A “decade of neglect” by successive conservative administrations has weakened the National Health Service to the point that it will be unable to address the care backlog of 7 million people, a government-commissioned report concluded.
The paper from health think tank King’s Fund says years of denying funding to the health service and failing to address its growing workforce crisis has left it with too few staff, too little equipment and too many outdated buildings to carry out the amount of surgery necessary.
Poor public finances in the UK, burned-out health service staff and a wave of NHS strikes this winter will also mean ministers cannot deliver on key promises to end routine long waits, the think tank says.
The findings are especially embarrassing for conservatives because the report was ordered by the Department of Health and Human Care (DHSC) late last year. They are critical of the impact on the NHS of the austerity program started by David Cameron in 2010 and continued by his successor, Theresa May.
The report strikes an unfavorable contrast to the tactics used by the Labor governments of Tony Blair and Gordon Brown in the 2000s to address the excruciatingly long waits for care they inherited in 1997.
“While Covid certainly exacerbated the crisis in the NHS and social care, we are ultimately paying the price for a decade of neglect,” King’s Fund chief executive Richard Murray said.
“The sporadic injections of cash during the austerity years after 2010 were intended, at best, to cover [the service’s] daily running costs. This dearth of long-term investment has led to a health and care system crippled by understaffing and equipment and dilapidated buildings. These critical challenges have been obvious for years.
“The NHS in 2022 faces many of the same challenges it did in 2000: unacceptably long waiting times and a service hampered by understaffing. Added to that now is a cost-of-living crisis, industrial action by staff, and a backdrop of a weak economy and weak public finances.”
The report is based on the first in-depth academic research carried out in the UK into what measures NHS ministers and heads can put in place to deal with situations such as those prevailing today, where large numbers of patients again face long delays in accessing planned hospital care.
Their findings are based on a review of the evidence on waiting times and, in particular, interviews with 14 experts, including many of the key figures in Labor’s successful eradication of long waits.
One of the experts, neither of whom is named, said: “Basically, we’ve had 10 years of controlled decline. This is not a covid issue. This is an austerity problem.”
The report points to Cameron’s decision to cut annual NHS budget increases from 3.6% of work to an average of just 1.5% as the main reason for the loss of service capacity. Service performance against a number of wait-time targets introduced by Labor began to spiral downward in 2015 and has gotten worse every year since.
The report comes days after the latest official figures showed England’s waiting list for non-urgent hospital care had reached a new record high of 7.2 million people. Of those, 410,983 had been waiting for more than a year for treatment, such as hip or knee replacement, cataract removal or hernia repair, which should take a maximum of 18 weeks.
Leaders of Britain’s A&E doctors, as well as heads of the NHS ambulance service in England, have expressed deep concern about the number of patients who are harmed, and even dying, as a direct result of waiting for it to arrive. an ambulance or to enter A&E or from there in a hospital bed.
The 81-page document will be published later this week. He says that the NHS’s lack of resources, combined with the different political, financial and economic circumstances that apply today, means that the politically important promises made earlier this year in the “plan of elective recovery” of the NHS of England.
They included promises to end waits of two years, 18 months and one year for the summer, next spring and 2025 respectively.
The government has promised to earmark £8bn to tackle the backlog and NHS England has set up dozens of community diagnostic centers to help speed up testing and treatment of patients.
In his Guardian response to the report, Blair criticized the five Conservative administrations since Labor lost power in 2010 for deviating from the three strategies he used to stamp out delays: reform, investment and political focus. He said the change in approach damaged the NHS’s ability to deliver care within set waiting time targets.
“These key elements were, and I believe continue to be, essential to improving public services. Since Labor left office, every pillar of these principles has been weakened in relation to our health service,” Blair said. “As the report says, waiting lists are now at their highest level since the 18-week referral measure was introduced in 2004, as well as a collapse in urgent care.”
He also pointed to repeated efforts by ministers to describe the huge waiting list for care, already at 4.4 million when the pandemic hit in spring 2020, as “the covid backlog.” Blair said: “This is not the result of Covid, but chronic underinvestment and mismanagement exacerbated by Covid.”
And he added: “The lessons of that [Labour government] period, which ended with levels of satisfaction with the NHS at record levels, remain the same because they are lessons in governing: the government and the prime minister make it a priority, devoting time and energy; there is a policy that is based on what works; and then there is a relentless government-wide effort to ensure delivery.”
Blair said the King’s Fund findings “should act as a political wake-up call to renew efforts to reform the NHS, give this reform the political focus and grip it needs and align this with the right strategic investment.”
The Department of Health and Social Care has been contacted for comment.