NHS waiting lists could go up even more, health minister says on 75th anniversary – UK politics live | Politics

The Tony Blair Institute, the eponymous thinktank run by the former prime minister, has published a report today setting out how he thinks the NHS should be reformed. As Denis Campbell reports, it advocates greater use of private healthcare firms to provide services for NHS patients (something Blair championed when he was in office).

The report is not about charging patients. It says being “free at the point of use and funded through general taxation” should remain the principle at the heart of the health service, and it warns that if the NHS does not reform, the private sector will benefit.

But it does suggest using the NHS app, and NHS “personal health accounts” (which it advocates), to make it easier for people to access certain health services for which they might pay. In his forward to the report, Blair writes.

There should be active encouragement of new providers to enter the system, particularly for high-volume, low-complexity services, many of which can now be provided digitally. The NHS App is creating a vibrant marketplace for digital providers to enter the NHS centrally in ways that were not possible before, creating opportunities for greater choice and competition; and for partnership between the private health sector and the NHS. This can include the availability of co-payment options to expand more rapidly or offer additional features.

By “high-volume, low-complexity”, Blair is referring to services like dermatology and physiotherapy.

In an interview with Sky News this morning, Wes Streeting, the shadow health secretary, was asked if he favoured people paying to access some health services. He rejected the idea, saying:

I think we’ve already got a two-tier system in this country where people who can afford it are paying to go private and those who can’t are being left behind.

Good morning. The NHS is celebrating its 75th anniversary today, but “celebrating” might not be the most appropriate word. There are strong grounds for believing it’s in a grim state, and they have been set out this morning in a powerful letter to political leaders from three leading health thinktanks.

In the letter, the King’s Fund, the Nuffield Trust and the Health Foundation say the NHS is “in a critical condition”. They acknowledge that public support for the institution is “rock solid”. But they say that, unless it gets investment and reform, it faces “managed decline that gradually erodes the guarantee of safety in place of fear it was designed to create”.

The full letter is here. And here is an extract:

The NHS has endured a decade of under-investment compared to the historic average, and capital spending has been well below comparable countries. As a result, the health service has insufficient resources to do its job: fewer hospital beds than almost all similar countries, outdated equipment, dilapidated buildings and failing IT. Despite long-term objectives to reduce reliance on acute hospitals and move care closer to people’s homes, spending continues to flow in the opposite direction. Long-term thinking is essential to meet the challenges ahead – from responding to changing health needs to harnessing AI and new technology …

Long-term political action is also needed to address the fraying health of the UK population. The NHS was not set up to go it alone. Protecting and improving people’s health depends on a wider system of services and support that includes local government and social security. Yet people are falling between the cracks of public services and the NHS is often left to pick up the pieces …

Persisting with the current addiction to short-termism and eye-catching initiatives will risk the health service being unable to adapt to the huge challenges ahead and reach its centenary. It is time to move away from quick fixes and over-promising what the NHS can deliver and give it the tools it needs to succeed.

This morning Maria Caulfield, a health minister, has been giving interviews. She was asked about the recent figures showing that a record 7.4 million people in England are on an NHS waiting list, and she said the figure could go up. Speaking to Sky News, she said:

To patients, what matters is how long they’re waiting. They’re not really worried about who else is on the waiting list. They want to know when their procedure or operation is happening, and we’ve significantly reduced that delay. We’ve virtually eliminated a two-year wait.

Asked again about the 7.4 million figure, she said:

That probably will go up higher because we are offering more procedures.

This was interesting, for two reasons.

First, and most obviously, Caulfield was admitting that Rishi Sunak is currently not on track to meet his pledge to reduce waiting lists. This is obvious to anyone who has looked at the figures, but getting ministers to admit the obvious is not always straightforward.

Second, and more interestingly, Caulfied seemed – intentionally or not – to be redefining the pledge. In his announcement in January Sunak said: “NHS waiting lists will fall and people will get the care they need more quickly.” Asked to explain it at his press conference, he refused to set a timescale for when he expected the number of people on the headline waiting list to go down.

But he also mentioned subsidiary targets, reducing the amount of time people spend waiting for an operation, and he did set deadlines for these targets. He said he wanted waits lasting more than 18 months to be eliminated by April. (This target was narrowly missed.) By next spring he wanted waits of more than a year to be eliminated, he said.

Today Caulfield seemed to be saying that these are the targets that matter most. “To patients, what matters is how long they’re waiting. They’re not really worried about who else is on the waiting list.”

She may be right. But this is not what Sunak told the nation in January.

Here is the agenda for the day.

11am: Rishi Sunak and Keir Starmer are among those attending a service at Westminster Abbey to commemorate the 75th anniversary of the NHS.

12pm: Oliver Dowden, the deputy PM, faces Angela Rayner, the deputy Labour leader, at PMQs.

1pm: Claire Coutinho, the education minister, gives a speech on free speech to the Policy Exchange thinktank.

After 3pm: Peers begin the third day of the report stage debate on the illegal migration bill.

Here is the agenda for the day.

If you want to contact me, do try the “send us a message” feature. You’ll see it just below the byline – on the left of the screen, if you are reading on a PC or a laptop. This is for people who want to message me directly. I find it very useful when people message to point out errors (even typos – no mistake is too small to correct). Often I find your questions very interesting too. I can’t promise to reply to them all, but I will try to reply to as many as I can, either in the comments below the line, privately (if you leave an email address and that seems more appropriate), or in the main blog, if I think it is a topic of wide interest.