The NHS needs more resources in the wake of Covid-19 – pay is not the only issue

The Covid-19 crisis has built up a hidden waiting list of six million patients, according to the NHS Confederation, which represents the trusts and organisations that provide NHS services. As we report today, the confederation calculates that this is the number of patients who were not referred for treatment in 2020 but who would have been had it not been for the pandemic.

Many of them will still need treatment, but do not appear on waiting lists yet. As it is, the official waiting list situation is bad enough, with four million people already in line and waiting times drifting ever further away from the government’s targets.

The future of the NHS was just looking up, after a decade of squeezed resources, when the pandemic hit. The Conservatives were finally planning to raise health spending substantially, and Boris Johnson had just been elected on a manifesto promising 50,000 more nurses, 6,000 more GPs and 50 million more GP consultations a year.

Now we are back to a long way behind square one. The government urgently needs to bring forward planned spending increases in later years to pay for catch-up investment now. One thing the pandemic response showed was that the NHS workforce is more flexible and more resilient than was previously thought. The increase in acute capacity between the first and second peaks of hospitalisations was impressive, as was the deployment of staff to the vaccine programme. And cancer screening and other public health measures were maintained at a higher level than some feared.

But staff burnout is a real problem, and although numbers were boosted temporarily by returners during the crisis, many of them will not stay long.

That is why, as The Independent argued yesterday, the offer of a mere 1 per cent pay rise for nurses is so short-sighted. Recruitment and retention are essential, not only to meet arbitrary targets in the Conservative manifesto but to restore the NHS’s capacity after the huge setback of the crisis.

The flexibility shown by the NHS workforce during the crisis has shown that the service can adapt and change to meet urgent priorities, but that workforce needs to be rewarded and expanded if it is to do so sustainably.

That is why The Independent has called for some time for a permanently higher level of taxation to pay for a permanently higher level of NHS and other public services.

The pandemic has delayed the timetable for that change, but it has not changed the principle. Rishi Sunak, the chancellor, was right to put off big tax rises for the next two years – although he missed a trick in failing to label the rise in corporation tax in 2023 a “levy for the NHS”. But he needs to borrow more – even more – in the short term in order to get the NHS to work on clearing the backlog caused by the pandemic. At current interest rates such borrowing is affordable. There is no time to lose.