The Prime Minister must choose between settling his government’s escalating dispute with the trade unions on NHS pay, or ‘wave goodbye’ to his pledge to reduce waiting lists and make sure people get the care they need more quickly.
That is the stark warning from the NHS Confederation, the membership body that represents all parts of the NHS in England, in a letter to the Prime Minister.
It comes as the Royal College of Nursing (RCN) has confirmed its plans to significantly step up its planned strike activity, with three further days of strike action from 1-3 March. Nurses working in emergency departments, intensive care units and cancer care services will prepare to walk out next month, including in the first continuous 48-hour intervention for the profession. A further escalation of the dispute is likely next week with junior doctors expected to announce a three-day walkout in March, subject to the British Medical Association confirming its ballot results.
With over 141,000 appointments and procedures already having had been postponed in response to the 12 strikes that have taken place since December, the NHS Confederation has written to the Prime Minister to warn that the ongoing standstill between both sides is not compatible with the commitment to reduce waiting lists.
On 4 January, the Prime Minister set out his five priorities for 2023, which included the pledge that “NHS waiting lists will fall and people will get the care they need more quickly”.
In the letter to the Prime Minister, the NHS Confederation warns that a continuation of the Government’s apparent refusal to discuss or compromise on pay is jeopardising the Prime Minister’s public commitment to reduce waiting times. The organisation argues that the two policies – on NHS pay and on NHS waiting lists – are becoming mutually incompatible.
The letter calls for the government to urgently reconsider its stance in relation to the pay dispute, which continues to be that a further pay rise for 2022/23 is not an option. This is despite the trade unions having shown a willingness to compromise and negotiate.
The spiralling situation is a blow for health leaders after the NHS has made solid progress to tackle the backlogs, including virtually eliminating the two-year waiting list last summer and in delivering 70,000 more elective procedures in November 2022 than in the same month before the pandemic. This progress now risks being undermined because of intensifying waves of strikes.
The overall elective backlog has risen to over 7.2 million entries and in December, there were nearly 55,000 procedures on the 78-week waiting list. Analysis from the Institute for Fiscal Studies has revealed that even without industrial action, it is most likely that this waiting list will flat line, rather than fall this year.
Health leaders are also concerned about the knock-on impact industrial action will continue to have on primary, mental health and community services, as well as their capacity to improve urgent and emergency care.
The body last wrote to the Prime Minister only two months ago to warn of the level of harm and risk that patients could be exposed to from ongoing industrial action. In its latest letter, the body has said its “members are extremely concerned that their worst fears about the impact of the strikes on patients are playing out before their eyes and that there appears to be no end in sight.”
Several health leaders have told the NHS Confederation that since the start of the pay dispute, hundreds of their staff have joined a union, leading to the prospect of individual employers seeing more and more of their workers taking part in the walkouts as they continue.
Matthew Taylor, chief executive of the NHS Confederation said:
“The stakes have just got higher and NHS leaders are becoming increasingly concerned about the escalating waves of industrial action. They are desperate for a resolution so that they can continue to recover their services for patients.
“NHS leaders are managing the individual days of strike action, but we are storing up problems as waiting lists grow and patients wait longer for treatment that could see their conditions deteriorate. This has drifted into dangerous ‘business as usual’ territory now and we need the government to break the cycle.
“We share the Prime Minister’s ambition to reduce waiting lists but the government’s apparent refusal to discuss or compromise on pay is jeopardising his public commitment to reduce waiting times. Increasingly, the government’s policies on NHS pay and on NHS waiting lists are becoming mutually incompatible.
“The Prime Minister has a choice to make, which is to either seek to settle the dispute with the trade unions or to wave goodbye to his own pledge to cut NHS waiting lists.”
We are the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.