The number of people in England waiting for planned hospital care could hit 10.7 million by March 2024, leaked projections prepared for ministers and NHS bosses show.
Even under the best-case scenario, the waiting list could reach 9.2 million, according to modelling about potential growth in the size of the NHS backlog seen by the Spectator magazine.
The figures emerged a day after the health secretary, Sajid Javid, told MPs that the backlog – already at a record 6 million – would keep on growing for another two years.
His admission, while launching the “elective recovery plan” intended to tackle the backlog, has led to disquiet among Conservative MPs. They fear that the waiting list will keep growing in the run-up to the next general election in May 2024, threatening to damage the party’s efforts to rebrand itself as a strong supporter of the health service.
There is also considerable unease in Tory ranks due to a suspicion that the rise in national insurance from 1 April, which several cabinet ministers believe is unwise given the cost of living crisis, will make little difference to that upward trend.
The Spectator reported on Wednesday that, according to NHS England modelling, “the optimistic scenario shows that, [in] March 2024, the waiting list would stand at 9.2 million, falling to 8.5 million by March 2025.
“The downside scenario shows the list peaking at 10.7 million and easing to just 10.3 million the following year.”
Sources with knowledge of the figures said they were accurate. They emerged the day before NHS England publishes its latest monthly performance figures covering waits for operations, cancer treatment, A&E care and access to diagnostic tests such as scans and X-rays.
However, while the Spectator said the projections had been drawn up by NHS England last week, NHS sources insisted that they had come from the Department of Health and Social Care.
Javid himself has previously said that the waiting list could reach as many as 13 million if no remedial action was taken to ensure faster treatment. He told the Commons on Tuesday that about 10 million people did not seek NHS help during the pandemic, and that an unknown number of them, potentially as many as 80%, would probably do so over the next two years.
Labour and the Liberal Democrats have called for the 1.25% rise in national insurance to be scrapped and for the £12bn a year the increase is expected to raise for the NHS and social care to be found elsewhere. The Daily Mail is running a vociferous campaign against what will be the biggest tax increase for many years. But Boris Johnson and Rishi Sunak, the chancellor, have insisted that it is going ahead.
The ballooning of the waiting list – which stood at 4.4 million when the Covid pandemic struck in March 2020 – and the likelihood of its continued rapid growth is causing great concern in Downing Street.
Under the elective recovery plan, NHS England has committed to ensuring that by this July no patient has to wait longer than two years for planned care, and that no one will have their care delayed by more than a year by March 2025.
However, in a letter to local NHS leaders on Tuesday about the new plan, two senior health service figures, David Sloman and Sir James Mackey, said that those dates were merely “ambitions” rather than binding targets. NHS leaders and Javid agree that the uncertainty over how many people will seek care in the coming years makes it impossible to predict how big the headline waiting-list figure will become or by when.
Under the NHS’s longstanding referral to treatment programme, 92% of patients who need an operation should be treated within 18 weeks. But that target – supposedly a right patients enjoy – has not been met since 2015, which staff groups blame on underfunding and staff shortages.
Wes Streeting, the shadow health secretary, said: “Working families are being made to swallow another Tory tax rise. Yet it is clear from the government’s plan that patients will still be waiting longer for care.”
