A ‘very tense’ behind-the-scenes row over how quickly hospitals in England can expect to reduce the huge backlog of surgery has erupted between NHS bosses and ministers.
The dispute has delayed the release of the government’s ‘elective stimulus package’, which Downing Street said would be part of Boris Johnson’s ‘Operation Red Meat’ policy response this week.
Johnson’s plan to salvage his job as prime minister after revelations from anti-lockdown parties in Downing Street was to announce a series of populist policies, including freezing BBC licensing fees for two years.
No 10, the Treasury and the Department of Health and Social Care are pressing NHS England to ensure hospitals carry out as many operations as possible, as quickly as possible, to tackle the backlog, which now stands at a record 6 million patients.
They want to impose “broad and demanding” targets on hospitals, sources familiar with the talks said.
However, trusted NHS bosses say the continued impact of treating sick Covid patients, due to the current Omicron push, long-standing gaps in their workforce, burnout in front line and record levels of staff illness, means they need time to start doing as much surgery as they did before the pandemic.
The Treasury are said to be frustrated with NHS England and privately believe they are “dragging their feet” on targets. NHS bosses, for their part, fear the plan is driven by “political expediency”, given growing concern over the huge number of people facing long delays in care.
A source said: ‘The Treasury is keen to set some pretty bold targets, but there has been a backlash on this [from the NHS]. The Treasury says ‘let’s really get going’, and the NHS says ‘let’s keep it real and remember the pressures on us right now from Covid, the vaccination program and other things’.
Both sides agree that targets for what percentage of pre-Covid levels of non-urgent care hospitals should start providing again, and by when, will be a key part of the “elective recovery plan”. It was due to appear last month but was delayed when Omicron hit in early December and threatened to overwhelm the NHS, forcing some trusts to cancel some elective surgeries.
However, hospital bosses say the targets must be “realistic”, given the pressures they face. An NHS official said ministers needed to be pragmatic and ‘not make the NHS fail’.
Matthew Taylor, chief executive of the NHS Confederation, which represents health service trusts, said: ‘We need to set ambitious targets, but the worst thing the government can do is set unrealistic targets which risk undermining public confidence in the NHS if and when they are not achieved.
Ministers should wait several weeks, until the full impact of Omicron is known, before finalizing targets, he added.
Hospitals were already doing their best to make inroads into their waiting lists, Taylor said. “But they are facing a crisis of rapidly rising demand for care, a high number of hospital admissions due to Covid and staff absences which are double the normal level for this period of the year. ‘year.”
The rapidly growing care backlog is becoming a key policy priority for Johnson. Last week brought another round of grim NHS performance figures. They showed that the number of people on the waiting list had reached almost 6 million, that more than 2 million people had already waited beyond the supposed maximum of 18 weeks and 18,585 had waited more than two years.
The waiting list already stood at 4.4 million before the pandemic. But Covid’s disruption of many normal hospital services, and people’s reluctance to seek NHS care when infection rates have been so high, have pushed it to record highs. It has grown by around 150,000 every month since last year.
The Prime Minister has appointed a team of civil servants, all with significant NHS experience, to advise him on how to reduce waiting lists and to review the progress of NHS England. Sir Michael Barber, the former head of Tony Blair’s Downing Street delivery unit, who strongly believes targets ensure the NHS delivers its products, has advised Health Secretary Sajid Javid on the backlog .
Chris Hopson, chief executive of hospital group NHS Providers, told the Health Service Journal earlier this week that ministers should wait to see the full effect of Omicron on the NHS before finalizing details of what the targets will be.
“What needs careful thought and may not be done if the plan is rushed too quickly is the difference Omicron is making and what the NHS can reasonably commit to, particularly for 2022-23 , given the significant disruption that the Omicron surge caused,” he said.
A DHSC spokesperson said: “The pandemic has put enormous pressure on the NHS, but we are committed to ensuring people get the treatment they need.
“We have provided an additional £5.9bn to help resolve Covid backlogs and we are investing £36bn over three years. The elective recovery plan is an important part of our recovery, and we will define the details in due course. »
Meanwhile, patients who fear they may have cancer but are unlucky with their GP can call a hotline for help, a health minister has told MPs.
Maria Caulfield, Minister for Patient Safety and Primary Care, told the House of Commons Health and Social Care Committee that the NHS was piloting cancer helplines staffed by specialist nurses as a way to a rapid diagnosis.