Plans to reform NHS have ‘chilling echoes’ of HS2 failures, MPs warn

Labor is at “serious risk” of failing to deliver on its promise to cut waiting lists, MPs said, as they said plans to reform the NHS had “chilling echoes” of the failures around HS2.

The Public Accounts Committee (PAC) has warned that “poor practice” seen in the troubled project to build a high-speed rail link could be replicated in the health service and could lead to “futile efforts” to overhaul the NHS.

HS2 has been described by politicians as a “terrible mess” after billions of pounds of taxpayers’ money was wasted over years of delays.

The criticism came as MPs warned that initiatives to cut waiting times for scheduled care in England were not meeting their targets under “extremely variable” management of programmes.

MPs on the cross-party committee stressed billions of dollars have been spent transforming diagnostic and surgical services but the pace of change was still “too slow”.

The report also highlights plans to decommission NHS England and transfer its functions to the Department of Health and Social Care, reducing local health management teams and having the health department take responsibility for leading initiatives to cut waiting lists.

“Unless programs are brought under control, there is a serious risk of not meeting the target of having 92 per cent of the waiting list treated within 18 weeks by 2029,” MPs wrote.

Sir Keir Starmer’s change plan promised that by July 2029, 92 per cent of patients will be seen within 18 weeks for routine hospital treatment such as hip and knee replacements.

Clive Betts, Labor MP and deputy chair of the PAC, said: “Every unnecessary day a patient spends on the NHS waiting list is both an increased concern for that person’s unresolved case and a continually increasing risk to their life if a diagnosis is not made.

“Every penny of funding spent on returning the NHS to its pre-pandemic state needs to be precisely targeted, otherwise the system itself will become a barrier to appropriate care.

“Unfortunately, our report reveals that over the past few years, billions of dollars have been poured into the system without the necessary focus on ensuring the money does what it is intended to do – improve outcomes for patients.”

He also said they were now seeing “chilling echoes of past failures at HS2” as he called on the government to provide reassurance and detail about how it hopes to take its plans forward.

MPs on the committee also raised concerns about plans to restructure the top tier of the health service, amid concerns that the changes would be announced “without rollout plans or funding”.

Last week, health secretary Wes Streeting confirmed that thousands of NHS staff would be made redundant after an agreement was reached with the Treasury over an estimated £1bn in funding.

The government has already announced that staff numbers at both NHS England and the Department of Health will be reduced by around 50 per cent, and around 18,000 administrative staff and managers will leave, including from local health boards.

The new PAC report states: “We do not accept that it is prudent to make a major change, such as the introduction of Integrated Care Boards (ICBs) and structural changes to NHS England, without ensuring that funding is available to pay for the changes and carrying out an impact assessment or taking other steps to protect value for money.

“These changes, particularly planned cuts to ICBs (integrated care boards), could have a significant negative impact on patients and the healthcare workforce due to the level of uncertainty they create, and may limit the ability of NHS organizations to plan for the future.

“We are concerned that these bad practices, previously seen in the New Hospitals Program and High Speed ​​2 program, will be repeated here and lead to wasted efforts.”

The report comes as doctors embark on a five-day strike over wages; This was the 13th such strike since March 2023.

Shadow health secretary Stuart Andrew said Independent: “Wes (Streeting) has taken his eye off the ball. I think No 10 is tired of showing off and wants to clip his wings.”

A DHSC source said Independent: “Waiting lists have increased every year for 14 years under the Conservatives. Thanks to Labour’s investments and reforms, waiting lists have decreased for the first time in 15 years. This is the difference Labor has made.”

“Whether it is the staff retention crisis, Andrew Lansley’s restructuring or chronic underinvestment, Wes is cleaning up the mess left by the Tories and rebuilding our NHS.”

A DHSC spokesperson said:: “This government inherited a broken NHS, with waiting lists soaring and elective services in need of urgent modernisation. This report focuses on the previous government, where we took immediate and robust action to tackle waiting lists and modernize elective care.

“Thanks to record investment and modernization, we reduced the backlog by more than 230,000 and exceeded our target for additional appointments, providing more than five million extra appointments. Healthcare efficiency increased by 2.7 percent compared to last year.”