A strange thing happened to me last week. An unknown number called me, and when I picked up, I was invited for a planned, non-urgent hospital scan. When first referred, I’d been told the waiting list would be five months; this call came after just one. I almost felt ambushed, hastily checking my calendar and struggling to find a window. I was reminded of the bizarre 2005 Question Time episode during the New Labour years in which audience members complained to Tony Blair about being given GP appointments too quickly.
This exotic experience of the NHS racing ahead of my schedule tallies with headline figures about the health service – that Labour is beginning to turn things around on the backlog, GP recruitment and waiting times at A&E. I’m not alone. Those who survey the public, and I’m sure many of our readers, will have heard a few more positive experiences among the usual frustrations and grim stories of late.
For a while now, when ministers are trying to defend their government’s record so far – pointing to tangible changes in voters’ everyday lives – they reach for these trends. This was clear in the resignation letter of erstwhile health secretary Wes Streeting, who left his job but stopped short of a formal leadership challenge on 14 May, which was the same day that new figures showed hospitals in England met their target to treat at least 65 per cent of patients within 18 weeks. Since Labour came in, the number of people on waiting lists has shrunk by more than half a million, and the overall figure – now 7.1 million – has dropped for five months in a row, despite strikes.
After Streeting stepped down, I spoke to a number of front-line health workers – including GPs, a paramedic and various hospital doctors – as well as policy experts to work out the mood within the NHS. It is not a happy one.
Corridor care in A&E is still standard, GPs are overwhelmed, patients are stuck in hospital beds because social care provision is so stretched. There is also scepticism about the focus of the big restructure – scrapping NHS England, but failing to rewire Whitehall to unite departments in Labour’s “mission” to reduce the rich-poor health gap.
“The first meeting I had with a government official after the election was about the health mission, and honestly I left that meeting more excited than I’d been in years. It really felt like coordinated government,” said Siva Anandaciva, chief analyst at the health think tank the King’s Fund. “The next time we tried to get in touch, people [working in government] were saying, ‘We’re not sure we’ll still be in a job.’ It just sort of died on the table, and the government reverted to how long people wait for planned hospital care as its main measure [of success].”
There are also concerns about the sustainability of “sprinting” through the backlog by outsourcing procedures to private healthcare, which is often delivered by the same doctors – and even sometimes the same infrastructure – as the NHS.
“It becomes very easy to just keep falling to that option,” said Dr Tej Pradhan, who switched a few weeks ago from a hospital orthopaedics ward to a GP practice. “And if you do, in reality you’ll keep spending more and more money as an ongoing cost on the private sector, when actually if you’d have just invested in capital and infrastructure for more capacity in the NHS, you’d end up saving money in the long run.”
Ironically, while Streeting attracted hostility from doctors who have continued striking under his leadership, his departure appears to have compounded the gloom. It is reminiscent of the constant reshuffling under the Tories. “At least he was starting to understand what the problems are,” one doctor told me.
Yet pessimism among the British public may be even harder to shift. Researchers running focus groups are observing a phenomenon dubbed “I’ve been lucky” syndrome when it comes to the NHS’s improvements. Coined in the early 2000s by Viki Cooke and Deborah Mattinson (Gordon Brown’s former chief pollster and ex-adviser to Tony Blair and Keir Starmer), the phrase refers to voters putting positive experiences of the health service down to luck, rather than improvements.
“People’s own experience is almost outweighed by all the media noise about [the NHS] all falling apart and going to hell in a handcart, and so they just think: ‘Oh gosh, I was really lucky,’” said Cooke, who co-founded Thinks Insight & Strategy (formerly BritainThinks) with Mattinson. “Stories resonate much more than facts.”
“I’ve been lucky” syndrome could deflate any political capital Labour might expect for improving the NHS today. “When you drill down into people’s experiences of care, they often have quite positive things to say, but they think they’re unique in that situation,” said Allie Jennings, director of Thinks Insight & Strategy, where she holds focus groups and interviews with the public on health and social care. “The key thing they’re really worried about is getting a GP appointment, and I still think that feels very hard. It’s going to be difficult to shift that wider perception of the NHS as a whole – that even if you get a GP appointment very quickly, people will put that down to luck and not typical of the wider country.”
There will be a lot more work for James Murray – Britain’s eighth health secretary since 2018 – to do to fix the NHS and to have staff and patients feel the benefits.
[Further reading: The long coup[
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