FTI Consulting UK Public Affairs Snapshot: One year on from Sunak’s five pledges: Cutting NHS waiting lists

Sunak’s promise to cut the NHS waiting list is both an ambitious and unambitious goal. While an undeniably massive challenge, 13 years of Conservative administration have seen the waiting list balloon by over five million people. Even a substantial reduction would leave Britain in a significantly worse position than before.

The Government is not solely to blame for this growth – social and economic factors have worsened the outlook, not least the pandemic and strike action. Yet while No 10 continues to point to these factors, the ghosts of austerity past continue to haunt the health system.   

With voters consistently ranking health as one of their top policy priorities, improving the situation is critical for the Government. It is particularly important for the Conservative Party, as its support base is on average older and more likely to be directly impacted by poor service and long waiting times.

However, at present, the Prime Minister has not achieved his fourth pledge. While the end of 2023 offered a glimmer of hope, with the waiting list falling modestly, it still sat at 7.6 million in November, which is 400,000 higher than at the start of 2023. That is nearly one-eighth of Britain’s population.  

The Government has injected billions into the NHS to try to address this issue and has also allowed patients to select where they receive care. However, with a plethora of issues plaguing the NHS – from staff and funding shortages and an ageing population to an elongated period of industrial action – these interventions have failed to move the dial in a meaningful way. The situation is also unlikely to be improved by Sunak’s recent advice to hospital leaders that controlling costs should be prioritised.

The Government may hope that this week’s launch of “Wayfinder”, a waiting time information service on the NHS app, will make a significant difference. However, with reports already surfacing that the app provides “disingenuous” information, it remains to be seen how impactful this will be.  

Meanwhile, the Labour Party has been quick to criticise the current waiting list as a failure of Conservative government and demonstrative of a broader crisis engulfing the NHS. However, Labour is not alone in declaring a state of crisis, with a British Medical Journal Commission on the future of the NHS calling for the state of the health service to be declared a “national emergency”.

As one of its five central electoral pledges, Labour has committed to “get the NHS back on its feet” and to reduce the waiting list. Pledging £1.1 billion to provide NHS staff overtime, Labour argues that this plan will provide an extra two million operations, scans, and appointments in the first year.

The Shadow Health Secretary, Wes Streeting, has also committed to a technological transformation of the NHS, focusing on prevention over intervention and on bringing care back into the community. Criticising “waste and inefficiency” within the NHS, Streeting has demanded that the service provides better value for taxpayers’ money and has looked to Australia and Singapore for inspiration.

To a certain extent, the Opposition can substantiate its claim of being the party capable of reversing the NHS’s fortunes, given New Labour’s record of successfully reduce waiting times. However, this is not 1997. The problems plaguing the health system today are incomparable, with the economy worse off, the population older, and the NHS in a much more precarious position.

Ultimately, there are still millions of patients waiting for operations and unable to access a hospital bed, secure a timely GP appointment, or get an ambulance if they need one. For these voters, a small decrease in the national waiting list is unlikely to offer much solace.

To reverse his party’s fortunes in the polls, the Prime Minister will need to demonstrate how the Conservative Party will improve the state of the NHS and make substantial progress on an issue that touches everyone’s lives. However, given the length of time his party has been in office, convincing the public will be yet another mountain to climb.

In the next piece in our series, we will review the Prime Minister’s fifth and final pledge. To sign up to FTI Consulting’s mailing list to get our snapshots delivered straight to your inbox, please click the button below.