Today [5 December 2024] Prime Minister Keir Starmer and the Cabinet decamped to Pinewood Studios, home to James Bond and ‘Would I Lie to You?’, to launch the ‘Plan for Change’, an attempt to inject new purpose into the Government after a sometimes shaky first five months in power.
Fixing the NHS is one of the Prime Minister’s five national missions. There is a lot in there that we support, not least the shift from treating sickness to preventing ill-health. With a population that is getting older and living longer, improving public health will help more people live more of their lives in good health, avoiding costly medical intervention.
Midwives have much to contribute here, being able, for example, to intervene and encourage a woman to quit smoking in her twenties or thirties before too much damage has been done, rather than the NHS trying to help the same woman quit in her fifties or sixties after a heart attack or stroke.
But where this falls down is that the Government has decided that it will have one thing that, above all else, is its healthcare focus for the remainder of this Parliament. This “milestone,” as it calls it, “is to end hospital backlogs by delivering … the NHS standard that 92% of patients should wait no longer than 18 weeks from referral to start consultant-led treatment of non-urgent health conditions.”
Cutting the backlog so that people get treatment faster is of course welcome and much needed. People wait too long, sometimes in pain, for hip and knee replacements, for cataract surgery and hernia repairs, and for many other operations.
But the NHS is so much more than just people waiting to go under the surgeon’s knife, and the risk is that focusing on this single “milestone” over the next four or five years means everything else gets deprioritised. A&E, out-of-hours GP services, neonatal intensive care, cancer screening programmes – as well, of course, as maternity – are all examples of things the NHS does that aren’t about waiting lists.
Additionally, take the example of Black and Asian women, who are more likely than white women to die during childbirth. Labour committed in their manifesto to close that gap. That has nothing to do with hospital backlogs, but eliminating that deep and appalling inequality should be an overriding national mission, and not just for the NHS. It isn’t mentioned in today’s plans from the Government.
Babies being born right now in our maternity units – the 1,600 or so babies born in England whose date of birth will be 5 December 2024 – can expect to live into the 2100s. Not getting maternity services right today will affect the health of people who will likely live for the remainder of this century and into the next. Improving maternity care – employing enough midwives, having maternity units with rooms that are physically fit for purpose, supporting those trusts that need it to deliver better, safer maternity care – these are not just things that would be ‘nice to have’ or things that can safely be left for a second or subsequent Labour term of office, way off in the 2030s.
This work cannot wait. As the Care Quality Commission said in September, in its report on the nation’s maternity services, action is needed “now”.
Maternity services can deliver on so much of the Government’s agenda, especially around helping to improve the health of mothers and babies. Earlier is always better when it comes to improving health, and it hardly gets earlier than pregnancy and childbirth. But the Government does need to wake up to this fact.
There is one opportunity the Government does have to ensure that maternity care and other NHS services without waiting lists don’t get forgotten. That is its 10 Year Health Plan, which they are currently consulting on.
The Secretary of State has said multiple times now that maternity care is a top priority for him. The 10 Year Health Plan, due out next spring, is an opportunity for him and his Department to turn those words into reality and to ensure that things the NHS does that aren’t about waiting lists get fixed too.
