No10 U-turned on waiting list target as forecast hit 10m

By HUGH OSMOND, a leading businessman who says the chronic waste and inefficiency is hurting patients

DOWNING Street climbed down on waiting list targets after the NHS forecast they will hit 10million, it emerged last night.

Leaked models show that by March 2024, waiting lists will stand at 9.2million, falling to 8.5million by 2025. But in the worst scenario, they could peak at 10.7million in 2024 and fall to 10.3million the following year.

Ministers admitted this week that NHS waiting lists will grow for two more years despite the huge tax rise in April.

The national insurance increase will raise £12billion a year to help hospitals clear post-Covid treatment backlogs. Yet year-long waits for surgery will not be eliminated until after the next general election.

Last night The Spectator published figures showing the predicted scale of the backlog on which the Government’s ‘elective recovery plan’ to address it was based.

Before the pandemic, NHS waiting lists stood at 4.4million. This has risen to six million because operations have been postponed. But even optimistic scenarios show the total will hit 9.2million in two years, The Spectator said.

The Department of Health had previously modelled that an £8billion cash injection should reduce waiting lists to 5.5million by 2025.

But Whitehall sources said health chiefs had refused to accept tough targets demanded by Government.

Tory MP Craig Mackinlay said last night: ‘The amount of money going into the NHS is beyond description – it’s not a funding issue any more. The NHS has got to work very smart, very quickly… to get these numbers down.’

A Government source said last night ministers had set ‘a really ambitious, really tough target that is going to be held to account’.

The NHS said: ‘As set out by the Government, the NHS committed to using additional funding made available to address the impact of Covid to increase elective activity by around 30 per cent.’

Let me ask you a question. Are you shocked by the fact NHS waiting lists will continue to grow for years despite an eye-watering injection of another £36billion of your and my money?

Or does this news, reported in yesterday’s Mail, merely make you shrug? If it’s the latter, I’m not surprised.

Health secretary Sajid Javid admitted on tuesday that the waiting lists caused by the pandemic will not start to fall until — wait for it — March 2024.

Patients waiting for more than a year, often in serious pain, for operations such as hip replacements, will continue to do so until March 2025.

Mr Javid called it a ‘hard truth’ that waiting lists will keep growing. then he added, with revealing fatalism: ‘In the short term, there is no amount of investment or reform that could prevent that reality.’

Despair

But is he right? Can nothing be done to streamline and speed up NHS care? Or does Mr Javid need to hear some ‘hard truths’ of his own?

I’ve been involved in the successful creation, management and development of a number of large businesses — including Pizzaexpress PLC, Punch taverns PLC, Phoenix Group PLC — and smaller ones. And as someone with such extensive experience in the private sector, I despair at the way the NHS is being run and the money it is wasting.

the truth is that we could do it so much better — and Britain deserves it.

No one at the NHS is trying to do a bad job, of course, but there seems to be no control over cost-effectiveness or quality of delivery.

even after countless reorganisations by successive health secretaries, diagrams of how the NHS is run are astonishingly unwieldy, including endless committees, substructures and trusts.

It all adds up to a bloated mess — with zero accountability. this disobeys every law of sound business practice.

the £36billion that is to be thrown at the health service over the next three years — thanks to swingeing tax hikes on workers who are facing an unprecedented cost-of-living crisis — is coming on the back of healthcare funding having already increased substantially in real terms (that is, above inflation) every year in the decade before Covid.

In 2009/10 alone, the NHS ate up £124.1billion of public money, rising every year to £148.9 billion in 2019/20. Once Covid struck, funding shot up, to £191 billion in 2020/21.

Contrary to the claims of the Left, the NHS is not starved of funds after ‘tory austerity’. Quite the opposite. Healthcare spending per capita in Britain is actually slightly above the average of eU countries.

So, rather than just pouring more money into the NHS, what can we do to fix it?

Some years ago, I did some research into healthcare for a think tank that was reporting its findings to government. As you may expect, I found that patients being treated privately had better outcomes than their NHS counterparts.

But what surprised me was that private hospitals often carried out the same treatments for far less money than NHS hospitals.

When a patient visited a private hospital for a hip replacement, for example, not only was the standard of care higher but it was also 25 per cent to 40 per cent cheaper than the same operation in the NHS.

that is partly because private hospitals are run more efficiently, with less unnecessary administration, less duplication of effort and less waste. It is also because they don’t spend millions every year hiring more and more managers driving a politically correct agenda, who do not contribute to patient welfare or improved outcomes.

Last year, King’s College Hospital trust in London advertised for an ‘equality, diversity and inclusion manager’ at a salary of £70,000 a year — almost three times the wage of a newly qualified nurse. So taxpayers’ money is frittered away on add-ons rather than devoted to front-line healthcare.

then there are so-called ‘secondary infections’ such as e-coli, MRSA and C Difficile. In the year 2016/17 there were an estimated 653,000 healthcare-associated infections in NHS hospitals in england, out of which almost 23,000 patients died.

Private facilities have far fewer reported cases — let alone deaths — arising from secondary infections acquired in hospital: 0.2 per cent of patients having hip replacements in private hospitals pick up secondary infections.

In the past year, to make matters worse, we know that thousands of NHS patients being treated for other issues became infected with Covid.

Envy

the reality, which it is high time ministers admitted to the country, is that no developed nation imitates the NHS. If it really was ‘the envy of the world’, as politicians proclaim, our neighbours would be queuing up to copy us. But they aren’t. the UK has 2.5 hospital beds for every 1,000 people, just over half the eU average and one-third of Germany’s.

We have 2.8 doctors for every 1,000 people, the eU average is 3.7. France, Germany and Italy all do better than us on cancer survival rates.

Now, politicians often dodge these much-needed conversations. It’s cheaper and easier to post a picture of yourself online banging a saucepan in support of the Health Service rather than admitting the system badly needs reform.

But we need to address these long-term problems and create a health service fit for this century.

And instead of getting sidetracked by politics, we can start by asking: what’s the best system to provide the highest standard of care — at the lowest cost?

If I was in charge, I would move swiftly to an insurancebased model, starting with elective procedures.

When people hear the word ‘insurance’, they immediately worry they will be charged to take out premiums as they do for their houses and cars.

But that’s not the case. Publicly funded, insurancebased models — such as those in Switzerland, Holland and Germany — still ensure healthcare is free at the point of use, especially to those who can’t afford to pay.

the Government pays the premiums to private companies out of general taxation or perhaps a dedicated healthcare tax — as National Insurance was originally intended to be.

Care

But the insurance firms running the schemes ensure the system’s high standard of care and its cost-effectiveness. Importantly, they would have to compete for ‘customers’ (patients), meaning they would drive up care quality and drive down costs.

In an insurance-based model — unlike in a vast statist organisation like the NHS — healthcare providers can be incentivised to provide the best care. If they don’t, their rivals will muscle in and do the job for them. that, in miniature, is the miracle of competition that has helped create the prosperous and comfortable civilisation we enjoy in the West.

these changes wouldn’t have to be brought in overnight. A pilot insurance-based system could be introduced in a small region and assessed after four years: say for hip replacements or cataract operations, which are fairly straightforward procedures.

eventually, such a scheme could transform Britain’s health service into one of the best performers in the world.

the alternative is too depressing for words: watching politicians pour ever more money into the NHS, waxing lyrical about the supposed virtues of a failing system, and refusing to be honest with themselves — or we who pay for it. the question is: who will be brave enough to take these steps?

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