Do Labour's plans to cut NHS waiting lists go far enough?
By Elisa Menendez, Westminster Producer
Labour has set out its plans for tackling the mammoth NHS waiting list backlog and improving a healthcare system that's "on its knees" - but do they go far enough?
The party has made cutting the enormous backlog within five years the core focus of their plan, with Shadow Health Secretary Wes Streeting warning "shameful numbers of patients are spending their final months stuck on waiting lists, waiting for treatment that never comes."
A key issue at the heart of this General Election is the future of the NHS and parties from all sides of the political agenda recognise the public will vote with its feet to protect the creaking health and social care services.
According to those surveyed by YouGov, health is the second biggest issue the country is facing - closely behind the economy - and 75% believe the government should spend more money on the NHS.
Labour's big health policy came on a day that junior doctors announced a fresh round of strikes amid their long-running battle with the government - with medics and experts warning the party's plans to tackle the backlog won't happen until NHS staff working conditions and pay are improved.
Former Deputy Chief Medical Officer Jonathan Van-Tam told ITV News tackling waiting list times "should be a massive immediate priority for whichever government is in office after July 4" as well as preventing ill health in the first place, but added: "The situation has become so bad in the last few years that sadly it will take a long time and a lot of resources to reverse."
The Doctors' Association UK say that while efforts are welcome from any political party, they fear many politicians still do not quite grasp the scale of the task and the complexity of the issues at play - and are mistakenly failing to put social care at the top of the agenda.
What has Labour pledged?
Labour says it would use a combination of investment and reform to cut NHS waiting lists, warning that the current 7.54 million treatment backlog could soar to 10 million if the Tories stay in power.
According to NHS trusts, around 148,000 people died in 2023 while waiting for NHS care, say Labour.
On the election campaign trail on Wednesday, Mr Streeting said the NHS was “on the ballot” and urged voters not to “give the matches back to the arsonists to finish the job” as he pledged to create an extra 40,000 appointments every week.
Evening and weekend appointments, scans and operations would be offered to tackle the backlog. Labour hope that paying overtime rates for the extra out of hours shifts will incentive staff.
The party also pledged to double the numbers of scanners, including AI enabled ones for earlier diagnosis, as well as using the independent sector to help speed up the process.
The longest anyone would wait for treatment would be 18 weeks, vow Labour.
It also aims to provide an extra 700,000 dentistry appointments per year - boosted by a targeted recruitment scheme.
Labour promise to recruit 8,500 new mental health staff to speed up access to services, while offering each school a specialist mental health professional for pupils to speak with and community "mental health hubs" for young people offering drop in sessions.
Britons would see the "return of the family doctor by cutting red tape so that patients can see the same GP each appointment if they choose to", while one-stop shop "Neighbourhood Health Centres" will be trialled in the community.
But Labour's plans to ask medics to work extra shifts came as exhausted junior doctors announced five more days of walkouts over their conditions and pay before the country goes to the polls.
Mr Streeting admitted a Labour government would not be able to afford the full 35% pay rise requested “on day one” to quell the disruptive strikes.
He told ITV's Good Morning Britain: "I’m willing to sit down and negotiate on those wider conditions so that junior doctors are genuinely valued and and look forward to a career in the NHS rather than thinking about whether they’re going to stick it out because things are so terrible.”
How is it all being paid for?
Labour says the plans would cost around £1.3 billion and will be funded by cracking down on tax dodgers, while also tightening the rules and closing the loopholes on non-domiciled people (non-doms).
The recruitment drive for mental health professionals, including in schools, will be paid for by ending the tax breaks for private schools, say Labour.
Andrew McCracken, of the King's Fund - a charitable health and care think tank - thinks Labour's plans to slash the waiting lists within five years sound ambitious.
In the early 90s, the then-Labour government set about bringing down long waiting lists and the managed it, but, he pointed out "it took the best part of 10 years".
"They did that through a number of things - one through beefing up investment and recruiting a whole lot more of staff. We know the economic context this time round is going to be very different," Mr McCracken added.
He argued that dealing with medics' pay and working conditions are at the heart of making their plans work - and that it's "not normal for the NHS and its staff groups to go on strike" - but both Labour and the Tories are not willing to match the junior doctors' pay requests.
How have medics reacted?
Doctors have welcomed Labour's ambition to tackle the waiting lists - but say it will take a lot more than that to make real, lasting change.
They argued that many staff are already exhausted and overworked and don't want to work overtime.
Medics warn that much of the NHS runs on goodwill "and that goodwill has been significantly eroded over the last few years," according to Helen Fernandes, consultant neurosurgeon and co-chair of the Doctors' Association UK.
She told ITV News "things have got extraordinarily bad over the last few years" and that any efforts to reduce waiting times are welcomed - but the political soundbites she's heard do not fully address the multi-layered issues at play in the NHS.
If any incoming government really wants to tackle the backlog, Ms Fernandes says it first must address the issues in social care and second, improve the quality of life of NHS workers.
"Most hospitals are full of patients who don't need to be there," she added, saying if they were safely discharged when necessary this would free up beds enabling more procedures and treatment to go ahead.
"Operations are cancelled during the week because there are no beds to put patients in. And this would relieve the pressure on A&E departments that are trying desperately to admit sick patients into those beds.
"And it frustrates lots of doctors, and managers as well, that that elephant in the room is still unsolved."
She pointed out that to get a patient into the operating theatre safely, a hospital bed is needed to transfer them to and from the ward, with staff needed inside and outside theatre.
"So at any one time, you might have anything from seven to 20 staff involved in delivering that episode of patient care," Ms Fernandes explained. "So the bottleneck is not just an empty operating theatre, it's often the bed that isn't vacant for the admitting patient to come into."
On the issue of working conditions, she warned NHS staff live with a fear of speaking out and of disciplinary procedures.
She argues that poor pay, parking and canteen facilities, and doctors "being sent to far-flung hospitals on rotations all lead to inefficiencies in care", as well as the lack of engagement of not only doctors, but all hospital staff.
"If you don't look after your staff properly, then you know you can't expect them to look after the patients as well as they might be able to," Ms Fernandes said.
However, she said Mr Streeting's "commitment to make a change is rather welcome" and she was impressed by his "knowledge and understanding of the plight of junior doctors" and "how they are being poorly managed and treated by the present government".
"That gave me some confidence that perhaps he does have some insight into how complex the NHS is and how looking after patients is so multi-layered," she added.
The British Medical Association (BMA) agreed investment is welcome "but it’s unclear how far £1.3 billion will stretch given the scale of the task", agreeing that expecting doctors working round the clock "to spread themselves even more thinly won’t cut it now".
It said: “It’s a laudable aspiration for Labour to commit to bringing waiting times down, but they will need to do more to support the workforce to make this a reality...
"Without restoring this pay – and most urgently resolving the dispute with junior doctors – doctors will continue to leave and any promises to solve the backlog will fall at the first hurdle.”
What have the Tories said?
The Conservatives reiterated their criticism of Labour, saying the party "has no plan" for government and called it "more 'copy and paste' politics".
Rishi Sunak appeared to suggest the timing of the junior doctors strikes was suspicious, adding it "does slightly ponder the question as to whether this is politically motivated - it's hard to escape that conclusion given the timing and to call a strike in an election campaign".
The Conservatives pointed to their own long-term NHS workforce plan and a £3.4 billion plan to upgrade NHS technology.
Health Secretary Victoria Atkins said the Tories "will take bold action to strengthen the economy and continue to deliver the technology and innovation the NHS needs to keep cutting waiting lists".
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