Backlog in NHS and courts will take 10 years to clear, says thinktank

Public services will not recover until the 2030s, even under a Labor government, and it will take a decade to clear the backlog in the NHS and the courts, a report has said.

This is evident from a study by the Institute for Public Policy Researcha progressive think tank, outlines the challenges a new Labor government will face, with voters eager for change within a first term.

“The next government will inherit one of the most challenging public services contexts of any new government since the Second World War,” said Harry Quilter-Pinner, an IPPR director, who warned that reforms and higher spending would be necessary are.

Some of the IPPR's ideas include rolling out AI tools, such as ChatGPT, to the public sector to save an estimated £24 billion a year, with a “right to retrain” for workers whose jobs are affected.

Labor is expected to fight the next election with a promise to transform public services, but the party will have little money to promise a big spending programme.

Keir Starmer is expected to warn during next year's election campaign that institutions such as the NHS will take years to rebuild. Photo: Joe Giddens/PA

In the article, titled Great Government, the IPPR says it will take almost a decade to reduce NHS waiting lists to 2010 levels.

The rule of law analysis is also sobering, with the prediction that it will take until 2033 for case backlogs to fall to pre-pandemic levels.

In education, the IPPR found that it would take more than one term for secondary schools to reduce the achievement gap between richer and poorer students to 2017 levels.

Opinion polls in the report showed that a majority of people said many public services were getting worse, but that they had not given up their faith in state services, with half of the public willing to pay more tax if the money was spent on e.g. hospitals. .

The IPPR, whose work has previously been used as inspiration by Labor, describes a recipe of “prevention, personalization and productivity” as the key to improving public services.

It says that previous attempts to change public services have focused on goals and outcomes, choice and competition, without paying sufficient attention to 'intrinsic motivation', which can be found in a better educated, more trusted and more autonomous workforce.

The blueprint for transforming public services is likely to be closely scrutinized by Labour. One of the key recommendations is to legislate for new missions or overarching goals for the country, such as making Britain the healthiest country, the safest country and the country with the best start in life. Each mission would have its own independent body, based on the Climate Change Commission, to hold the government to account.

Starmer has already set out his ambition for a mission-led government, including rebuilding Britain, taking back crime on the streets, getting the NHS back on its feet, mobilizing more British energy and breaking down barriers to opportunity.

The FT reported this week that Starmer would try to reduce turnover in the civil service, which he said could hamper the ability of senior Whitehall officials to deliver on Labour's priorities.

The IPPR also suggests better management and training of public sector workers so they can rebuild their capacity after losing 900,000 local government positions, and introducing a new 'failure regime' to support public services that need improvement.

Other ideas from the IPPR include shifting public spending towards prevention and long-term social returns, such as investments in social care, community policing and childcare.

“Public services have been decimated by budget cuts, the pandemic and rising demand,” Quilter-Pinner said. “Additional expenditure will be necessary to address this problem. But money alone will not solve the problems in our hospitals, schools and courts. The next government will need an ambitious, modern, long-term reform agenda. This blueprint we set out today provides the building blocks needed for a decade of reform and renewal.”

Responding to the report, a government spokesperson said it was already investing “record amounts of money in public services”.

They said: “We have delivered record funding for the NHS and social care and this investment will help increase bed capacity, operating capacity and workforce, including more doctors and nurses.

“School standards in England continue to improve and funding will be at its highest ever level in real terms per pupil by 2024-2025, including extra funding for disadvantaged pupils.

“We have lifted the cap on the number of court days, recruited more judges and invested more money in the criminal justice system, meaning the Crown Courts are now processing the highest number of cases since 2019 to provide justice for victims.

“We look at how new technologies such as AI can improve public services. This has already saved billions over the past financial year and ministers are continuing to build on the progress already made to drive greater efficiency and productivity in the public sector.”

The political parties are looking for policies to include in their manifestos and looking to think tanks to provide some of the ideas. The backdrop of tight public finances and rigid self-imposed fiscal rules means that they are looking for policies that are cost neutral or have few upfront costs.

Leora Cruddas, the chief executive of the Confederation of School Trusts, said it was important to debate public service reform.

“The report rightly states that the role of the state should be more strategic,” she said. “We think the focus on rebuilding the resilience of public services is absolutely right. And the focus on personnel capacity and investments is very welcome.

“We look forward to real engagement and debate on the ideas in this report in the coming months, leading up to the next general election.”

Penelope Gibbs, director at Transform Justice, said: “IPPR identifies the need to delegate power across the board. Only by delegating power can we ensure that services, such as criminal justice, focus on what communities need.

“Through the localization of power and budgets, a future good government will be able to shift the balance of spending from prisons to community solutions.”

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