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27 June 2023

The NHS’s decline will have political consequences

People still value the service but they don’t think it’s well run.

By Freddie Hayward

It’s not surprising that the NHS is not a “world-beating” healthcare system. Dissatisfaction with the service has doubled in the last two years, while only 29 per cent say they are satisfied with how the NHS is run, according to the 2022 British Social Attitudes survey. The pandemic both heightened people’s affection for the public service and exposed its limitations.

That’s the context in which the NHS will celebrate its 75th anniversary next week. The government seems to know this milestone could be politically consequential. It has pre-empted the inevitable scrutiny and goodwill towards striking workers that the anniversary will bring by promising a workforce plan “later this week”. But at the moment that strategy has not prevented bad headlines. Yesterday (26 June), Sunak secured suboptimal news coverage for suggesting he would override the independent pay review recommendations for nurses and junior doctors.

A new report from the King’s Fund trust finds that three years after the start of the pandemic, the NHS is a middling healthcare system when compared with similar countries. It praises the protection the NHS provides from the high costs of healthcare, but notes that high waiting times are creating a divide between those who can afford private care and those forced to wait. The UK has below-average health spending per person and it has struggled to recover from the pandemic. As the report’s authors write: “Waiting times in the UK for common procedures like knee, hip and cataract operations were broadly ‘middle of the pack’ compared to peer countries in 2019 – before the Covid-19 pandemic. But the fall in activity for these procedures in the first year of the pandemic was dramatically sharper in the UK than in peer countries.”

Most important for the politics, remember the NHS places third – behind the economy and inflation – in the list of voter priorities. In other words, people really value the NHS but don’t think it’s being well run. These are not the conditions Rishi Sunak would have chosen to launch his workforce plan for the NHS. As I reported last week, senior Tories doubt the public will even listen to any plan for the future until he delivers on his five priorities. And there’s some way to go on that front yet.

This piece first appeared in the Morning Call newsletter; subscribe to it on Substack here.

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[See also: Sunak has no right to lecture Starmer on character]

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