It’s not NHS leaders who are to blame for lengthening queues – that’s the government’s fault

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I was troubled to read this in the FT this morning:

Health leaders are demonstrating a “troubling” lack of understanding about the harm to patients from lengthening waiting lists, a Commons spending watchdog has warned as it called for urgent action to improve National Health Service performance.

The public accounts committee said that only 38 per cent of NHS trusts were meeting the 62-day waiting time limit for cancer patients to begin treatment after an urgent referral. Meanwhile, the waiting list for elective, or non-urgent, care had increased by 1.5m since March 2013 to 4.2m in November 2018.

The FT added:

Following its inquiry, the committee said it was “concerned that the national bodies responsible for setting and managing waiting times appear to lack curiosity regarding the impact of longer waiting times on patient outcomes and on patient harm”.

And it was clear the FT was not misreporting. This came from thge Labour chair:

Meg Hillier, who chairs the committee, said that it was unacceptable that the proportion of patients being treated within NHS waiting times was continuing to spiral downwards and called on NHS England and the Department of Health and Social Care to regain control.

And this was also said:

The long-term funding settlement for the NHS announced by the prime minister a year ago, the NHS long-term plan published in January, and a review of waiting times standards currently under way, presented “an opportunity to get the NHS back on track in meeting waiting times standards”, the MPs said.

Normally I have a lot of time for the Public Accounts Committee. Over the last decade few committees have done better work. But this is far from its finest hour. There are three reasons why the NHS is in trouble. They are:

  1. The internal market, which creates massive costs and enormous inefficiencies
  2. A lack of funding
  3. Brexit, which has harmed recruitment

None of these has been corrected. The situation is getting worse by government choice. And demand is growing. NHS managers know all this. They are struggling with a dire structure created by this government, poor funding delivered by the government and Brexit which leaves 100,000 posts unfilled and demand is growing. For MPs to blame them is ridiculous: this is one where all the blame lies at the Tory (and LibDem, let's not forget) door.