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19 August 2022

When will Liz Truss and Rishi Sunak get real about the NHS?

The health service is still in crisis, but the Tory leadership candidates seem more interested in eroding the NHS’s “free at the point of use” principle than fixing it.

By Rachel Wearmouth

Clobbered by endless reform, Covid and an ageing population, the weather-beaten NHS is in peril. Last week it was announced that treatment backlogs had reached a record high of 6.7 million, and A&E departments reported their worst-ever performance in the month of July – almost 30,000 were stuck waiting for care for more than 12 hours. By themselves the figures mean little; the real story is the human beings behind the data.

News bulletins this morning (19 August) were dominated by the distressing case of Daphne Syms, a 90-year-old woman from Cornwall. She waited 40 hours for an ambulance after breaking her hip in a serious fall. Once upon a time, Syms’s ordeal would have been considered an aberration. Not anymore.

On 10 July Jackie Hulbert, a 78-year-old woman from Leicestershire, fell in her bedroom. She called 999 and waited on her floor for an ambulance, which eventually arrived after 11 hours. Hulbert died in hospital two days later after medics discovered she had an infection. Her son, Matthew, who could not move his mother without the help of paramedics, came to exactly the same conclusion as Syms’s son, Steven: “The system is clearly broken.”

The never-ending chaos of Brexit, Boris Johnson and the Tory leadership race has perhaps distracted from the fact that the NHS has not met its A&E target of seeing 95 per cent of its patients within four hours since 2015.

Overworked NHS staff are in despair. There is a recruitment crisis, exacerbated by Brexit, with 105,000 vacancies lying unfilled in March earlier this year.

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The Royal College of Nursing will ballot its members for a strike after the trade union called the government’s pay-rise offer of 3.7 per cent “pitiful”, in light of the Bank of England’s forecast that inflation will peak at 13 per cent later this year.

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Reacting to a Health and Social Care Committee report into NHS workforce burnout last year, the King’s Fund think tank said that “chronic excessive workload is damaging staff health, patient care” and staff’s long-term ability “to provide high-quality and compassionate care”. Meanwhile, research by NHS Charities Together estimated that 60,000 of NHS staff could be living with post-traumatic stress after the pandemic. The NHS has been struggling for years but Covid has created the perfect storm.

Billions more pounds will be injected into the system via Rishi Sunak’s National Insurance (NI) tax increase, but the Resolution Foundation predicts health and social care will account for 40 per cent of the government’s day-to-day spending by 2024-25. The inescapable truth for would-be prime ministers Liz Truss, Sunak and Keir Starmer is that voters expect the NHS to be world-class and free at the point of use. And they are prepared to vote en masse for it.

Vote Leave won the 2016 Brexit referendum, in part, by peddling the inaccurate claim that wrenching the UK from the world’s biggest trading bloc would allow the government to send £350m to the NHS instead of the EU. After years of austerity, the pledge had obvious appeal. In 2019, Boris Johnson secured an 80-seat majority by promising more doctors and nurses, 40 new hospitals, and that as PM he would make the health service his number-one priority.

New Labour dramatically cut NHS waiting times and Tony Blair’s record of delivery was central to him being re-elected twice. Backing the NHS early and often should be a no-brainer for any aspiring leader because of how deeply British voters care for it.

Instead, the Conservative leadership candidates barely mention the crisis engulfing hospitals. Indeed, they seem relaxed about eroding its “free at the point of use” principle. Sunak, the moderate in the race, would charge patients £10 for missing an appointment. And Truss, who has promised to scrap Sunak’s NI rise and embark on a general tax-cutting agenda, is scrambling to distance herself from a 2009 pamphlet she co-authored, which recommended cutting doctors’ pay by 10 per cent and charging for GP appointments.

The pair are more comfortable trading barbs and talking up culture wars than they are engaging with the ugly reality of the country’s most important public service.

The NHS Confederation chief executive, Matthew Taylor, urged Truss and Sunak “to do away with the myths and political rhetoric”, and blasted the “lack of realism” over the fact the NHS has faced under-investment since 2010.

If either candidate is serious about winning the next election, they would do well to listen.

[See also: What Liz Truss doesn’t get about “graft”]