Cutting waiting times won’t grow the economy. A problem for Labour?

Posted on: July 14th, 2023 by Morgan Arnold

Yesterday’s Office for Budget Responsibility ‘Fiscal risks and sustainability’ report might give the Labour health team cause for concern.

It concludes that “rising NHS waiting list itself is unlikely to have been a significant driver of rising inactivity”.

Why?

Because a large majority on waiting lists are either in employment already or not of working age.

The median wait time on lists is also 15 weeks, meaning it’s “a vastly higher-turnover group than those who are inactive due to long-term sickness.”

This “limited correlation” is so limited that even if waiting lists were cut by half this would only reduce working age inactivity by around 25,000 – that’s out of 2.6 million people of working age outside the labour force for health reasons.

This poses a problem for Labour’s flagship policy goal of reducing NHS waiting times.

Specifically: “The last Labour Government reduced waiting times by using the private sector, increasing staff numbers and spreading good practice. We did this before. We will do it again.”

You can see why it’s appealing.

It’s very easy for the public to understand.

It anchors the sometimes contentious use of the private sector to a common sense goal that’s hard to argue with.

And it aligns the current Labour Party with its electorally successful predecessor.

And clearly it’s important in policy terms too – the 2023 GP Patient Survey, also released yesterday, shows this vividly.

But it caps Labour’s ability to link its leading health mission with its more important political objective of economic growth.

You can say cutting waiting times will help patients, save money and is just the right thing to do.

But you probably can’t say it’ll contribute to creating highest sustained growth in the G7.

Instead, given the obvious role health inequalities are having (also made clear by the OBR) and the increasingly visible wider social impacts of poor health, there may be an argument to spotlight the care in the community or preventative health prongs of the Labour mission in the coming months.

It might take some work to get the thumbs up in focus groups, but could pay dividends down the line as Labour’s arguments come under increasing scrutiny.

From Ming vase to Wedgwood teapot: Do Labour’s policies on health and technology match the ambition?

Posted on: May 22nd, 2023 by Morgan Arnold

There’s been such an avalanche of health policy announcements, op-eds and speeches on health in the last few days, it’s hard to keep up.

But the topline message is indicative of Labour’s wider challenge, how to communicate the party’s transformative intent without committing to incremental spending that they know is likely to be torn apart and which they may lack the room to manoeuvre to deliver on if they find themselves in power.

Today’s speech from Keir Starmer made a particular effort to explain how this seemingly restrained agenda was still a forward thinking, genuine embodiment of the sometimes mercurial values of the NHS (note the two references to Nye Bevan in today’s speech and none on the Missions Statement and nine references to the ‘future’).

Among the most future-focused of the three health ‘Shifts’ needed to achieve their goals – was technology; including harnessing the power of the NHS app, digital patient records, using AI to improve early diagnosis.

All commendable ideas which few would argue with, but equally, ideas which wouldn’t have been out of place in a pre-pandemic 2019 manifesto, so perhaps lack some of the visionary flair needed to build “a tomorrow service”.

Likewise, on genomics, in a piece in the Guardian today Starmer said: “genomic screening can spot predisposition to big killers…diagnose rare diseases and help personalise treatments….[to] prevent more illness and take more care of our lifestyle choices.”

This is true and it is exciting – but is probably more of a statement of fact than a clear vision.

On improving clinical trials, more will be needed than “a bit of application…and a degree of belief in the possibility of a better future” to help regulators keep up with the potentially paradigm shifting leaps in technology that have been happening around them.

And in a week where leaders from across the world come together to discuss the global health priorities at the World Health Assembly, there was a notable absence of a word that’s dominated the health landscape in recent years: ‘Covid’.

Undoubtedly a deliberate decision to focus on the domestic agenda and perhaps more the purview of international development, global health policy issues like health equity and health security are still key and ones that many NGOs, life science bodies and international health organisations will be keen to hear more on.

One possible kicker to the ‘future-focused’, visionary narrative of health policy is that change will take time. Both Wes Streeting and Starmer have been clear that the focus is on long-term reform, and repeatedly categorised any short-term fixes as ‘sticking plaster politics’. Whilst there’s no doubt the reforms needed to health systems need long-term thinking, many, stumbling into a post-pandemic world, will also want to know what the first hundred days look like.

These recent announcements then come as welcome additional detail for the public and those in the health sector, but given the breadth of ideas on display, fails to really communicate a clear strategy or direction.

This is perhaps be expected given how far out we still are from a general election – making this less of a polished version of Labour’s health vision and more an evolution on the way to achieving it – less of a Ming vase and more of a Wedgwood teapot.

The UK Budget: a shot in the arm for the global ‘science superpower’ vision

Posted on: March 16th, 2023 by Morgan Arnold

Britain has always had key strengths in these areas. A global life sciences sector, some of the world’s leading universities and an open and highly skilled R&D workforce. The challenge has always been to meld those into something greater than the sum of their parts, and optimise policy behind that vision.

In his Autumn Statement last year, the then new Chancellor, Jeremy Hunt, marked life sciences as one of his key growth industries and tasked Chief Scientific Advisor, Sir Patrick Valance, with understanding how we should change regulation to improve the safe, swift introduction of new technologies. 

And in yesterday’s budget, to the broad approval of the sector, they started to deliver.

Alongside the tax incentives designed to nurture SMEs and retain big business, was an important development in the drug approval process aiming to continue the re-integration of the UK into a global network of regulatory partners.

The announcement focused on building new ‘recognition routes’ through the UK Medicines and Healthcare products Regulatory Agency (MHRA) and their counterparts in the US (FDA), Europe (EMA) and Japan (PMDA), building on pre-existing partnerships through Access Consortium and Project Orbis.  

Backed up by £10m in additional funding over the next two years which also looks to improve internal processes at the regulator, this new global ambition aims to fast track approvals of ‘best in class medical products’ already green-lit in partner countries from 2024.

The idea is of course nothing new and forms part of a decade old trend, but its centrality in yesterday’s Budget, and increasingly in British politics, is a reassuring signal that the UK is re-establishing itself as a global life sciences hub. This is also the first tangible dividend for industry from the decision to separate the MHRA from the European regulatory orbit. 

The sentiment has echoed around the sector as well with the likes of the ABPI and AMRC welcoming the global ambition and domestic reforms to boost competitiveness.

The proof, as ever, will be in the pudding, and we look forward to hearing more on how the UK government and its wealth of world-class health and sciences companies can work together to forge a global future for life sciences.