Rishi Sunak’s pledge to cut NHS waiting times will be impossible to meet if strikes are still disrupting care beyond the summer, health service chiefs have privately warned ministers.
The prime minister promised in January that “NHS waiting lists will fall” when he outlined five pledges, reflecting “the people’s priorities”, by which voters should judge his performance, he said.
However, NHS England has told ministers that hospitals will not be able to ensure that Sunak fulfils his pledge because of the disruption caused by junior doctors’ ongoing strikes.
Services, including surgery and outpatient appointments, will be hit again from Thursday when tens of thousands of junior doctors in England take part in a five-day walkout – the longest stoppage in NHS history. It will be their fourth bout of industrial action since March.
Junior doctor leaders at the British Medical Association have threatened to keep striking until next spring if they get a renewed legal mandate unless Steve Barclay, the health secretary, makes them a “credible offer”.
The BMA is calling for “full restoration” of pay, which it says has been cut by 26%. The government has offered 5%.
The chances of Sunak delivering on his commitment appear to have slimmed even further after ministers agreed that the NHS could do almost 200,000 fewer operations than planned in 2023/24.
They have done so as a direct result of the ongoing wave of strikes that have significantly set back hospitals’ efforts to cut a treatment backlog that has risen from 7.2 million when Sunak first made his pledge to almost 7.4 million.
Hospitals were originally due to carry out this year 107% of the number of planned procedures, such as hip and knee replacements, they undertook in 2019-20, before Covid-19 hit. But ministers have agreed to lower it to 105%, the Health Service Journal revealed.
Opposition parties seized on the deal as proof that the prime minister would not be able to make good on his vow. “Sunak’s pledge to cut waiting lists is crumbling, and with it the ability of patients to get care on time”, said Wes Streeting, the shadow health secretary.
Senior doctors are also preparing to go on strike over pay and will walk out next Thursday for the first time since June 2012. Like their junior colleagues, consultants are also seeking “full pay restoration” after seeing the value of their salaries fall by 35% since 2008/09.
Daisy Cooper, the Liberal Democrat health spokesperson, said the prime minister’s promise “has been left in tatters”.
In a dramatic illustration of NHS bosses’ acute concern at the havoc the strikes are wreaking, one of the service’s largest trusts has warned the walkouts would result in a “devastating impact of further delays in care and longer waits for patients, including for those people waiting for cardiac surgery and cancer treatment”.
Guy’s and St Thomas’ trust (GSTT) in London has already cancelled or rescheduled 55,000 outpatient appointments and almost 6,000 operations since NHS nurses, doctors and ambulance workers began walkouts last December.
Prof Sir Stephen Powis, NHS England’s national medical director, said that both sets of industrial action by doctors will result in “tens of thousands of routine appointments and procedures for patients being postponed each day”.
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Sunak said he was “absolutely laser focused” on fulfilling his pledges at a press conference at the Nato summit in Lithuania on Wednesday but stopped short of repeating his guarantee that waiting lists would fall.
Since making that promise he has sought to redefine it as applying to just people who have been waiting the longest time – 18 or 24 months – for NHS care.
Sunak and Jeremy Hunt, the chancellor, are due to decide on Thursday whether or not to honour recommendations made by public sector pay review bodies of rises of up to 6.5% and, if they do, if they will provide extra funding to departments to cover the costs involved. The prime minister said he would be guided by “fairness” and “responsibility” in his decision.
Hospital bosses have voiced their alarm at the spiralling financial cost to them of repeated stoppages by doctors. Junior doctors’ three-day strike in April cost the NHS about £100m from having to pay consultants to cover their colleagues’ shifts and lost income from operations they could not perform.
“There’s a high level of frustration and deep concern that there doesn’t appear to be a resolution in sight,” said Sir Julian Hartley, the chief executive of NHS Providers.
“As long as we’ve got a black cloud of industrial action without a solution in sight, the scale of the challenges facing the NHS will continue to mount. Within the NHS, there is a sense that this is never-ending.”
Barclay said that the junior doctors’ stoppage would “have an impact on thousands of patients, put patient safety at risk and hamper efforts to cut NHS waiting lists”.
He repeated his assertion that the BMA is being “unreasonable” in seeking a 35% pay rise.