Convening a meeting at No 10 is not a solution to the NHS crisis

Rishi Sunak has hosted what he calls an NHS Recovery Forum at 10 Downing Street – on a Saturday, to show that he means business – but he is already lagging behind the pace and urgency that the issue requires.

He has only been prime minister for 75 days, but that ought to have been long enough to have got beyond the “let’s convene a top-level meeting for the cameras” stage of getting to grips with the crisis in the National Health Service.

The best model for dealing with the problem is the prime minister’s delivery unit that operated under Sir Michael Barber in Tony Blair’s second term. It was a small unit that focused on outcomes, identifying obstacles to achieving them and tracking progress towards targets that would mean that they had been achieved.

Boris Johnson revived a similar unit, but never gave it the direct attention it needed to drive through change using his personal authority, and its head, Dame Emily Lawson, was diverted to the coronavirus vaccine booster programme instead.

Mr Sunak should have re-revived it on day one of his premiership. It might by now have made some headway in identifying the bottlenecks in clearing the NHS backlog. It might have started to solve the puzzle described by the Institute for Fiscal Studies, by which there are significantly more doctors and nurses working in hospitals than before the pandemic, and yet the number of treatments has fallen.

It seems likely that the main explanation is the growing number of patients who cannot be discharged because there is no social care for them, but the statistics on this are patchy, and the solutions, which could include such temporary measures as Nightingale wards, have not yet been identified. No doubt a series of meetings in No 10 might discuss such things – and jaw-jaw is better than doing nothing – but they should already have been discussed and the Department for Health and Social Care should be on to the implementation stage by now.

Mr Sunak understands the politics of the problem well. Cutting waiting lists was the fourth of his five promises unveiled in his new year speech on Wednesday. He is quite right that the state of the NHS is the most important thing that people worry about after the cost of living.

But his promise bore the traces of haste and improvisation. Confusion reigned over a commitment to cut waiting lists “by March” that appeared in a news story on the No 10 website to accompany the speech; words which have now been deleted. It seems likely that waiting lists will fall by March, as the winter flu wave passes, but they are likely to rise again next winter.

If the prime minister had an effective delivery unit, it might have set some interim targets by now that would show whether lasting, seasonally adjusted improvements were being made – and if not, why not.

If Mr Sunak were serious about getting a grip on the NHS crisis, he would have settled the pay dispute with the nurses by now, with a one-off payment if necessary, removing the threat of disruption and allowing him and Steve Barclay, the health secretary, to focus exclusively on the backlog and how to clear it. The prime minister should have moved from words to actions by now.