NHS backlog: surely tougher targets won’t be enough?
Three-quarters of suspected cancer patients will be diagnosed or have the disease ruled out within 28 days, under “tough” new NHS targets announced by Boris Johnson today, in an attempt to tackle the colossal backlog of patients.
On a joint visit to Maidstone Hospital with the Chancellor, Rishi Sunak, the PM said the backlog was a “massive priority” for his government. He added: “We are now working with the NHS to set some tough targets so that we are able to deliver for the patient and also for the taxpayer.”
The two men put on a show of unity, but the visit was an awkward one. Johnson was asked whether he had confidence in the Chancellor’s loyalty after Sunak chose not to defend Johnson’s accusation that Sir Keir Starmer had failed to prosecute Jimmy Savile. Johnson said he “absolutely” did not doubt the Chancellor’s loyalty.
Johnson had hoped to unveil the full “elective recovery plan” to tackle waiting lists with great fanfare today. But the Treasury blocked its publication because of an ongoing dispute with NHS England about just how tough the targets should be.
The delay comes as the number of people waiting for hospital treatment hits six million – a rise of nearly 50 per cent since the pandemic began. Over 300,000 of these patients have been waiting for over a year.
The number of cancer patients this year in England waiting longer than the supposed two-week maximum to see an oncologist and start treatment has hit a record high of half a million.
But the idea of solving the crisis with more targets was criticised today by former Health Secretary Jeremy Hunt, who said the government cannot simply set deadlines for clearing the backlog without addressing workforce shortages: “What we should be doing is having a debate about how we are going to find extra doctors and nurses.”
The pandemic has placed vast pressure on the NHS and caused waiting lists to grow. But this is also a staffing issue, which predates the pandemic.
The NHS had 100,000 staff shortages and record waiting lists even before Covid hit.
Some hospitals have had to limit the amount of chemotherapy they provide because they are short of specialist cancer nurses. Maternity care has deteriorated due to a shortage of over 2,500 midwives. Maternity units across England shut their doors to women in labour more than 323 times in 2020-21, forcing them to go to an alternative hospital to give birth. Staffing shortages were cited as the reason for over two-fifths of these closures.
The number of full-time midwives is falling for the first time since 2009, despite NHS England promising to recruit an extra 1,200 in March last year as part of a £95 million investment.
Tough targets may help. But they won’t be enough to solve the backlog crisis on their own. Under New Labour, two decades ago, there was a successful drive to cut waiting lists by using more private sector capacity, at a cost, to get procedures done. This time, post-pandemic there seems to be little appetite for a debate about NHS reform.