The Labour Party’s general election campaign pledge to clear the backlog of NHS patients waiting more than 18 weeks for treatment within one parliament will be challenging to deliver, experts have said.
While they broadly welcomed the party’s intentions, leading health professional bodies and think tanks insisted that these could be fulfilled only with sufficient funding, staffing numbers, and support for the workforce.
“It will take more than a few new scanners to deliver this promise, and much more engagement with, and recognition of, staff who are leaving the NHS due to poor pay, conditions and exhaustion,” said the BMA’s council chair, Philip Banfield.
Calling for additional funding in NHS capacity, Tim Mitchell, president of the Royal College of Surgeons of England, said, “It is good for all parties to set out ambitious plans, but the sums have to add up if we want the NHS to be transformed.”
The NHS waiting list for elective care stands at 7.5 million treatments, and for over 40% (around 3.2 million) of these the wait is longer than 18 weeks.1
The current target that 92% of patients in England should start their treatment within 18 weeks has not been met since 2016. Labour pledged this week to hit the 92% target by the end of a five year parliament if it wins power on 4 July. It said that hospitals would be told immediately to start establishing weekend and evening clinics, citing “proven” local examples of NHS trusts setting up such “high intensity” theatre lists.
The shadow health secretary, Wes Streeting, told the BBC’s Today programme on 29 May that the country faced a challenge “far greater” than in 1997 and that waiting lists could reach 10 million if the Conservatives were returned to office. “Our first step will deliver 40 000 extra appointments at evenings and weekends, paid for by clamping down on tax dodgers and closing non-dom loopholes,” he said.
Spread thinly
Labour said that it would roll out new ways of working, such as hospitals in the same area sharing staff and working on joint waiting lists. It has already estimated that £1.3bn will be needed to deliver the extra 40 000 appointments and to double the number of scanners to ensure speedier diagnoses. Labour has previously also pledged to use spare capacity in the private sector, free of charge to patients.
Banfield said, “‘Spare capacity’—either in the private sector or at evenings and weekends—relies on the same doctors already working in our NHS, 24/7. Expecting them to spread themselves even more thinly won’t cut it, now that goodwill has been so roundly eroded over the last few years. The elephant in the room remains pay for the expertise of doctors needed to clear these waiting lists.”
The King’s Fund said that offering weekend and evening appointments for planned treatment and outpatient clinics was a good idea but that scaling this up would rely on having enough NHS staff to take on the extra shifts at a time when so many were reporting high levels of stress and burnout.
The Health Foundation said that its analysis of waiting lists trends showed much uncertainty, including whether referrals for treatment would “bounce back” to the levels anticipated as part of the post-pandemic recovery. “If they do, then the task of tackling the waiting list could become much harder,” said Kathryn Marszalek, the foundation’s senior analytical manager.
Matthew Taylor, chief executive of the NHS Confederation, said, “To make inroads in tackling the waiting list we need long term planning, which means the right support and resources to ensure the extra beds opened this winter continue to be staffed, as well as opening new theatres to keep tackling the backlog.”
He said that NHS Confederation members wanted a £6.4bn a year boost to capital funding to tackle the backlog of repairs and to invest in new technology and equipment.
