The NHS will be the Conservatives’ “achilles heel” at the next election, ministers have been warned in a new report by a former government special adviser on health.
Richard Sloggett said the Tories’ standing has been badly undermined by their failure to deliver on most of the pledges to improve the NHS they made at the 2019 general election.
“The NHS is back as the Conservatives’ electoral achilles heel,” Sloggett said in a report for his Future Health thinktank. “The inability to deliver on the health promises in the [2019] manifesto and deteriorating access to care mean that the NHS is back once again as the issue of greatest threat to Conservative prospects at the next election.”
Sloggett was a policy adviser to then health secretary Matt Hancock at the Department of Health and Social Care (DHSC) in 2018-19 and before that worked at Policy Exchange, the right-of-centre thinktank.
The government has met or is on track to fulfil only 14 of the 35 health-related pledges it made during the 2019 campaign, according to his analysis.
It should increase the number of nurses working in the NHS in England by 50,000 by the 2024 election, as there are already 44,000 more than in 2019, he said.
It has also kept its word on boosting the NHS budget: the Tories pledged to increase it 29% by this year but they have already exceeded that target by 4%. The health service’s budget has risen from £114.6bn in 2018-19 to £152.8bn last year, the report found.
And a vow to boost the number of health professionals such as physiotherapists and pharmacists working alongside doctors and practice nurses in GP surgeries by 26,000 has also been met.
However, many of Boris Johnson’s headline-grabbing pledges have not been delivered and “will not be met” by the next election, Sloggett found. These include:
Recruiting 5,000 more GPs. Numbers have fallen by 3% since 2019.
Building “40 new hospitals” by 2030. The National Audit Office recently said that the government “will not now deliver 40 new hospitals” by that year.
A promise to help people live healthier lives and tackle obesity. Anti-obesity measures have been watered down or delayed by successive prime ministers.
Sloggett argues in his paper that the “most damaging” factors for the party’s standing on the NHS are the soaring hospital waiting list during their time in office, from 2.4 million in 2010 to a record 7.7 million, and the long wait for care.
He rejects the persistent claim by Rishi Sunak and the health secretary, Steve Barclay, that Covid-19 is to blame. While operations and services were cancelled and backlogs of care did build up because of the pandemic, the report says, “it is a mistake to lay the blame for the state of the service completely at Covid’s door. Deteriorating performance had already set in. The four-hour A&E target has not been met since 2015 [and] the 18-week elective [treatment] target since 2016.”
Sloggett argues that after 2010 the Tories had managed to shed their traditionally poor reputation on the health service through a “park the NHS bus” strategy, under which the service’s income was relatively protected during the years of austerity and then given bigger annual rises. However, that strategy is no longer viable because the government’s simultaneous neglect of social care, public health, the NHS workforce and capital funding have combined to leave the service no longer able to deal with the growing demand for care it is facing.
The DHSC defended the government’s record on the NHS. A spokesperson said: “Cutting waiting lists is one of the government’s five priorities and we are reducing the longest waits for care and taking action to improve access to services.
“There are 26,000 additional primary care staff and the government is on track to deliver 50,000 more nurses by next year. The NHS Long Term Workforce Plan will also deliver expanded training in the NHS, backed by over £2.4bn in government funding.
“The government is committed to delivering 40 new hospitals by 2030, expected to be backed by over £20 billion of investment.”
New research last week by pollsters Ipsos found that four out of five (81%) Britons believe that the NHS is overstretched. People in the UK are the second most likely out of people in 31 countries to believe their health system cannot cope with the demand for care it is seeing, Ipsos’s global health service monitor tracker survey said. That was just behind France, where 82% think their system is overstretched.
It comes as it was revealed hospital bosses believe as many as 2 million outpatient appointments and operations have been cancelled as a result of NHS strikes – double the official total.
The NHS Confederation said the true number is far higher than the NHS’s 1 million figure released last week because so many hospitals now do not book any patients in on strike days to save having to reschedule them.
Matthew Taylor, the chief executive of the NHS Confederation, which represents hospital trusts, said: “NHS leaders tell us that they are increasingly forced to pre-empt strikes by not booking in appointments and operations for strike days because of the amount of capacity being taken up by then needing to cancel them.
“While over 1m cancelled appointments are already impacting the health, wellbeing and livelihoods of hundreds of thousands of patients, our fear is that the true number of cancellations – including those that are hidden from the official statistics – could be as many as double.”
The NHS in England is bracing itself for an unprecedented three-day simultaneous strike by consultants and junior doctors, in the latest stage of their industrial action to win higher pay rises.
This week’s action will be even more disruptive to NHS services than usual because radiographers are also striking on one of the three days, Tuesday, that both types of doctors are withdrawing their labour. The loss of radiographers is expected to mean that cancer patients in particular cannot have scans they need such as a CT scan or X-ray.
• This article was amended on 2 October 2023 to add a DHSC comment received after publication.
