UK Health Secretary Sajid Javid said Sunday that the number of people on National Health Service waiting lists could reach as high as 13 million in a matter of months. He told the Sunday Telegraph, “It’s gone up from 3.5 million to 5.3 million as of today, and I said to the officials so what do you mean ‘a lot worse’, thinking maybe it goes from 5.3 million to six million, seven million. They said no, it’s going to go up by millions… it could go as high as 13 million.”

It was during the pandemic that the number surged to over five million, already the highest since records began in 2007.

The backlog is being utilised by the Conservative government to ensure that vaccinated health workers stay in work, no matter the threat to their health. Last Friday, the government said it may bring forward plans—to be rolled out for the whole population from August 16—so that health workers are not required to self-isolate even if they come into contact with someone who has tested positive. Javid confirmed Sunday that there is “every reason to think that we can take a more proportionate and balanced approach to the isolation policy”.

While the number of people already waiting longer than a year has gone down, by 50,000 to 385,000, this is considerably more than the 1,600 people waiting that long before the pandemic. Subsets of the NHS figures show that there are over 2,000 people who have been waiting for over two years for surgery.

Hospitals are currently running at 90 percent of pre-pandemic levels of surgeries. Over 1.5 million operations were cancelled during the pandemic, according to researchers. There was a 33.6 percent decrease in surgical activity, across England and Wales during 2020. The biggest drop was in operations classified as “Class 4”, including replacement knees and hips, as well as eye operations.

In a statement made before the government announced that the ending of all restrictions would be delayed from June 14 to July 19, Danny Mortimer, deputy chief executive of the NHS Confederation, declared, “A third wave, no matter the size, will have an impact on the services the NHS can provide, especially as 5.1 million people are waiting to start treatment. If the data gives rise to any doubt, health leaders would urge him [Prime Minister Boris Johnson] to take decisive action and delay the final lifting of lockdown restrictions.”

The government and its apologists seek to place the blame for the massive backlog solely on the pandemic, but this would have had significantly less impact had they carried out basic public safety measures and had not gutted health care year after year.

The backlog has been increasing year-on-year. According to the New Statesman, figures show that since 2013 the NHS waiting list had been at record highs and climbing annually. By the beginning of 2020, prior to the onset of the pandemic, over 4 million people were on the list.

According to a leaked report from Downing Street’s Cabinet Office, as much as £40 billion over the next four years is required to clear the existing backlog.

Tim Gardner, of the Health Foundation thinktank, noted that major difficulties in clearing the waiting list backlog was due to factors including a shortage of staff, the social distancing measures for beds, and, significantly, staff burnout.

This was the focus of a key report earlier this year by parliament’s Health and Social Care Select Committee. It found that staff burnout across both the NHS and social care had reached “emergency” levels. The report analysed data sets, such as the NHS Staff Survey. The parliamentary report states, “[T]he 2019 survey found that 40.3 percent of respondents reported feeling unwell as a result of work-related stress in the last 12 months, up from 36.8 percent in 2016.”

The report notes that in 2018 one in four doctors in training and one in five trainers felt burnout to a high or very high degree because of their work. Drawing on research by the Kings Fund, the report notes, “NHS staff were 50 percent more likely to experience high levels of work-related stress compared with the general working population.”

A 2021 report by the General Medical Council found, “Abundant evidence that workplace stress in healthcare organisations affects quality of care for patients as well as doctors’ own health […] Patient satisfaction is also markedly higher in healthcare organisations and teams where staff health and wellbeing are better.”

The Committee’s report concludes, “Burnout is a widespread reality in today’s NHS and has negative consequences for the mental health of individual staff, impacting on their colleagues and the patients and service users they care for. There are many causes of burnout, but chronic excessive workload is a key driver and must be tackled as a priority. This will not happen until the service has the right number of people, with the right mix of skills across both the NHS and care system.”

The principal architect of parliament’s report is none other than Jeremy Hunt, the Conservative Health Secretary between 2012 and 2018, and now chair of the Health and Social Select Committee. In 2005, it was Hunt who co-authored a report that insisted, “The problem with the NHS is not one of resources. Rather, it is that the system remains a centrally run, state monopoly”.

In 2016, Hunt imposed a contract on junior doctors that included the reduction of unsocial payments for weekend working, with Saturday and Sunday between 9 a.m. and 9 p.m. reclassified as normal working days, and nightshift rates reduced, along with the elimination of automatic pay progression.

The latest report naturally makes only a glancing mention of pay, merely stating that “[A]lthough pay and reward were not the focus of this inquiry we received evidence that suggested that pay could also contribute to stress and burnout in health and care.”

Hunt’s successor Hancock rammed through a one percent pay increase, a real terms pay cut after inflation. Health workers have seen a 20 percent pay cut over the last 10 years when inflation, measured by the retail price index, is factored in. Most experienced front-line nurses are £6,144 per year worse off.

Despite the government hypocritically lauding the importance of NHS and social care staff, including backing the weekly Clap for Carers, and designating them as “key workers” during the pandemic, the determination of the Tories to further slash pay reveals their real agenda aimed at the privatisation of health care. The Telegraph reported Sunday that, “Plans under consideration [for dealing with the growing waiting list] “include boosting the number of virtual appointments and drawing on private hospitals to provide care funded by the NHS.”

The health sector trade unions have dutifully played their part and ensured that no mobilisation occurred against the latest assault—a continuation of their role in selling out the junior doctors strikes of 2016, and then selling the lie that a previous pay cut was the “best pay deal in eight years”.

NHS workers must organise a fightback independently of the unions in defending their pay, terms and conditions. The Socialist Equality Party and NHS FightBack calls for the formation of rank-and-file committees in every hospital, as part of a network of action and safety committees in every workplace.

For further information visit NHS FightBack.