What will happen to the additional £22 billion allotted to the NHS in Labour’s first Budget? Will it transform the service – and reduce the NHS England waiting list – or disappear into the abyss?
This remains one of the biggest outstanding questions from the Budget just under two weeks ago. Over half the tax rises announced – roughly £22 billion – went to topping up day-to-day spending in the NHS. Yet despite Labour repeatedly prompting that there would be no cash without reform, there were no new requirements or productivity improvements attached to the additional funds.
So what can the public expect? An interesting new report from the Institute for Fiscal Studies shines some light on attempts to improve productivity in the health service over the past year. The upside: improvements have been made from 2023. The downside: productivity in the NHS is still far below pre-pandemic levels, despite near-record levels of resources and an increase in the number of staff.
According to the IFS, there has been some improvement in carrying out elective surgery: ‘Over the first seven months of 2024’, the report reads, ‘the NHS treated around 5 per cent more people from the waiting list than during the same period in 2019.' But this is still a long way off where productivity gains were supposed to reach – the ‘elective recovery plan’ published by NHS England in 2022 set a target of almost a 21 per cent increase by 2024-25, compared to pre-pandemic levels.
The problem remains that the NHS has more resources than ever to carry out these procedures, yet is falling below productivity levels in 2019. ‘Between January and July 2024, the NHS had 18.2 per cent more consultants and 22.9 per cent more nurses and health visitors than during the same period in 2019, but only delivered 9.1 per cent more elective admissions and 12.1 per cent more outpatient appointments.’ The IFS argues, based on its own findings and backed up by the NHS’s own analysis, that this suggests ‘hospital labour productivity (i.e. treatments per staff member) is substantially lower’ than it was before Covid hit.
This does not bode well for the new cash injection. Despite promises that the most recent cash injection will lead to a productivity boost in the NHS next year, patients will still be – as they have for years – getting fewer operations and treatments for more cash. And that’s assuming that productivity boost is indeed delivered. Talk of reform still circulates, but the nuts and bolts of that change have not been announced. Rather, a consultation was pushed forward instead, to give politicians and the public even more time to talk about the state of the NHS.
Those conversations have been going on for years – albeit with little talk of reform, among politicians anyway – until Health Secretary Wes Streeting came onto the scene. Still, Labour does not have a precious moment to spare if its reform agenda is going to result in the first signs of improvements before the next election. Productivity figures will be a key factor in the calculations that determine whether or not the party has made good on its promise. And there’s a lot of improvement that needs to be seen.
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