Fixing the NHS is a key concern for voters ahead of the general election on July 4th. Since the end of the Covid pandemic, the health service has grappled with record demand while simultaneously attempting to clear a backlog in treatment that has swelled to 7.54 million.

The latest British Social Attitudes Survey – a long-running poll tracking the views of the public – found that only 24 percent of the public are satisfied with the NHS. However, 91 percent believe it should remain free of charge. A survey conducted last week by Ipsos found that 63 percent of adults felt that improving the health service was one of the three or four issues a Labour government, if elected, should focus on in the first six months.

Labour has accused the Tories of running down the NHS during their 14-year period in Government, but the Conservatives insist that the disruption in the health service is a natural consequence of the pandemic. Here we look at the main issues facing the NHS in the near future, and how both parties have promised to fix it.

Strikes

Industrial action began in the NHS with the nurses’ strike in December 2022. Within six months, they were joined by paramedics, physiotherapists, junior doctors, and consultants. While the Government has settled the pay dispute with nurses, consultants, and paramedics, action by junior doctors in the British Medical Association (BMA) is ongoing. The BMA is seeking “full pay restoration” in the form of a 35 percent pay rise to correct a real-terms fall in income since 2008.

For months, ministers branded the pay demand “unaffordable” but the union and Health Secretary Victoria Atkins began four weeks of mediated talks on May 16th. The length of the negotiations means that it is unlikely that strikes will take place before the general election, but there is no guarantee of a successful outcome. It remains unclear what a deal could look like given how far apart the sides are and how committed the BMA’s leadership is to achieving full pay restoration. However, Prime Minister Rishi Sunak may well see settling the dispute as a victory on the NHS that he can sell to voters.

The BMA could yet come to haunt Labour’s shadow health secretary Wes Streeting, who has never promised to meet their pay demand. If talks collapse with the Government, he will inherit the dispute and face a union that recently strengthened its mandate.

Long GP Waits

There is no more noticeable effect of the decline of the NHS for the average Briton than the long wait to see a GP. As the “front door” of the NHS, it is the main prism through which voters see the health service. Primary care has struggled to recover from the pandemic, with four-week GP waits jumping dramatically in some regions in England. GPs complain that they are under significant pressure due to staff shortages and an increase in demand.

The collapse in morale has created the frightening prospect of a GP strike, with a recent survey by the BMA finding that 72 percent of family doctors would strike over pay and working conditions. Labour has promised the “return of the family doctor” by allowing patients to see the same GP for each appointment if they choose to. They have pledged to pay GPs more for agreeing to the plan and reform the NHS App to make it easier to get an appointment. The party also plans to create a network of “neighbourhood health centres” which will bring GPs, district nurses, care workers, physiotherapists, and mental health specialists under one roof.

In 2019, the Government promised to recruit 5,000 more GPs – but this target has not yet been met and the number of full-time family doctors has declined. Ministers have also promised to end the “8am rush” for appointments by replacing analogue phones in surgeries with modern systems.

Cancer and the Waiting List

Reducing the NHS waiting list was the only health-related pledge made by Prime Minister Rishi Sunak when he set out his five key priorities last year. But the grim reality remains that around one in nine Britons were waiting for NHS treatment at the end of February and the figure has not meaningfully come down since Mr. Sunak took office. The PM has repeatedly blamed industrial action for a failure to tackle the backlog in treatment, pointing out that the waiting list has reduced in months where junior doctors have not been on strike.

Labour has promised an extra 2 million operations, scans, and appointments in its first year of Government. This will be achieved by paying NHS staff extra money to work evening and weekend shifts, which will be funded by abolishing non-dom tax loopholes. The party has also vowed to double the number of CT and MRI scanners to speed up the diagnosis of cancer and other illnesses.

Mental Health

Improving the dire state of mental health services is among the key priorities laid out by Labour leader Sir Keir Starmer. NHS data shows that around 120,000 children waited six months or longer between referral for mental health support and treatment in 2022/23, figures that Sir Keir said were “a scar on a civilised society”. He has committed to funding an extra 8,500 new mental health staff for the NHS and promised that children will have access to a specialist mental health professional at school. Young people aged 11-24 will also be able to access an early intervention hub in every community, paid by closing tax loopholes.

The promise of reform will put pressure on the Conservatives to renew their focus on mental health in the weeks leading up to the general election. In the Government’s mandate to NHS England, published in March, ministers pledged to roll out specialist mental health ambulances and ensure mental health support is “universally accessible” through NHS111. They also vowed to improve access to mental health support for children, young people, and adults.

As the general election approaches, the differing approaches of Labour and the Tories to the NHS and private healthcare will be closely scrutinised by voters, with the future of the health service hanging in the balance.