Question: when is an NHS waiting time target ‘politically motivated’ and when is it ‘in the interests of patients’? Answer: it depends whether the target is being achieved or not…
Readers will remember that the Conservative Party had a very clear policy on NHS waiting time targets. During the five years leading up to the last election they were consistently promising that if they were to win they would drop waiting time targets – and when they came to power they did just that.
They spent the year between winning power in May 2010 and May 2011 dismantling the sets of relationships between Whitehall and the NHS that had signified the public’s concern about maximum waiting time targets.
Then there was the pause in the Health and Social Care Bill when the Prime Minister took over health policy for a few months. He discovered, through extensive polling, that the thing that concerned the public above all others was waiting a long time for treatment.
So when policy was relaunched in June 2012 waiting times reappeared as one of the government’s main concerns. Ever since then – as with the publication of the mandate in November when the government were proud to announce that waiting times were lower than ever before – they have been pleased to demonstrate how important waiting times are.
But then, a few days ago, a report showed that a survey conducted by the Care Quality Commission found that one in three patients were not being treated within the four hour target.
That raises the question of whether this is a target or not.
Apparently, because the Government isn’t hitting this one, it isn’t. To quote health minister Dan Poulter: 'Rightly the NHS has moved away from the narrow focus on four hour waiting standard which sometimes forced A&E staff to make a broken toe as much as a priority as a patient with potentially life threatening chest pains. Meeting targets and ticking boxes does not ensure good patient care, and we are putting doctors and nurses in charge of making clinical decisions to ensure that the most sick patients in A&E are the highest priority.'
In the 30 months since the government came to power we now have a third policy on targets.
Between May 2010 and June 2011 then Health Secretary Andrew Lansley said that all waiting time targets no longer mattered. Then, from June 2011 to the present, the Prime Minister said that targets do matter – because they matter to the public.
The latest policy is that targets matter when they are made – and don’t when they’re not.
In the second half of this Parliament, as the election draws nearer, this will get tricky. Because what will become clear is that if waiting times matter to the public – and they do – missing them becomes an issue of government competence.
Paul Corrigan was formerly senior health policy adviser to Tony Blair when he was prime minister. This post first appeared on Health Matters
