In a bold and contentious move, Labour Health Secretary Wes Streeting has unveiled plans to publish league tables ranking the performance of NHS hospitals in England. The proposal, which follows a comprehensive review of the health service, has been met with fierce backlash from NHS leaders and staff who argue the strategy will do more harm than good.
A “Crude” Approach to a Complex Problem
Under the new system, hospitals will be ranked based on metrics such as patient access to care, waiting times, financial performance, and quality of leadership. Top-performing trusts will be rewarded with increased funding and autonomy, while those at the bottom face the prospect of “turnaround teams” and potential sackings.
Critics have slammed the league tables as a “crude” and punitive approach that fails to account for the myriad factors influencing hospital performance. They argue that naming and shaming struggling trusts will only serve to further demoralize an already beleaguered workforce and erode public confidence in the NHS.
Addressing the NHS’s “Existential Crisis”
Streeting, however, remains resolute in his belief that drastic action is needed to address what he sees as an “existential crisis” facing the health service. In a recent speech, he warned that the NHS is living on “borrowed time” and that “if a Labour government can’t improve the NHS, then it simply won’t survive.”
The NHS faces an existential crisis […] if a Labour government can’t improve the NHS, then it simply won’t survive.
– Wes Streeting, Labour Health Secretary
Echoes of New Labour’s NHS Reforms
The health secretary’s stance draws inspiration from the early years of Tony Blair’s Labour government, which also inherited a struggling NHS and implemented a series of performance targets and league tables. Streeting has even appointed former Blair-era health secretary Alan Milburn as a senior adviser to help apply lessons from the past to today’s challenges.
Unfair Comparisons and Unintended Consequences
However, many within the NHS argue that the league tables fail to account for factors beyond hospitals’ control, such as the availability of local GP services and the health needs of the population they serve. They fear that trusts in poorer areas, which often face higher demand and more complex cases, will be unfairly penalized compared to those in more affluent regions.
There are also concerns that the rankings could exacerbate the NHS’s chronic staffing crisis, with Dr Adrian Boyle, president of the Royal College of Emergency Medicine, warning that the policy risks driving even more talented professionals away from the health service.
A Political Gambit?
Some observers suggest that the league tables are as much a political maneuver as a practical solution, allowing Streeting to demonstrate to the Treasury and the wider government that he is taking a tough stance on NHS performance in exchange for increased funding.
A big part of Streeting’s speech is about showing the Treasury and the rest of government that he’s being tough on the NHS, that he’s not just accepting the £22.6bn increase in day-to-day NHS funding without ensuring the government gets value for its money.
– A senior NHS official, speaking on condition of anonymity
The Road Ahead
As the debate over the league tables rages on, one thing is clear: the challenges facing the NHS are deep-rooted and complex, and there are no easy solutions. While Streeting’s plan may be well-intentioned, many fear that it risks doing more harm than good to a health service already on the brink.
The coming months will be critical as the government seeks to balance the need for reform with the concerns of those on the frontlines of the NHS. For the sake of the millions who rely on the health service every day, one can only hope that a constructive way forward can be found.
