MPs raise concerns about hospital waiting lists and plans to reform NHS

There is a “serious risk” that a key Labour pledge to cut NHS waiting lists will not be met, MPs have said as they likened Government plans for NHS reform to “poor practices seen on HS2”.

The Public Accounts Committee (PAC) said that initiatives to reduce waiting times for pre-planned care in England “have not met their goals”, with management of these programmes “extremely variable”.

“NHSE missed its recovery targets by significant margins,” MPs said.

They highlighted how billions have been spent to transform diagnostics and surgical services, yet “too many people are still waiting too long for diagnostic tests and treatment, and the pace of change to meet recovery targets is too slow”.

The latest PAC report highlights plans to axe NHS England (NHSE) and absorb its functions into the Department of Health and Social Care, while reducing local health management teams, saying that after these reforms the Department will take responsibility for managing the initiatives to cut waiting lists.

“Unless it gets a grip on the programmes, there is a serious risk that it will not meet its target for 92% of the waiting list to be treated within 18 weeks by 2029,” MPs wrote in the latest PAC report.

Prime Minister Sir Keir Starmer’s plan for change pledged that by July 2029, 92% of patients will be seen within 18 weeks for routine hospital treatment such as hip and knee replacements.

Meanwhile MPs on the committee also raised concerns about the announcement of plans for structural reform at the top of the health service.

“We have significant concerns that the reform of NHSE and DHSC, as well as local NHS services, has been announced without either delivery plans or funding in place,” they said.

Last week, Health Secretary Wes Streeting confirmed that thousands of NHS staff redundancies will now go ahead after funding for the estimated £1 billion cost was agreed with the Treasury.

The Government has already announced that headcount across both NHS England and the Department of Health will be cut by around 50%, with around 18,000 administrative staff and managers, including on local health boards, set to go.

It is now understood that the Treasury has not granted additional funding for the departures over and above the NHS’s current cash settlement.

Instead, the NHS will be permitted to overspend its budget this year to pay for redundancies, recouping the costs further down the line.

The new PAC report states: “We do not accept that it is prudent to make a major change, such as the structural changes that are being made to Integrated Care Boards (ICBs) and NHS England without ensuring there is funding in place to pay for the changes, and without conducting an impact assessment or taking other steps to safeguard value for money.

“These changes, especially the planned cuts to ICBs (integrated care boards), could have a significant negative impact on patients and on the healthcare workforce through the level of uncertainty they create, and because they may limit the ability of NHS organisations to plan for the future.

“We are concerned that these poor practices, previously seen with the New Hospitals Programme and the High Speed 2 programme are being replicated here and will lead to wasted effort.”

HS2 has been delayed by several years, over-run its budgets by billions of pounds, and seen its scope heavily reduced.

Elsewhere in the report, MPs say they are “not confident that the Department is being realistic about the immense effort needed to reduce NHS elective care waiting times” adding they see a “significant risk that digital solutions are being treated as a ‘cure-all’.”

Clive Betts, deputy chairman of PAC, said: “Every unnecessary day that a patient spends on an NHS waiting list is both one of increased anxiety for that person’s unresolved case, and if they are undiagnosed, a steady increasing of risk to their life.

“Every penny of funding spent to put the NHS back on a pre-pandemic footing must be precisely targeted, or the system itself becomes an obstacle to proper care.

“Unfortunately, our report establishes that billions have been poured into the system over the past few years without the requisite focus on making sure that money does what it was intended for – improving outcomes for patients.

“The rollout of shiny new surgical hubs and diagnostic centres will only be superficially impressive if they are not used in the most productive way.”

He added: “Alarmingly, in the Government’s approach to the absorption of NHSE and 50% cuts to local health boards, we are now seeing chilling echoes of past failures on HS2 and the New Hospital Programme.

“Our Committee has long established that large unfunded commitments, without plans for delivery, while good at generating headlines, can only end one way.

“We hope the Government can provide reassurance as part of this inquiry that it can come forward with the underpinning detail that can marry its ambitions to reality.”

A Department of Health and Social Care spokesperson said: “This Government inherited a broken NHS, with waiting lists soaring and elective services in dire need of modernisation.

“For the first time in 15 years waiting lists are falling.

“Through record investment and modernisation, we’ve cut backlogs by more than 230,000 and smashed our target for additional appointments, delivering more than five million extra.

“Health service productivity is up 2.7% on last year – and just last week, we pressed ahead with halving the headcount of NHSE and DHSC, saving billions to reinvest into the front line and patient care.

“We’re delivering the change the NHS is crying out for – while slashing wasteful spending to ensure maximum value for taxpayers.”