Sunak’s pledge to bring down the NHS waiting lists wasn’t an off-hand pledge, an off-the-cuff remark, or a long-term policy proposal

Dr Julia Patterson is Chief Executive of EveryDoctor, a doctor-led campaign organisation fighting to save the NHS

We’ve been hearing Rishi Sunak blaming the length of the NHS waiting lists on striking NHS staff for many months now. Despite recent analysis from The Health Foundation which showed that industrial action from consultants and junior doctors had only contributed to 3% of the overall size of the waiting list, he has repeated his rhetoric again and again. 

Several days ago, Sunak admitted for the first time (to Piers Morgan during an interview) that he had failed his pledge to bring down the NHS waiting lists. This received a huge amount of attention in the national media, and for good reason. Sunak’s pledge to bring down the NHS waiting lists wasn’t an off-hand pledge, an off-the-cuff remark, or a long-term policy proposal. It was one of the 5 key pledges he made as Prime Minister in January 2023, and it was made in the midst of the worst NHS winter crisis that we have ever experienced. 

Several days before Sunak’s pledge was made, Dr Adrian Boyle (president of the Royal College of Emergency Medicine) had publicly stated that up to 500 people could be dying each week because of their inability to access urgent care within the NHS. The situation was incredibly stark. I run the organisation EveryDoctor (www.everydoctor.org.uk) and we were hearing from both NHS staff and patients who were experiencing terrifying situations. Patients were calling for ambulances which simply never arrived. GPs were driving emergency patients to hospital in their own cars, because they had no other option. When patients arrived at A and E departments, they were met often with chaos. Beds had been removed from A and E cubicles to make way for 6 patients to sit on chairs. Patients were receiving life-saving treatment in non-clinical areas, in corridors, even on the floor, as staff held up sheets to try to preserve their dignity. 

EveryDoctor had been running emergency parliamentary briefings for MPs for several months by this point. Our doctor members had seen what was coming down the track, and they were incredibly concerned. They described the situation as a humanitarian crisis. This was the context of Rishi Sunak’s pledge. His pledge to cut the NHS waiting lists should not have been a soundbite, or a weapon with which to attack striking workers many months later. It was desperately important, and should have been taken incredibly seriously by Sunak and his government. 

That is not what happened, as we know now. Rishi Sunak failed to take the necessary steps to bring NHS waiting lists down in any meaningful manner, and now millions of people are unable to access the treatment they need. Many are waiting, and will be waiting for many more months or even years. While they wait, they’re likely to experience anxiety, worry, pain and even a deterioration in their condition. Many more are being pushed into the private sector, with soaring numbers taking out private healthcare insurance or self-funding their treatment. Worryingly, their decision to access private healthcare is often being referred to as a “choice”; a “choice” to go private”, a “choice” to take out private insurance. But if you’re stuck on a long NHS waiting list, you’re feeling unwell and you know the wait will last for years, this isn’t necessarily a choice you are making freely. It shouldn’t have to be a choice you’re making at all; because the public already pays for the NHS. 

At some point, we are going to need to start looking at this situation differently. If you need a hip operation and you are told that you will have to wait 2 or even 3 years to access NHS treatment, at what point does that stop being simply a delay in treatment, and instead become a denial of your treatment? At what point are we going to look at the NHS constitution, a constitution which is clearly defined and featured on the UK government’s own website, and consider that our leaders are failing to adhere to its principles? 

The NHS principles are clear; equal, comprehensive treatment for all, free at the point of delivery. Some might consider that 2 of those principles are now being failed. The treatment available to people across the UK is not equal; stark differences exist between different patient populations. The treatment available to people across the UK is no longer comprehensive, either, because millions are currently unable to access the care that they need. The government may even introduce NHS charging at some point, if Sunak gets his way. After all, during his bid for the Conservative party leadership, he proposed a policy to charge patients if they missed GP or A and E appointments. The proposal was dropped when he claimed it was “not the right time”, but there’s no guarantee that he won’t propose it again in future. 

This government has failed NHS patients and staff profoundly. They have not supported the NHS workforce properly, they are failing to provide a functioning public health service, and we all deserve better than this. It’s time to hold this government to account. 

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