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At this year’s Byline Festival, I was on a panel with Lord Victor Adebowale and Professor Deborah Christie discussing this very theme, just two days after the General Election. Subscribers can access the recording here.
It’s a great question, but my starting point was that whilst it does need more than “just” (more) money, the money really matters. And without it, the services will have to do fewer things for fewer people and the public will have to accept a struggle to deliver anywhere near the standard of service they could reasonably expect and which was the norm in the decade before the 2010 election and the year or two beyond it.
Declining NHS Performance
The decline in performance since is not anecdotal. It is illustrated very clearly in the national performance data.
The 2023 Institute for Government report ‘The NHS Crisis. Does the government have a plan?’ and Professor Chris Ham’s Report for The King’s Fund ‘The NHS 2000-2020. Rise and Decline‘ set out in some detail the story of vast improvement during the Blair/Brown government and progressive decline since, to the point where we have undone those gains. In the wake of the election result the Nuffield Trust’s policy lead, Mark Dayan posted an excellent thread on the worsening performance and underlying strengths of the system on X.
Towards the end of the last Labour administration in 2009/10, the annual social attidues survey showed higher levels of public satisfaction with the the NHS in England that at any point before or in subsequent years since in over four decades of reporting.
This was mirrored in the highest scores on the annual staff satisfaction survey with those working in the NHS. These have also plummeted since Labour were last in office and in the last two years have reached a nadir. It is any surprise that with morale low and disputes over terms and conditions, we have a serious staff retention problem?
Public Satisfaction with NHS and Social Care Falls to Record Low
NHS doctor David Oliver explains why the results of a damning new survey should alarm patients and healthcare professionals
The sustained focus on access and wait times over the previous decade had drastically improved A&E performance with over 90% of patients assessed, admitted or discharged within four hours, and 12 hour waits a thing of the past.
Waits of months or years for elective care were largely over due to effective referral to treatment time targets and monitoring and there were only two million people on waiting lists, not the current 7.6 million. Performance against the two week cancer wait was good. And consistent speed of access to general practice appointments was unrecognisably better than the new normal in 2024.
The NHS ranked well on international league tables such as the Commonwealth Fund’s annual report although there was still big room for improvement on certain disease outcomes.
The NHS is Now So Under-Pressure People Want to Pay for Treatment, Poll Reveals
A Bylines Times commissioned poll has revealed that people might finally be prepared to pay for better medical care in the UK as frustrations with the service grow
After 14 years of Conservative-led government, the NHS is now failing to hit a whole range of Key Performance Indicators and both recorded staff and patient satisfaction are at a new low.
When new Health and Social Care Secretary, Wes Streeting MP said on his second day in Office that, “the policy of my department is that the NHS is broken” this divided opinion. But I commend his honesty. Whilst many brilliant staff do fantastic work, the evidence is in plain sight and for too long we have failed to be honest about this.
It’s not all about the money but the money does matter
Whilst not the only enabler, money was a big part of that success.
Over the lifetime of the NHS since 1948, the average real terms annual funding uplift has been 3.4%. From 2000 to 2010 it was 6% – the highest in the service’s history.
From 2010-2019, it was 1.4 % – the lowest in the NHS history. And even since 2020, in the wake of the Covid pandemic we have yet to return to those historic averages.
Department of Health Sets Aside £21 Billion for Negligence Cases – But Has No Idea if Situation is Getting Better or Worse
A new report has found the ministry spends £3 billion a year on maternity services but paid out an ‘eye-watering’ £1.1 billion in claims for 2022-23