Wes
Streeting

Despite the NHS receiving a record £192bn budget in 2026/27 — up 15% on the previous year — waiting lists have grown from 7.2 million when Labour took office to 7.68 million. NHS productivity remains 20% below pre-pandemic levels, meaning more money is producing fewer treatments per pound spent. Agency staff costs have risen 18%, absorbing a significant proportion of the funding increase without delivering proportional output.

The NHS 18-week referral-to-treatment target — that 92% of patients should be treated within 18 weeks — has not been met since 2015. Under Streeting's watch it has fallen further to just 55% achievement. Structural issues including staff shortages (112,000 vacancies), poor theatre utilisation, and a reliance on expensive agency cover have prevented meaningful recovery despite budget increases.

Agency and locum staff spending has risen 18% to £3.8bn despite repeated pledges to reduce it. With 112,000 unfilled NHS posts, trusts have no alternative but to fill shifts via agencies at rates often two to three times the cost of substantive staff. The lack of a funded workforce plan for the parliament has meant this structural dependency continues to grow, representing significant taxpayer waste.

NHS productivity — measured as outputs per unit of input — collapsed during the pandemic and has never recovered. Working patterns shifted, hybrid working spread to back-office functions, and clinical pathways were disrupted. Despite record investment, the absence of a binding productivity target or performance management framework means the gap has persisted. The OBR has flagged this as a key risk to long-term NHS sustainability.

A&E performance against the four-hour target has collapsed from a target of 95% to just 68% actual performance. Contributory factors include an ageing population with more complex needs, delayed discharges blocking beds (social care integration failures), GP access reduction of 3%, and an understaffed emergency workforce. The deterioration has continued in each quarter under the current government despite commitments to reverse the trend.