NHS England's latest dataset puts the Referral-to-Treatment waiting list at 7.31 million cases. That is a number larger than the population of Bulgaria. It is also larger than the figure Labour inherited from the Conservatives in July 2024. Twenty-two months in, with the Health Secretary now resigned, the central health pledge of the Starmer government is in tatters.
The Number Behind The Spin
Ministers will point you at March's announcement that the 18-week standard was hit. Read the small print. The standard was hit for a single month, on a single measure, because three rounds of industrial action artificially suppressed appointment volumes in the comparison period. Hitting a target by cancelling the appointments that would have failed it is not progress. It is accounting.
Strip out the gimmick and the picture is grim. The pre-pandemic baseline for the RTT waiting list was 4.6 million in December 2019. Today it stands at 7.31 million. That is over two and a half million more people waiting in pain, in fear, and out of work than would have been waiting on the day before COVID. The NHS has not recovered. It has been managed in slow decline by a government that promised the opposite.
125,000 Vacancies And A Strike Calendar
NHS England admits to over 125,000 unfilled posts. Consultants, nurses, healthcare assistants, radiographers, midwives. The British Medical Association has now warned of monthly resident-doctor strikes for the rest of 2026. We are heading into a summer of cancelled cancer appointments and postponed cardiac surgery — for the third year running.
Wes Streeting's resignation last week was the loudest admission of failure this government has produced. The Health Secretary did not jump because the job was going well. He jumped because the numbers do not lie and the pretence had run out.
The Money Is Not The Problem
The NHS budget for 2026/27 sits at over £190 billion. That is more, in real terms, than at any point in its history. Funding is not the problem. Structure is the problem. Productivity is the problem. A workforce planning system that takes seven years to train a GP while the asylum queue grows by 70 people a boat is the problem.
What Reform UK Would Do
Reform UK has been clear. The NHS will remain free at the point of use. But we would zero-rate VAT on independent healthcare, allowing patients who want to pay to take themselves off the NHS list and out of the queue ahead of those who cannot. That is one immediate, no-cost way of shortening the wait for everyone else.
We would scrap the layers of NHS England management bureaucracy that swallow more than £2 billion a year. We would tie ICB performance to outcomes, not box-ticking. And we would train more British doctors and nurses, on British soil, rather than poaching from countries that can ill-afford to lose them.
The British public pays for the NHS through some of the highest taxes in our peacetime history. They deserve more than a Health Secretary's resignation letter as their care plan. Labour has had its chance and produced a 7.31-million case backlog. The next government must do better, and Reform UK is the only party offering serious reform rather than another reshuffle.