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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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.