The performance of the NHS will be a central general election
issue. How the NHS has performed under different governments
could well feature in the debate, and a measure often focused on
is the size of the NHS waiting list. But changes in the way this
is measured – both to the types of activity included and to what
actually counts as ‘waiting’ – mean that accurate comparisons of
performance over time are not straightforward. For example, it is
not possible to compare NHS waiting lists and waiting times
directly before and after 2009 or to assess whether waiting lists
are higher now than in the 1980s or 1990s. We should therefore be
sceptical of simple narratives and sweeping claims that seek to
compare the incomparable.
Nonetheless, some broad conclusions can be drawn from the
available data. The NHS waiting list in England rose under
Conservative governments between 1987 and 1997, fell during the
following New Labour governments and then rose under
Conservative-led governments since 2010. But the overall size of
the waiting list is not the only measure that matters. Waiting
times for inpatient and day-case activity fell during
Conservative governments between 1987 and 1997, and continued to
fall from the early 2000s under Labour governments. Since the
early 2010s, median waiting times for care have risen again, but
many fewer people experienced very long waits in the 2010s than
in the late 1980s and 1990s.
Max Warner, a research economist at IFS and author of the
briefing, said:
‘It is natural to want to compare public service performance
under different governments, particularly in an election year.
But measurement changes over time make this challenging. If you
just focus on the size of the NHS waiting list, over the last
four decades it has tended to rise under Conservative governments
and fall under Labour governments. But waiting times – which will
be more important for individuals needing treatment – tell a more
nuanced story. Waiting times fell under both Conservative and
Labour governments between 1987 and 2007. Average waiting times
have then risen substantially since 2010, but far fewer people
were waiting more than a year for treatment pre-pandemic than was
the case in the late 1980s and 1990s.’
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