over five years ago when the Conservatives led the Coalition Government. This is a record that any party should be proud of, and with the same drive and commitment, and a recognition that both public and private sector providers can help contribute to lower NHS waiting times, it can be achieved again.