In a pivotal policy address this Thursday, UK Prime Minister Keir Starmer is poised to unveil a suite of ambitious new targets aimed at dramatically reducing waiting lists in the National Health Service (NHS). The centerpiece of his plan, according to well-placed sources, is a bold commitment to ensure that 92% of all routine operations and appointments in England are carried out within 18 weeks by March 2029 – a benchmark not achieved in nearly a decade.
The Prime Minister’s announcement comes on the heels of Chancellor Rachel Reeves’ autumn budget, which earmarked an additional £22 billion for the NHS over the next two years specifically to help trim waiting times that have ballooned in the wake of the COVID-19 pandemic. The extra funding and waiting list targets represent key planks in the government’s strategy to shore up the beleaguered health service.
Shifting Focus to Concrete Metrics
Insiders at No. 10 suggest that Starmer’s emphasis on numerical targets, while not without political risk, reflects a calculated shift away from the more conceptual “missions” he campaigned on during the general election. The thinking is that hard numbers will resonate more tangibly with the public.
In addition to the 18-week target for routine procedures, the Prime Minister is expected to recommit to building 1.5 million affordable homes, measurably improving school readiness for nursery-aged children, and delivering on a pledge to boost real disposable incomes across the board. Specific metrics on living standards and early childhood development will replace vague aspirations to achieve the highest growth in the G7.
Concerns Percolate Among Health Chiefs
However, the Prime Minister’s NHS targets are reportedly stoking unease behind the scenes among some high-level health service bosses. According to reports in The Times, there are fears that an unrelenting focus on elective procedures could come at the expense of other critical areas such as emergency care, community health, and mental health services.
A recent survey by NHS Providers found that 71% of NHS trust leaders, and a staggering 100% of those overseeing acute care and ambulance services, harbor doubts about meeting Starmer’s ambitious 18-week goal on such an accelerated timeline. The Society of Acute Medicine has bluntly warned that the plan is “doomed” without a concurrent effort to relieve pressure on overstretched urgent and emergency care.
“Any [18-week] plan that fails to do this is doomed, further increasing the misery of patients waiting prolonged periods for elective procedures and those experiencing appalling overcrowded conditions in emergency care.”
– Dr. Tim Cooksley, Immediate Past President, Society of Acute Medicine
Mental Health Services at Risk?
Particular alarm bells are ringing over the potential impact on mental health services. Former NHS England head Simon Stevens has cautioned Parliament that a single-minded political focus on waiting times for physical health could see psychological care “screwed” as budgets and resources are diverted elsewhere.
“At a time when, understandably, there will be great political focus on waiting times for physical health and routine operations, the most likely outcome, absent that mental health investment standard, would be that mental health services would get screwed at a time when other things are prioritised.”
– Simon Stevens, Former Head of NHS England
The Times report suggests that the NHS’s long-standing commitment to raise mental health spending at least in line with overall budget increases may be in jeopardy as acute care is prioritized. This despite Labour’s pre-election promises to beef up psychological support, including pledges to recruit 8,500 additional mental health personnel and cut wait times during its first term.
Government Dismisses “Reset” Claims
Cabinet Office minister Pat McFadden has pushed back against characterizations of Starmer’s forthcoming speech as a “reset” after a rocky initial foray into government. He insists that the Prime Minister is merely fleshing out a multi-year blueprint for change centered around a clutch of critical public priorities.
“We’re announcing what we want to do to get children ready for school, to get NHS waiting lists down, to get more people the chance to have a home of their own.”
– Pat McFadden, Cabinet Office Minister
But with concern already percolating through NHS ranks about the potential pitfalls and unintended consequences of Starmer’s targets, the Prime Minister may have his work cut out to unite disparate stakeholders behind his vision. The fear among many is that an over-emphasis on headline waiting list numbers could distort clinical priorities and leave gaping holes in the service.
As Starmer prepares to take the podium, all eyes will be trained on whether his rhetoric matches the reality of a health service still reeling from COVID, a cost-of-living crisis, and chronic staff shortages. In staking his premiership on these bold NHS targets, Starmer is placing a high-stakes bet. The question is whether he’s backed the right horse.
