Nothing but hard work ahead for Boris Johnson and the NHS

As the prime minister settles in for the long haul he will need to consider how to deliver on his NHS promises if he is to stand a chance in 2024, says Shaun Lintern

Spending increase will not reverse five years of decline (AFP/Getty)

In his search for the winning formula to win over the British electorate, Boris Johnson not only adopted the phrase “get Brexit done”, he also returned to one of the signature Leave campaign issues – the National Health Service.

He kept hold of the keys to No 10 partly off the back of his pledges to fund the NHS, recruit thousands more GPs and nurses and to build 40 new hospitals over the next 10 years.

There is little doubt this helped to convince wavering northern Labour voters to switch their support from Jeremy Corbyn’s Labour Party.

As the prime minister settles in for the long haul he will need to consider how to deliver on his NHS promises if he is to stand a chance of repeating this electoral victory in 2024.

But there is nothing but hard work ahead for Johnson on his NHS commitments which will be hard to deliver in reality.

As the Tories marked day one of their new government, data showed the health service is experiencing a significant winter crisis and pressure on the system is at record levels.

The waiting list for routine operations is now over 4.5 million and the service is short of 100,000 doctors and nurses.

The promised £34bn cash increase in the NHS budget will provide the health service in England with an average of 3.3 per cent a year spending increase – a significant uplift to the subsistence funding it has had since 2010.

But it is not transformative levels of funding. The Health Foundation think tank has made clear it will at best maintain performance at current standards – it will not reverse the decline of the last five years.

The promise of more GPs and 50,000 nurses appears near impossible to deliver. A recent leaked report on the NHS’s own workforce plan showed even with an extra 45,000 nursing staff by 2024 the NHS would still be short by 20,000.

The Tories NHS visa may be the route to success but it will require tens of thousands of immigrant healthcare staff and it’s not clear yet how that can be squared with the government’s wider immigration plans.

These are operational matters and Johnson may try to make this the problem of his old university friend, NHS England chief executive Simon Stevens, who has successfully negotiated more and more money out of a succession of prime ministers but with seemingly few measurable improvements.

Stevens’ long term plan for the health service – on which the government’s £20bn investment was secured – is a vision for a new NHS system. Stevens has made clear his desire for new legislation to sweep away some of the unhelpful changes introduced by the coalition government in 2013.

Interestingly, the proposals from NHS England include rowing back on many elements of competition in the NHS – something traditionally a Conservative government would approve of.

In their manifesto the Tories pledged to legislate to secure funding for the NHS in its first 100 days but will Mr Johnson be tempted to make more of it to secure wider reforms? One to watch in the months ahead.

Whatever the government attempts with the health service the elephant in the room remains the adult social care system.

Mr Johnson deftly dodged the issue in the election. But with a £4.5bn funding gap, thousands of patients queueing in A&E, and memories of a little boy sleeping on a hospital floor, social care cannot be ignored for long if the new government is to retain any credibility among its new supporters.