The phrase “corridor care” has come to sum up the state of the crisis in the National Health Service.
As we report today, patients are being put on trolleys in front of vending machines or fire escapes, or on chairs rather than trolleys, and are sometimes having CPR administered on the floor because there are no other flat surfaces available. All of these occurrences are now part of the normal functioning of some of our hospitals.
A survey by the Royal College of Nursing (RCN) finds that nine in 10 nurses report that they are delivering care in inappropriate settings such as corridors at least once a month, while nearly seven in 10 say they have to do so daily.
As the NHS experiences a worse than usual surge in winter flu cases, Professor Nicola Ranger, general secretary and chief executive of the RCN, says she has “no doubt at all” that this crisis is costing lives.
In all the new government’s talk of milestones, targets and missions, the NHS is perhaps the most urgent and immediate priority for Sir Keir Starmer. He and Wes Streeting, the health secretary, have been rightly cautious about overclaiming improvements – and the winter crisis has indeed made it impossible to detect any change for the better.
But Mr Streeting has said many of the right things, and has taken some of the early decisions that may make improvements possible over time. He secured a generous settlement from the Treasury, and was able to end the pay dispute with the junior doctors. These elements will not solve the problems of the NHS by themselves, but they are the conditions of progress.
Most of the problems in the health service are not caused by underfunding as such. The crisis is one of organisation as much as it is of resources, as the corridor care crisis visibly demonstrates. Patients are kept in corridors because of a lack of organisation rather than a lack of funds.
But it is not possible to address the issues of organisation without some extra funding, and Mr Streeting has created a potential breathing space, once the flu surge subsides, to press ahead with reform that will make better use of the resources available.
He will face criticism from within the NHS and outside it, but he has the intellectual confidence to argue his case and take most people with him. He will face resistance on two fronts in particular. It will be difficult to persuade some people that the NHS ought to make more use of private companies to provide healthcare services free at the point of need. But the experience of the last Labour government is that this is important, not least because the NHS tends to raise its performance to match that of this private “competition”.
It is significant that Alan Milburn, the reforming health secretary in Tony Blair’s government who oversaw the most dramatic period of improvement in the NHS’s history, has been brought in as the lead non-executive director at the Department of Health and Social Care. If anyone can help to turn the supertanker round, it is he.
The other front on which Mr Streeting will meet opposition is on the philosophy of targets. He and Sir Keir are said to be focused above all on getting waiting-list numbers down. This is right, but there will be many who complain that concentrating too much on one objective will mean neglecting other parts of the NHS, or distorting clinical activity, as doctors sometimes put it. The fear is that an obsession with waiting lists could, for example, exacerbate the crisis in A&E departments.
But the lesson of NHS reforms under the last Labour government, as Mr Milburn will be able to confirm, is that demanding targets, provided they are well chosen, raise performance all round. NHS trusts that make the most progress in cutting waiting lists will also be more efficient in everything else that they do.
Mr Streeting appears to understand this, and to be showing some of the urgency and relentless focus on “what works” that was so successful in raising patient satisfaction to record levels under the last Labour government.
The appalling findings of the RCN survey, which show the extent of the corridor care currently provided by the health service, make it imperative that Labour succeeds a second time.
