David Hare is Chief Executive of the Independent Healthcare Providers Network
“It’s NHS waiting lists, stupid” should be the mantra for all political parties as we head towards the next general election.
With NHS waiting lists at a record high – recent figures show 6.1 million are currently waiting – and improving access to NHS care consistently rated as the number one priority for the public, tackling the backlog in NHS treatment must be top of the to-do list for the Government/ a government in waiting.
This is especially sensitive since, from April, people and businesses will be paying more in National Insurance for the health service, and, not unreasonably, will want to see something tangible in return.
Tax rises are always controversial but with a cost-of-living crisis on the horizon due to rising inflation and energy prices, this new health and care levy represents yet another additional squeeze on people’s already-stretched finances – and one which the Government will come under ever increasing pressure to justify.
Last week Sajid Javid, the Health and Social Care Secretary, announced the NHS’s new “elective recovery plan” setting out how the NHS intends to tackle the backlog of treatment. The plan includes some important goals including eliminating the number of people waiting more than a year for treatment, with the anticipation that waiting lists will start coming down from 2024.
It also sets out how it will bring in more capacity to a desperately stretched NHS, including making more use of independent sector capacity and giving people greater information and choice over where they can receive their NHS care.
These measures are welcome and recognise the important lessons of how the Blair/Brown government successfully tackled record waiting lists in the 2000s. But how do we turn the plan into concrete action to make sure the public gets value for money from the new levy?
First, as this is essentially a question of demand for NHS services currently outpacing supply, let’s make it easy and straightforward for new providers to open up services for NHS patients.
There are currently over 400 independent healthcare facilities in the country with capacity available in every clinical commissioning group location. And like the establishment of “Independent Sector Treatment Centres” set up in the Blair years, new investment could swiftly be brought in to establish even more local services for patients to help bring down the waiting list.
Second of all is getting the finances right. The public will not be happy with billions of pounds going to the health service with no way of understanding what it has bought. It’s therefore important that the principle of “payment by results” or, more simply, “money following the patient” is retained so there’s a clear trail of where the additional money for the NHS has gone, and a real incentive for as much activity to be delivered as possible.
Third, to real see change in the NHS, there needs to be a relentless focus on driving down NHS waiting times with every part of the health system understanding its role. The plan published this week sets out some welcome ambitions to reduce the waiting list from 2024 and eliminate the number of people waiting over one year by 2023.
But while the public don’t expect miracles overnight, they are unlikely to be content sitting tight for two years before they see any tangible impacts on their access to care. Clear milestones setting out how exactly the NHS will get reach these targets are therefore needed to reassure people that action is being taken now to clear the backlog.
There’s no doubt that the health service has a mountain to climb in bringing waits down for patients and that those working in the health system have already moved mountains for their patients. But higher taxes for a materially poorer NHS is simply not an option for the Government. The hard work of delivery needs to start now.