If there was ever a saying that suited the claims made during an election cycle, it has to be Mark Twain’s famous statement about “lies: lies, damned lies, and statistics.”
If you have tuned in to heaven leaders event on Wednesday or the ITV match that preceded it, you might be forgiven for thinking that the NHS waiting list in England is increasing and decreasing at the same time.
But as the waitlist debate continues (and we can expect more of this before the July 4 poll), real people are dealing with the consequences of the backlog.
Here, as part of our wider data series on how fourteen years of Conservative party rule has changed Britain, we look at some of the key statistics when it comes to health.
The waiting list is almost three times as large as in 2010
The regular NHS data release has been bringing good news to the government for several months, with overall waiting lists in England falling month on month since October. That followed two and a half years of near-consistent record highs: in three of just thirty months, the waiting list in England was at a record high.
But Thursday’s release was less good: the NHS waiting list in England grew slightly in April to almost 7.6 million (up from 7.5 million in March), undermining claims of improvement made by Rishi Sunak so far during the campaign has actually come to a standstill. . The figures are still almost three times higher than the 2.6 million waiting for treatment when David Cameron became Prime Minister in May 2010.
Devolution means that waiting lists are measured slightly differently in other parts of Britain, but the other countries have also seen waiting lists increase following the Covid-19 crisis. Overall, the size of the waiting list in Northern Ireland is around 32% of the population, compared to 25% in Wales and 13% in England and Scotland.
As for England, the A&E figures remain a mixed bag for the Prime Minister. There has been a moderate improvement in waiting times, with around 60% of patients attending major emergency departments now seen within four hours, compared to a low of December 2022 (49.6%). Emergency department data goes back to 2011, but in April of that year 95% of patients were treated within four hours in major emergency departments.
The cancer targets are not being achieved
None of the three cancer operational standards were met in April. The NHS abolished or changed some of its cancer targets at the end of 2023, making a current review of cancer rates more difficult.
However, the charity Macmillan Cancer Support says that in England, NHS performance on one of the previous cancer targets got significantly worse after 2014 and that, even after the worst impact of Covid on the healthcare system had passed, targets were mostly missed.
One of the three new targets – that 85% of patients receive their first treatment within two months of an urgent referral for cancer – has been missed every month since its introduction in October 2023, while indicative estimates from the same organization show that the service is did. Since the beginning of 2018, 85% of patients have not been treated within a two-month period.
In May 2010, the month the coalition government was formed, that figure was 89%.
Commenting on the latest data, Mairaid McMahon, policy manager at Macmillan Cancer Support, said that despite tireless efforts from NHS staff, people with cancer were being “failed” by a healthcare system that was not getting the resources it needed to support them.
“The story consistently told from the wait time data is that too many people are waiting too long to find out whether or not they have cancer, or before their cancer treatment begins.”
As the waiting list grew, satisfaction plummeted
Given the size of the waiting list and the knock-on effect on patients waiting for treatment for a range of medical conditions, it is perhaps no surprise that public sentiment towards the NHS has plummeted.
In 2010, when the Conservatives entered into coalition with the Liberal Democrats, the proportion of people who said they were “very or somewhat satisfied” with health and social care was a record 70%.
Last year that figure fell to below a quarter for the first time (24%), a record low for the UK Attitudes Poll, carried out annually by the National Center for Social Research (NatCen).
The crossover between those who said they were generally satisfied and those who were not came in 2021 in the wake of the Covid pandemic. The satisfaction levels do not cover early 2024, when the longest waiting times occurred in England, but provide a clear indication of the public’s disappointment with a healthcare system they have traditionally taken great pride in.
It is not just public satisfaction that is eroding
A relative lack of capital investment in the NHS over the past fourteen years has meant that England’s health infrastructure – hospital buildings, facilities and equipment – has in some cases literally begun to crumble. This poses the risk of serious failure, significant injury or disruption to clinical services.
The ‘maintenance backlog’ is the amount the government must spend to bring dilapidated buildings and worn-out equipment back to an acceptable risk level. Last year this amounted to almost £12 billion – a record – with the “high risk” backlog costing an estimated £4.2 billion to fix (compared to just £0.3 billion in 2011-12).
Since these figures were last compiled, the NHS has become embroiled in the crumbling concrete crisis 54 hospitals Since February it has been confirmed to contain RAAC, a reinforced concrete.
Clapped but not compensated
Rishi Sunak was booed by a studio audience on Wednesday as he tried to shift the blame for rising NHS waiting lists to trainee doctors taking industrial action.
The immediate reaction from the public was not surprising. Recent Ipsos polling found that the public was most likely to support NHS workers when it came to taking strike action. a majority supported nurses and ambulance staff, while 46% would support trainee doctors if they chose to strike (compared to 33% against).
Despite public appreciation for NHS staff, culminating in weekly public applause during the pandemic, the staff industrial action follows fourteen years of falling average wages for nurses and doctors in real terms.
NHS doctors have seen average pay fall by 9.3% since August 2010. Junior doctors have been punished even more severely, with a real pay cut of 17%.
But it is nurses and health visitors – who earn substantially less than doctors or junior doctors – who will feel the most pressure.
Their average salary fell by almost £4,500 in the period between 2010 and 2024 – a real pay cut of 10.5%.