What the NHS waiting list crisis means for Sunak – and Labour

John Rentoul looks at new analysis from the Health Foundation, an independent charity

Patients should have more support while on NHS waiting lists, Healthwatch England has said (PA) (PA Wire)

Waiting lists for hospital treatment in England could rise to over 8 million by next summer, according to new research by the Health Foundation, an independent charity.

It says that this is likely “regardless of whether NHS industrial action continues”, which contradicts Rishi Sunak’s attempt to blame the doctors for his failure to fulfil his promise to cut the lists.

What does the new research say?

The Health Foundation forecasts that waiting lists will peak at 8m by August 2024 “if there is no further strike action”, before starting to fall. “If strike action were to continue the waiting list could be 180,000 higher.”

The research suggests that strikes by consultants and junior doctors have so far lengthened the waiting list by around 210,000, while the list has gone up by 550,000 since the prime minister made his promise to reduce it in January this year.

The analysis also points out that strikes will have had indirect impacts, by squeezing NHS finances and diverting management attention away from productivity improvement – but it is clear that the waiting list would have continued to lengthen even if there had been no strikes.

What has Rishi Sunak promised?

At the start of this year, the prime minister announced his “five key priorities for 2023”, the fourth of which was “cutting NHS waiting lists”. There was some dispute at the time over the timescale for this “priority”, with some No 10 officials suggesting to journalists that the target should not be assessed until the summer of 2024, and that any rise in the winter of 2023 would not count.

However, as the title of Sunak’s speech concerned priorities “for 2023”, voters could hardly be blamed for gaining the impression that it was a promise that was intended to be met this year.

And the Health Foundation analysis makes it clear that there never was any prospect of waiting lists being cut before the election. The last possible date for an election in January 2025; and it is obvious from the Health Foundation work that, strikes or no strikes, waiting lists will not go back down below the 7.2m at the time of Sunak’s announcement by then.

What has happened to ambulance response times?

In the months before Sunak spoke in January this year there had been a sharp deterioration in ambulance response times, which produced some terrible stories. But that was more or less fixed over the winter of 2022/23. Ambulance response times are still poor, and fail to meet many of their targets, but most of the terrifyingly long waits for urgent cases were eliminated and have stayed eliminated.

Would things be better under Labour?

Wes Streeting, the shadow health secretary, put out a statement condemning the rising waiting list, and saying: “Labour has a plan to cut waiting lists by getting the NHS working around the clock, delivering 2 million extra appointments a year. We will pay for it by abolishing the non-dom tax status, because patients need treatment more than the wealthiest need a tax break.”

Abolishing non-dom tax status might raise £3bn a year, which is a significant sum, but the problems of the NHS are so serious that even this might not make much difference, especially when the service is suffering from staff shortages at all levels. Presumably a Labour government would be more likely to avoid strike action, but possibly only at the cost of higher pay, which would eat into any extra funds allocated.