Whitehall ‘lacks plan’ to turn extra NHS funding into better care, MPs warn

The government lacks a “real plan” to turn extra funding from a planned £12bn national insurance rise into better outcomes for NHS patients in England receiving cancer treatment or those stuck on waiting lists for elective care, MPs have warned.

The House of Commons public accounts committee criticised the Department of Health and Social Care in a report published on Wednesday for having “overseen years of decline” in cancer and non-urgent operation waiting times, which predate the pandemic. It called on the health service to “set out . . . timeframes, costs and outputs” to reduce the current backlog.

NHS England and the health department “appeared unwilling to make measurable commitments”, the report noted. MPs also said: “There is no national plan to address [the] postcode lottery” that determines patients’ quality of care.

The report by the committee follows a tussle between the Treasury and health bosses over setting clearer targets for the NHS pandemic recovery plan ahead of a manifesto-busting £12bn increase in national insurance contributions, which takes effect in April. NHS England has so far only promised that the extra money will help push elective care activity 30 per cent above pre-pandemic levels by 2024-25.

As of December last year, nearly 6.1mn patients were waiting for non-urgent care, including hip or knee replacements, the most since comparable records began in 2007. The eight targets for cancer care have not been met since 2014, the committee noted. A National Audit Office estimate indicates the backlog will continue to grow to around 7mn by 2024 despite the extra funding.

Meg Hillier, the committee chair, said her colleagues were “extremely concerned that there is no real plan to turn a large cash injection, for elective care and capital costs of dangerously crumbling facilities, into better outcomes for people waiting for life-saving or quality-of-life improving treatment”.

She accused the health department of struggling to understand its “biggest problem, and the only solution to all its problems” — the way in which it manages the “heroic NHS staff”. “Exhausted and demoralised, they’ve emerged from two hellish years only to face longer and longer lists of sicker people,” she said, adding that the problem was “compounded by staffing shortages”.

The committee also expressed concern over how “people who have avoided or been unable to obtain healthcare during the pandemic” could create a further burden on the NHS. Since February 2020, an estimated 240,000 to 740,000 cancer referrals have been missed.

Matthew Taylor, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said the report highlighted how the health service was “paying the price for the longest financial squeeze in the NHS’s history during the 2010s”. He added that the missing referrals and staff shortages were the “two major areas of concern” for the NHS in tackling the backlog.

Saffron Cordery, deputy chief executive of NHS Providers, which represents healthcare leaders, called on the government to “set out the concrete action it will take to tackle the 110,000 staff vacancies and provide a sustainable workload for the workforce”. “These staffing gaps are putting significant pressure on quality of care and patient safety,” she added.

“The pandemic has put unprecedented pressures on healthcare and we are tackling this head on,” the health department said, pointing to the “record multibillion-pound investment” in the NHS over the next three years and a 10-year plan to improve cancer treatment.

“We are clear that business as usual is not enough,” it added. “That’s why we are delivering brand new surgical hubs and another 100 community diagnostic centres providing an extra 9mn scans, checks and procedures by 2025.”