HHave you noticed that this is the government’s “health week”? Sajid Javid, the Health Secretary, appeared twice on Radio 4’s Today program to try and get it stolen, but somehow failed to distract of other Westminster dramas.
Hoping that health could act as a useful shield was a strange maneuver, because the NHS is the bad news that will follow the Tories in the next election. But where else can No 10 turn, to what paralyzed department, for one iota of good news to distract from all the other bad news? Blank denial, overturning the truth, is Boris Johnson’s way: During Prime Minister’s Questions on Wednesday, he bragged about his government’s ‘fiscal firepower’, just as the OECD told the world that the UK was heading for zero growth, bottom of the league (with the exception of Russia).
When the NHS appeared, it used a jaw-dropping blizzard of numbers, clearly not expecting to be believed. Inspect his numerology on staff recruitment and it reveals failure after failure. By July, no one will wait two years for an operation! But is it a success? Labor left office with a maximum of 18 weeks to wait. No, Covid is just one reason: 4.43 million people in England were on waiting lists just before the pandemic hit.
Johnson’s bluff infects his cabinet. Javid on Today didn’t flinch or flinch saying its 48 “new” hospitals by 2030 are on track. Listen carefully and they have become ‘hospital projects’, mostly wings and units, as only £3.7bn has been invested while a new mid-sized hospital costs £500m. How are they progressing? Government watchdog the Infrastructure and Projects Authority downgraded the scheme to ‘orange/red’ meaning delivery ‘is uncertain with major risks or problems apparent in a number of key areas’ , apparently calling it “unachievable”. Meanwhile, hospitals in ruins have no news of their reconstruction. The collapsing roof of the infant intensive care unit at Queen Elizabeth Hospital in King’s Lynn, Norfolk, is held up by 1,500 props. This hospital needs £862million, but the delays are costing more as construction prices rise by 24%.
Anita Charlesworth, health economist and director of research at the Health Foundation, explains the scale of the NHS deficit. “Running so you don’t stand still,” maintaining the same inadequate level of activity as the past decade, “would cost extra £2billion a year’, and that’s before pay rises. For a salary to keep up with inflation would cost £7billion, taken from the current NHS budget: there’s no chance of that happening. After the biggest funding crisis in its history, with 110,000 vacancies in England, she says: “We are spending less on the NHS than equivalent countries, and by the end of the decade we will be a quarter short of staff, with the number of over 85s increasing by a third.
The current danger, she says, is the haemorrhage of highly skilled, overworked staff at the top of their pay scales, being wooed into easier professions. The government voted against any labor strategy, a senior Conservative tells me, because the Treasury could not let the world see the true state of future spending needs.
The Royal College of Emergency Medicine’s recent report on NHS beds is another grenade dropped in health week, showing 25,000 beds lost across the UK over the past decade, causing occupancy levels “dangerous” beds, with the fewest beds per head in Europe. NHS beds are blocked for lack of social care, leading to cancellations of operations and ambulances stuck in front of overflowing A&Es. During Prime Minister’s Questions, Keir Starmer hammered home the 135,000 patients waiting for delayed cancer scans, the lack of GPs and those 48 Potemkin hospitals. The commentator wanted him to wrinkle the salt in Johnson’s leadership wounds, but it is the NHS delays that are causing real concern in most households.
Here’s the risk if Labor doesn’t win the next election: Years of acute underfunding in the 1990s led to feverish debate that the 1948 system was broken, with a crescendo of calls for insurance and supplements. In power, the Labor Party could prove how strong funding restores the health of the NHS.
As the prospect of power draws closer, the scale of the NHS collapse may be a good campaign story for Wes Streeting, Labour’s shadow health secretary, but what a nightmare to inherit. “It’s a two-term project,” he warns me. “We need to start with the most pressing priorities.” And it’s the workforce, with a massive training program to promise enough future employees.
“And wages need to go up. At a food bank in Colchester, they distribute food parcels to nurses. On GP services, he says, “The front door to the NHS is broken. Young doctors do not want to work as independent traders in a house at the end of the terrace. Thus, relying on networks of general practitioners, he is relaunching Labour’s plan for local polyclinics with multiple services, including diagnostics – abandoned by the Tories. “Our National Care Service is the only way to unlock NHS beds, and with good pay, training and career progression we can attract people into care.” But the last time it took Labor many years to undo the damage.
As health week failed, Johnson turned to housing instead. But that only highlights a story almost as bad, with equally empty promises. The Downing Street grid will continue to struggle from issue to issue. Crime, the courts now reserving criminal cases three years in advance? The climate, with Tory MPs tearing up net zero politics? Johnson will be brought back to the front page of conservatives, so expect loud, fake culture wars to try to fill the big void.