The NHS is at breaking point: it needs resources and leadership

Editorial: The health service was under pressure before the Covid-19 pandemic; now it is in crisis

The fog of the war against coronavirus is clearing to reveal the scene of devastation left behind (Getty)

It is undesirable that the secretary of state of a major delivery department should be changed at a moment of maximum stress, but at least Sajid Javid, the new health secretary, showed a clear grasp of his priorities on taking office. He said that what had struck him most in his first days in the now CCTV-free office on Victoria Street was the urgency of tackling the NHS backlog – not just the 5 million on the official waiting list, but the estimated 7 million more potential patients who are expected to come forward when the pandemic abates.

Shaun Lintern, our award-winning health correspondent, has been reporting from the front line with a consistent message in recent months: that the NHS is at breaking point. He reports that NHS emergency services are bracing for a flood of call-outs this weekend and that thousands of 999 calls were put on hold for longer than two minutes last month because there were too few staff to answer them.

In recent days he has highlighted the 15-hour waits in accident and emergency departments, and quoted the chief executive of the NHS in the west Midlands as saying: “There is no question that patients are coming to harm.”

Everyone knows what needs to be done. The NHS needs more resources, more staff and more leadership. We can leave to one side for now whether higher public spending is enough – obviously it is not, but it is needed in the short term and is the precondition for everything else. The NHS was already under pressure before Covid-19, and the government had only just started to deliver on promises of more spending and more staff after 10 lean years.

Now, as the fog of the war against the virus clears to reveal the scene of devastation left behind, those promises need to be redoubled and redeemed. The stretched and demoralised staff need higher pay, better management of tests to release them from Covid isolation rules, and more imaginative use of less-qualified support staff.

Well-placed sources in government say that the target of recruiting 50,000 more nurses during this parliament is “on track”, which is good news, but it needs to be reinforced and accelerated if at all possible. We need to see more of the innovation that the pandemic forced from the NHS. The vaccination drive has shown that health service IT need not be a disaster; remote GP consultations are not always suitable, but can be more efficient; and the commandeering of private-sector capacity has not been exploited to anything like the extent that it could be.

This will take leadership, but it will require significant resources too. Mr Javid, along with whoever replaces Simon Stevens as the chief executive of NHS England, will need to be blunt with the British people, including Rishi Sunak and Boris Johnson: the NHS needs even more resources than it did before coronavirus, and all of us will soon enough have to pay our share of those costs through our taxes.

It is possible, if unlikely, that the NHS could use the coronavirus crisis as a spur to innovation and a step-change in capacity that will allow it to recover the high ground it attained in 2010, after 13 years of a Labour government relentlessly focused on getting waiting lists down.

It can be done, but it will require money and leadership. We believe the British people are prepared to provide the money; can Mr Javid, Mr Sunak and Mr Johnson provide the leadership?