The NHS – in its 77th year – is the biggest of all albatrosses for the government of the day. Voters rank healthcare highly as a government priority. And though Labour tends to be more popular than the Conservatives when it comes to the big health question, if little change is felt in the current state of the NHS it could be the most fatal of reputational challenges.
Though voters are already uncomfortable with tax rises because of the cost-of-living crisis, clever phrasing can bring most around to supporting them for the NHS in principle. The electorate is broadly dissatisfied with the management of our hospitals, and would reward anyone who can bring material improvement.
But now the waiting lists, the waiting times, and the response rate to ambulance call-outs are among the highest on record. Yes, the problems were exacerbated by Covid-19. But the quality of life for NHS staff and the quality of care for NHS patients was poor pre-Covid – and was getting poorer too.
Let’s take a look at the statistics.
Surgery waiting times
In Covid the number waiting for surgery rocketed. But waiting lists have been growing since 2010 by a factor of a fifth of a million each year. In 2020 lists soared from four million at the start of the pandemic to almost eight million by the end of 2023. Today’s numbers are only 0.3 million off that historic peak.
The proportion of people waiting for fewer than 18 weeks for surgery remains its lowest of “normal” times. In 2020 the share that waited for fewer than 18 weeks had fallen to a trough of 47 per cent. Today it’s 59 per cent. Most of us are being seen in under five months, granted, but this figure was 80-plus per cent in February 2020 – down, mind you, from 91 per cent when the Conservative government first came in.
The share of us waiting more than a year for an operation is down from 5 per cent to 3 per cent – up, however, from the 0 per cent through much of the 2010s.
Ambulance waiting times
Ambulance response times have consistently missed their targets. Long before Covid they were rarely coming close to where they needed to be. But since the pandemic the situation has only worsened.
December 2024 is the worst it has been since the pandemic for emergency response times, and the fifth-worst month for life-threatening response times.
What’s going on here? Is it a case of services getting worse? Perhaps. But key to note here is the number of call-outs made – the number of people needing an ambulance dispatched – increased during the pandemic, and has stayed roughly at that level, compared to pre-Covid.
The worst month on record was December 2022.
A&E waiting times
More and more of us are checking into A&E, treating the service as an all-encompassing doctor’s surgery. Stories of people resorting to homemade dental work and needing immediate treatment after only adds to the number seeking A&E help.
The Consumer Healthcare Association also says hundreds of thousands of people are inappropriately checking into A&E for ailments which can be treated at home, attendances that cost the NHS near £16m.
And that report came from 2016.
Since then, the numbers have only got worse. When you do make your way to A&E, the waiting times follow the trend of everything else in this piece – they are getting worse and worse. Whereas in 2010 you had a sorely improbable one-in-20 chance of waiting in A&E for more than four hours; today you have a near one-in-four chance. And in the winter of 2022 you had more than a one-in-three chance of hanging about for more than four hours.
The number of people waiting more than 12 hours from decision to admit to admission – being lost in the ether of bureaucracy, basically – has shot up from just 15 individuals in December 2010 to 54,000 in December 2024.
Every winter pre-pandemic, the number waiting more than 12 hours to be seen (a different metric to admission) touched upwards of a thousand. But following the pandemic it’s never bottomed out below 20,000.
This dam of lines, of queues, of hours and weeks spent waiting burst following pandemic. But so many of these eye-watering statistics touch on long-term trends.
In 2005 the New Labour manifesto promise was that no more than 10 per cent of us requiring surgery should be waiting more than 16 weeks. By 2010 that promise was fulfilled. Nineteen years on, Britain is far removed from that. The problems made worse by Covid find their roots in long-held structural failures, encoded into the DNA of the system. Exactly how Labour plans to materially alter this reality remains a mystery. But voters are noticing the service get worse and worse, and they won’t be sympathetic to the government overseeing such decline.
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