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PMQs and the truth about waiting times

10/02/2012
by Rob Findlay

This week’s highly-charged Prime Minister’s Questions was all about the NHS. With Andy Burnham nodding behind him, Ed Miliband used his last two questions to challenge David Cameron about the Government’s record on waiting times:

EM: I’ll tell him about our record on the NHS, Mr Speaker. The shortest waiting times in NHS history. More doctors and nurses than ever before. The highest level of patient satisfaction ever in the health service. But everyone will have heard a Prime Minister unable to defend the promise he made. The promise of no more top-down reorganisations. A Prime Minister who has broken his word. And the reality is this: all his attention is on this pointless top-down reorganisation, and the front-line is suffering. The number of people waiting more than 18 weeks: up, under him. A&E targets being missed, cancelled operations. Mr Speaker, why won’t he just give up, and stop wasting billions, and drop his Bill?

DC: If the record was so good, why were they thrown out at the last Election? Let me remind the Right Honourable Gentleman of the clear test that he set for the reforms and that he set for the Government. He said the test was whether waiting times and waiting lists would come down. Let me now give him the figures. The figures are these. Inpatient waiting times: down. Outpatient waiting times: down. The number of people waiting more than a year: down to its lowest ever. The number of people waiting for six months: down to its lowest ever level. And indeed, the number of people on the waiting list – what he said was the clear test: that is down. That’s what it proves about this Labour leader: even when he moves the goalposts he can’t put it in the back of the net.

EM: Mr Speaker, the person who’s moving the goalposts is the Prime Minister. The reality is that the key test that was set for the health service was the number of people waiting more than 18 weeks, and that number is up 43 per cent since the General Election. Now however much he twists and turns, that is the reality.

So who is right? For all the statistics you can download a waiting times fact checker here (and become better informed than the Prime Minister). Point by point, here is the verdict:

EM: “The shortest waiting times in NHS history.” True. The last Labour Government transformed waiting times beyond all recognition.

EM: “The number of people waiting more than 18 weeks: up, under him.” True. When the Liberatives took power in May 2010 there were 209,411 patients on the waiting list over 18 weeks; in November 2011 (the latest figures available) there were 223,720.

DC: Inpatient waiting times: down.” Murky. When he says “inpatient” he is referring to adjusted admitted pathways, which measures the waiting times of those patients who are lucky enough to be admitted for treatment, not the waiting times of inpatients who are still waiting. Only one of the many “adjusted admitted” measures has gone down since the General Election, and that is the median, which doesn’t mean very much. All the other measures went up. But before we start callling the Prime Minister names, let’s reflect that if more long-waiters are being treated then this is actually a good thing: much better than letting them wait.

DC: Outpatient waiting times: down.” Exactly the same story as for inpatients: murky.

DC: The number of people waiting more than a year: down to its lowest ever.” True. There were 10,407 patients on the waiting list over 52 weeks in November, the lowest ever, and well below the 18,458 in May 2010.

DC: The number of people waiting for six months: down to its lowest ever level.” True. 26,564 on the waiting list over 26 weeks in November, the lowest ever, compared with 36,589 in May 2010.

DC: And indeed, the number of people on the waiting list – what he said was the clear test: that is down.” True. 2,504,758 on the waiting list in November, compared with 2,573,895 in May 2010. But this number does go up and down.

EM: the number of people waiting more than 18 weeks, and that number is up 43 per cent since the General Election.” The number of people on the waiting list over 18 weeks is up since the General Election, but by 7 per cent not 43 per cent. What has gone up by 43 per cent is the number of “adjusted admitted pathways” over 18 weeks. In other words, the NHS has sharply increased the number of over-18-week waiters being treated: a good thing, surely, and much better than making them wait.

There are just too many waiting times statistics being bandied around, aren’t there? And this is confusing politicians, journalists, and the public. Both Ed Miliband and David Cameron were on strong ground when they stuck to the waiting list, which (to both their credits) they mostly did. Where they floundered or got things wrong was when they strayed off into other figures.

It would be good to see politicians sticking more to the waiting list figures (the so-called “incomplete pathways”), because that’s what really matters, and that’s where the message is clearest. More patients waiting = bad. More long-waiters = bad. You just don’t get that clarity with the admitted and non-admitted data.

 

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