Sir Keir Starmer unveiled his plan during a hospital visit (Image: Getty)
Labour’s plan to slash NHS waiting times places too much focus on hospital targets and fails to address staff shortages, critics have warned.
Thousands more people will be sent for treatment in private hospitals under a deal struck with the independent sector, the Prime Minister announced on Monday.
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Sir Keir Starmer said the agreement would help ensure that 92% of patients wait no longer than 18 weeks for routine treatment by the end of this parliament.
At present only 59% are seen within 18 weeks and the target has not been consistently met since 2015.
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Experts welcomed the ambition but raised serious concerns about whether the NHS has enough staff to achieve it. And they called for equally ambitious action to improve performance in other areas such as availability of GP appointments and ambulance response times.
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Professor Phil Banfield, chairman of the British Medical Association council, said the NHS could not continue “relying on the good will of exhausted staff or new technology”.
He added: “Doctors have been just as frustrated as their patients by the lack of facilities to deliver care and want to bring waiting lists down, but the reality is that without the workforce to meet constantly rising demand, we will not see the progress we all hope for.
“Only when the Government has laid out its concrete steps to fully support the NHS workforce can we be confident that they have a plan which can achieve this target.”
Other measures in Labour’s plan include an expansion of the NHS app so patients can use it to manage their referrals, and shifting care out of hospitals by growing the network of community diagnostic centres (CDCs) so they can deliver up to half a million extra appointments each year.
The Society of Radiographers welcomed the expansion of CDCs but called for “clear detail about how these centres are going to be staffed”.
Executive director of industrial strategy Dean Rogers said: “Without a clear plan to increase the number of radiographers in the NHS, waiting lists will only continue to grow.”
The Prime Minister acknowledged that some people would not welcome increased use of the private sector but said he was “not interested in putting ideology before patients”.
He argued that to “catapult the service into the future, we need an NHS that is reformed from top to bottom, millions of extra appointments signed, sealed and delivered with the plan that we are launching here today”.
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Labour also faced strong criticism last week for launching yet another social care commission which is not due to make final recommendations until 2028.
Problems with social care capacity mean thousands of hospital beds are taken up by patients who are medically fit to be discharged.
Nuffield Trust chief executive Thea Stein said the Government’s plan for the NHS showed it was “serious about changing how planned health care is delivered in the long-term”.
But she added: “For the plan to be sustainable, and not simply a process that needs to be endlessly repeated, we need to see alongside this announcement the speedy implementation of social care reform, significant investment in community services and a real focus on the things that impact on ill health, such as housing and education.”
Sarah Woolnough, chief executive of The King’s Fund think tank, welcomed the ambitious waiting list target but said it should not be “the sole measure of how the NHS is faring”.
She added: “Equally important to people are how long they are waiting for a GP appointment or an ambulance, for mental health care, and other services.
“To seriously transform the NHS and the care patients receive, ministers should conduct a more wide-ranging and fundamental review of health service targets so that they incentivise the improvements to services that patients need.”
Under the deal outlined by the Department of Health, women on gynaecological waiting lists and orthopaedics patients are among those who will be offered treatment in the private sector, all funded by the NHS.
A backlog of 260,000 women are currently waiting more than 18 weeks for gynaecological treatment, while in orthopaedics more than 40% of patients wait longer than 18 weeks.
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Patients will be offered a shortlist of hospitals they can choose from and the overall plan aims to slash the number waiting longer than 18 weeks in England by nearly half a million over the next year.
NHS chief executive Amanda Pritchard said the independent sector was already delivering more than 100,000 elective appointments and procedures every week for the NHS – up by more than half since 2021.
She added: “We are under no illusions that we must go further and faster if we want to get the waiting list down to levels last seen in 2015.
“This new agreement will enable the NHS to make better use of capacity within the private sector where it is needed most, and help us see more patients, free at the point of use.”
GPs will also be able to refer patients for tests directly and 17 new or expanded surgical hubs will be launched to speed up operations.
The Prime Minister said the NHS must be “hungry for innovation” and cannot become a “national money pit”. “Working people can’t be expected to subsidise the current levels of care with ever-rising taxes,” he said.
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“That is the price of ducking reform, and I won’t stand for it. I believe in public service. I believe in the NHS. I’ll fight for it day and night. I’ll never stand for that.”
Sir Keir added that the NHS must deliver convenience for patients. He said: “Just think about it – every day, just a few swipes of their phone, millions of people buy food or clothes for themselves and their family, they book holidays, they even find love.
“There is no reason, no good reason, why a public, free-at-the-point-of-use NHS can’t deliver that kind of convenience. In fact, it must.”
Waiting times should not be the sole measure of NHS performance, says SARAH WOOLNOUGH
The government has set out its plan on how it hopes to cut waiting lists for planned hospital care in England.
At the moment, only 59% needing routine treatments like knee or cataract operations are seen within 18 weeks of referral. The government wants this to improve to 65% by March 2026 and then to 92% by March 2029.
This is a hugely ambitious goal and whether it can be delivered will partially hinge on government decisions on NHS funding and staffing levels due to be set out in Rachel Reeves’ spending review, expected in June.
There is much to welcome in the plan – more choice for patients over where and when we receive our care, greater use of digital technology to improve how services are accessed, delivering care in facilities that are closer to our homes and communities, and focusing on reducing the unequal experiences people face waiting for hospital care.
However, while waiting times for routine hospital care are hugely important and the goal to improve access is worthy, the 18 weeks target has never been – nor should it be – the sole measure of how the NHS is faring.
Equally important is how long people are waiting for a GP appointment or an ambulance, for mental health care, and other services.
Our healthcare system also needs serious transformation, including to prevent illness, move more care out of hospitals and into the community, social care reform, and making health care a more attractive career to recruit and retain more staff.
The political focus on this one hospital target needs to be better balanced with these other more fundamental long-term reforms if the NHS is really going to be made fit for the future.
Sarah Woolnough is chief executive of The King’s Fund