The coalition’s NHS headache gets bigger

Waiting times reach a three-year high following the decision to relax targets.

Iain Duncan Smith recently caused the government much embarrassment when he admitted that waiting times at his local hospital had increased since last year. Now, a new report by the King's Fund shows that the picture isn't much better elsewhere.

Hospital waiting times are now at their highest since April 2008, with 15 per cent of patients waiting over 18 weeks for treatment. Given the financial pressures on the National Health Service, these figures are hardly disastrous. But the numbers are moving in the wrong direction and cannot be simply explained by seasonal fluctuations.

The news will call into question Andrew Lansley's decision to relax Labour's waiting-time targets last June. As the King's Fund chief economist, Professor John Appleby, a co-author of the report, pointed out: "In the past the two things that kept waiting down were targets and extra money. Managers got sacked for not meeting targets. And of course in the future there won't be the same amount of extra money."

They may not have been fashionable, but Labour's much-derided targets and patient guarantees produced results. Lansley's decision to "relax" targets has had the reverse effect.

One of his first acts as Health Secretary was to pull back on the four-hour Accident and Emergency target, which has since been scrapped entirely. The result is that the number of patients waiting more than four hours has risen from 176,522 to 292,052, a 65 per cent increase and the highest level in five years.

At a time when the coalition is struggling to convince the public that the health service is "safe in its hands", a rise in waiting times is politically toxic. History teaches us that once governments lose trust on the NHS, they rarely win it back.

George Eaton is political editor of the New Statesman.

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The Brexit elite want to make trade great again – but there’s a catch

The most likely trade partners will want something in return. And it could be awkward. 

Make trade great again! That's an often overlooked priority of Britain's Brexit elite, who believe that by freeing the United Kingdom from the desiccated hand of the European bureaucracy they can strike trade deals with the rest of the world.

That's why Liam Fox, the Trade Secretary, is feeling particularly proud of himself this morning, and has written an article for the Telegraph about all the deals that he is doing the preparatory work for. "Britain embarks on trade crusade" is that paper's splash.

The informal talks involve Norway, New Zealand, and the Gulf Cooperation Council, a political and economic alliance of Middle Eastern countries, including Kuwait, the UAE and our friends the Saudis.

Elsewhere, much symbolic importance has been added to a quick deal with the United States, with Theresa May saying that we were "front of the queue" with President-Elect Donald Trump in her speech this week. 

As far as Trump is concerned, the incoming administration seems to see it differently: Wilbur Ross, his Commerce Secretary, yesterday told Congress that the first priority is to re-negotiate the Nafta deal with their nearest neighbours, Canada and Mexico.

In terms of judging whether or not Brexit is a success or not, let's be clear: if the metric for success is striking a trade deal with a Trump administration that believes that every trade deal the United States has struck has been too good on the other party to the deal, Brexit will be a failure.

There is much more potential for a genuine post-Brexit deal with the other nations of the English-speaking world. But there's something to watch here, too: there is plenty of scope for trade deals with the emerging powers in the Brics - Brazil, India, etc. etc.

But what there isn't is scope for a deal that won't involve the handing out of many more visas to those countries, particularly India, than we do currently.

Downing Street sees the success of Brexit on hinging on trade and immigration. But political success on the latter may hobble any hope of making a decent go of the former. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.