Remember NHS waiting lists? They used to be a political priority for the Labour government, which would claim it was meeting its targets on getting the length of the lists and the amount of time patients were waiting down. Strangely, that chat has all but disappeared lately.
Today’s waiting list data from NHS England underlines why. The number of people waiting for elective treatment on the NHS has gone up for a second month running, this time to 7.37 million treatments at the end of August. It’s the highest since October 2025, and the health service’s national medical director Professor Frankie Swords has warned that there are ‘ominous signs of early pressure’ ahead of the traditional winter high demand that the health service experiences. It is also now looking nigh-on impossible for the health service to reach the Labour manifesto target of 92 per cent of patients getting treatment within 18 weeks by 2029.
Unsurprisingly, Labour’s frontbenchers have made sparing references to waiting lists recently. Yvette Cooper has shifted to talking about quality of care and patient safety, preferring to focus her party conference speech on maternity scandals, social care, domestic violence and public health. When she did mention waiting lists, it was in the context of the last Tory government taking ‘us from the shortest waiting lists in generations to the longest’. It’s almost as though she was preparing the ground for a missed target by suggesting that Labour could have met it had it not been for the Tory legacy – even though of course Labour knew full well what that legacy was when it was publishing its 2024 manifesto.
There’s nothing intrinsically wrong with shifting from targets and numbers to a focus on quality of care: in fact, the last Labour government became far too obsessed with targets at the expense of genuine improvements in care. The four-hour A&E waiting target, for instance, was so rigidly enforced that NHS trusts ended up gaming the system in a way that had nothing to do with patients and everything to do with avoiding the kind of shouty control freakery that would come their way from Whitehall if too many people ‘breached’ the four hours. The worst examples I came across when writing my book on the history of the NHS involved A&E departments where staff painted or taped a line on the floor over which they could wheel patients who were about to breach the four hours, and claim that they’d been moved to another part of the hospital. Even if that other part was just a few feet away from the previous part, and involved the same staff and a long wait for care, it satisfied the target. It had nothing to do with care, though.
The problem is that patients tend to consider timely treatment to be part of quality of care, rather than antithetical to it. And so for all the shift from targets to something more cultural, people will still interpret the quality of the NHS in part by looking at how long they had to wait for an operation or test. The one thing that might give Cooper some comfort is that the NHS isn’t top of voters’ concerns at the moment: it currently lags behind immigration, the economy and defence and security. So even if voters are really quite unimpressed with healthcare, they might be more motivated to base their vote on other issues.
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