Government can hit NHS waiting times targets despite scepticism, says Reeves

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The Chancellor has insisted the Government can hit its NHS waiting times targets despite scepticism from some leaders.

Speaking after her spending review, Rachel Reeves said the Government was confident it could hit pledges set down by the Prime Minister last year.

Sir Keir Starmer said in December the NHS will carry out 92% of routine operations within 18 weeks by March 2029.

However, in March this year, the NHS waiting list for hospital treatment in England rose for the first time in seven months.

The Times has also reported that internal Department of Health modelling shows the NHS is on course to hit only about 80% by the end of the parliament, with officials suggesting anything above that is overly optimistic.

Asked about the pledge on Wednesday afternoon, Ms Reeves told reporters: “We’ve already delivered around three-and-a-half million additional appointments since we came to office last July.

“Waiting lists are already down by 200,000 so we are confident that we can meet our plan for change commitments because of the 3% annual increase in funding for the National Health Service.

“On top of that of course, we’re investing in capital spending in the NHS, including in more scanners, but also investment in the NHS digital app to make it easier for patients to access information, to book services, to take some of the costs out of the bureaucracy, as well in running our health service.”

Earlier, the 3% increase in real terms for the health service per year in the spending review was welcomed by health leaders but there were warnings it is not enough.

Matthew Taylor, chief executive of the NHS Confederation, which represents all health organisations, said the NHS funding boost was welcome, “given the precarious state of public finances and will help the NHS to cope with rising demand from an aging population, often with multiple or more complex physical and mental health conditions”.

But he warned “difficult decisions will still need to be made as this additional £29 billion won’t be enough to cover the increasing cost of new treatments, with staff pay likely to account for a large proportion of it”.

He added: “So, on its own, this won’t guarantee that waiting time targets are met.”

Mr Taylor said NHS leaders will need continued backing from the Government to redesign services and balance budgets.

“That means getting political backing when some services are redesigned or cut, including moving hospital services into the community and closer to people’s homes as part of the Government’s three shifts,” he said.

He added that the “flat settlement” from the Chancellor “continues to leave a major shortfall in capital funding, and it also fails to lift the ban on private investment that is required to boost NHS capital funding”.

There is currently an almost £14 billion maintenance backlog bill to repair NHS hospitals and buildings.

Mr Taylor said those issues needed to be addressed in the upcoming national infrastructure strategy and 10-year plan for the health service.

Government documents accompanying the spending review show that, on average, from 2023-24 to 2028-29, the NHS in England will receive 3% real terms growth in day-to-day spending, equivalent to a £29 billion real terms increase in annual budgets.

The Department of Health and Social Care (DHSC) budget will increase by £2.3 billion in real terms by 2029-30, compared with 2023-24, “representing a more than 20% real terms increase by the end of the spending review period”, the documents said.

Overall, the figures suggest DHSC spending will rise 2.8%, though this is less than the average 3.6% in recent years.

Sarah Woolnough, chief executive of the King’s Fund charity, said the 2.8% average increase in DHSC spending – or 3% for day-to-day NHS spending – “will have been hard-fought for in the spending round negotiations, despite still being lower than the historical average the NHS has received over recent years”.

She added: “We know there are already trade-offs happening in the NHS due to tight finances.

“The Chancellor said she wants the public to have an NHS there when they need it.

“It is hard to see how all the things she mentions: faster ambulance times; more GP appointments; and adequate mental health services and more; can be met on this settlement alone.

“Particularly when large parts of this additional funding will be absorbed by existing rising costs, such as the higher cost of medicines, which are currently being negotiated, and covering staff pay deals.”

According to spending review documents, the Government expects the NHS to deliver 2% productivity growth each year, “unlocking £17 billion savings over three years” to reinvest back into the NHS to improve patient care.

The Government will also invest up to £10 billion in NHS technology and digital transformation by 2028‑29, the documents showed.

NHS England boss Sir Jim Mackey, speaking at the NHS ConfedExpo conference in Manchester, said the NHS has done “really well relative to other parts of the public service”.

He added: “But we all know it’s never enough because of the scale of advancement, all the ambition, all things we want to do, the day-to-day cost pressures we’re trying to get on top of, etc.

“We’re always going to be in a world where we want more money, but I think everyone’s starting to accept and understand that we’ve got what the country can afford to give us.

“We really need to get better value for that money – it is broadly the equivalent of the GDP of Portugal, so it’s a huge amount of money by any standards.”

NHS England has already budgeted a 2.8% increase in pay for staff in 2025-26, but many leaders the King’s Fund spoke to were worried about funding pay rises above this amount.

After the spending review, Royal College of Nursing (RCN) general secretary, Professor Nicola Ranger, said staff will now decide whether the 3.6% pay rise offered by the Government is enough.

She added: “Against a backdrop of other cuts, nursing staff will see the NHS being protected but not transformed by today’s spending plans.

“When the Government lays out its vision for the future of the NHS and its workforce, it must say how it intends to reverse collapsing student recruitment, boost retention and deliver urgent, structural reform to nursing pay.”

Nuffield Trust senior policy analyst, Sally Gainsbury, said: “Compared to the settlements for other departments – from policing to education – the NHS deal looks generous.

“But seen in the context of all the promises made by the Government to the British people – to drive down waiting lists, shift care closer to home, rapidly improve tech – and the commitments to meet staff pay demands and rising costs of new drugs, today’s settlement soon melts away.

“With capital funding staying flat in real terms for the rest of the spending review period, it will be difficult for the NHS to invest in the technology and facility upgrades it needs to meet the Government’s ambitious productivity targets.”