Plans to reform the NHS have “chilling echoes” of the failures around HS2, MPs have said as they warn Labour is at “serious risk” of not meeting its pledge to cut waiting lists.
The public accounts committee (PAC) warned that “poor practices” seen in the troubled project to build the high-speed rail link were being replicated in the health service and could lead to “wasted effort” to overhaul the NHS.
HS2 has been described by politicians as an “appalling mess” after billions of pounds of taxpayers’ money were wasted amid years-long delays.
The criticism came as MPs warned that initiatives to reduce waiting times for pre-planned care in England have not met their goals under “extremely variable” management of programmes.
MPs on the cross-party committee highlighted how billions have been spent to transform diagnostics and surgical services, yet the pace of change is still “too slow”.
The report also highlights plans to axe NHS England and absorb its functions into the Department of Health and Social Care, while reducing local health management teams, with the health department set to take responsibility for managing the initiatives to cut waiting lists.
“Unless it gets a grip on the programmes, there is a serious risk that it will not meet its target for 92 per cent of the waiting list to be treated within 18 weeks by 2029,” MPs wrote.
Sir Keir Starmer’s plan for change pledged that by July 2029, 92 per cent of patients will be seen within 18 weeks for routine hospital treatment such as hip and knee replacements.
Clive Betts, Labour MP and deputy chair of the PAC, said: “Every unnecessary day that a patient spends on an NHS waiting list is both one of increased anxiety for that person’s unresolved case, and if they are undiagnosed, a steady increasing of risk to their life.
“Every penny of funding spent to put the NHS back on a pre-pandemic footing must be precisely targeted, or the system itself becomes an obstacle to proper care.
“Unfortunately, our report establishes that billions have been poured into the system over the past few years without the requisite focus on making sure that money does what it was intended for – improving outcomes for patients.”
He also said that they are now seeing “chilling echoes of past failures on HS2” as he urged the government to provide reassurance and detail on how it hopes to take its plans forward.
MPs on the committee also raised concerns about the plans to restructure the top of the health service, amid concerns that changes are being announced “without either delivery plans or funding in place”.
Last week, health secretary Wes Streeting confirmed that thousands of NHS staff redundancies will now go ahead after funding for the estimated £1bn cost was agreed with the Treasury.
The government has already announced that headcount across both NHS England and the Department of Health will be cut by around 50 per cent, with around 18,000 administrative staff and managers, including on local health boards, set to go.
The new PAC report states: “We do not accept that it is prudent to make a major change, such as the structural changes that are being made to Integrated Care Boards (ICBs) and NHS England without ensuring there is funding in place to pay for the changes, and without conducting an impact assessment or taking other steps to safeguard value for money.
“These changes, especially the planned cuts to ICBs (integrated care boards), could have a significant negative impact on patients and on the healthcare workforce through the level of uncertainty they create, and because they may limit the ability of NHS organisations to plan for the future.
“We are concerned that these poor practices, previously seen with the New Hospitals Programme and the High Speed 2 programme are being replicated here and will lead to wasted effort.”
The report comes as doctors stage a five-day strike over pay – the 13th such walkout since March 2023.
Shadow health secretary Stuart Andrew told The Independent: “Wes {Streeting] has taken his eye off the ball. I imagine No 10 have grown tired of the showboating and are looking to clip his wings.”
A DHSC source told The Independent: “Waiting lists increased every year for 14 years under the Conservatives. Thanks to Labour’s investment and reforms, waiting lists have been cut for the first time in 15 years. That’s the difference Labour is making.”
“Whether it’s the staff retention crisis, Andrew Lansley’s reorganisation, or chronic underinvestment, Wes is cleaning up the mess the Tories left and rebuilding our NHS.”
A DHSC spokesperson said: “This government inherited a broken NHS, with waiting lists soaring and elective services in dire need of modernisation. This report focuses on the previous government, and we have taken immediate and robust action to tackle waiting lists and modernise elective care.
“Through record investment and modernisation, we’ve cut backlogs by more than 230,000 and smashed our target for additional appointments, delivering more than five million extra. Health service productivity is up 2.7 per cent on last year.”
