Backlog in NHS and courts will take 10 years to clear, says think tank

Public services will not recover until the 2030s even under a Labour government, and it will take a decade to clear the backlog in the NHS and the courts, a report says.

The study from the Institute for Public Policy Research, a progressive thinktank, outlines the challenges an incoming Labour government would face, with voters impatient for change within a first term.

“The next government will inherit one of the most challenging contexts in terms of public services of any new government since the second world war,” said Harry Quilter-Pinner, an IPPR director, warning that reform and higher spending would be necessary.

Some of the IPPR’s ideas include rolling out AI tools, such as ChatGPT, to the public sector to save an estimated £24bn a year, with a “right to retrain” for workers whose jobs are affected.

Labour is expected to fight the next election with a promise to change public services, but the party will have little money to promise a major spending programme.

In the paper, titled Great government, the IPPR says it will take nearly 10 years to get NHS waiting lists down to 2010 levels.

Its analysis of the court service is equally sobering, with a prediction that it will take until 2033 for case backlogs to fall to pre-pandemic levels.

In education, the IPPR found it would take more than one parliamentary term for secondary schools to reduce the attainment gap between richer and poorer students to 2017 levels.

In polling in the report, a majority of people said many public services were getting worse but they had not abandoned their belief in state-run services, with half of the public willing to pay more tax if the money is spent on areas such as hospitals.

The IPPR, whose work has previously been drawn on by Labour for inspiration, sets out a prescription of “prevention, personalisation and productivity” as the key to improving public services.

It says previous attempts to change public services focused on targets and outcomes, choice and competition, without paying enough attention to “intrinsic motivation”, which can be found with a better trained, more trusted and more autonomous workforce.

Its blueprint for changing public services is likely to be closely examined by Labour. One of its core recommendations is legislating for new missions or overarching goals for the country, such as making the UK the healthiest country, the safest country, and the country with the best start in life. Each mission would have its own independent body, based on the Climate Change Commission, to hold the government to account.

Starmer has already set out his ambition for a mission-led government, including getting Britain building again, taking back the streets from crime, getting the NHS back on its feet, switching on more British energy, and breaking down barriers to opportunity.

The FT reported this week that Starmer would seek to reduce churn in the civil service workforce, which he believes could hamper the ability of senior Whitehall officials to deliver on Labour’s priorities.

The IPPR also suggests better management and training of public sector workers so they can rebuild capacity after losing 900,000 roles in local government, and establishing a new “failure regime” to support public services in need of improvement.

Other ideas from the IPPR include shifting public spending to focus on prevention and on long-term social return, such as investment in social care, community policing and childcare.

“Public services have been decimated by spending cuts, the pandemic and soaring demand,” Quilter-Pinner said. “Additional spending will be needed to address this problem. But money alone will not be able to fix the problems in our hospitals, schools and courts. The next government will need an ambitious, long-term, modern reform agenda. This blueprint we set out today forms the building blocks needed for a decade of reform and renewal.”

Responding to the report, a government spokesperson said it was already “investing record sums into public services”.

They said: “We’ve delivered record funding for the NHS and social care and this investment is helping to increase bed capacity, operation capacity and staffing, including more doctors and nurses.

“School standards in England continue to improve and funding will be at its highest ever level in 2024-25 in real terms per pupil, including additional funding for disadvantaged pupils.

“We have lifted the cap on the number of [court] sitting days, have recruited more judges and invested more funding into the criminal justice system, meaning crown courts are now processing the highest number of cases since 2019 to deliver justice for victims.

“We are looking at how new technologies like AI can improve public services. This has already saved billions in the last financial year and ministers are continuing to build on progress already for greater efficiency and productivity across the public sector.”

The political parties are casting round for policies to put in their manifestos and looking to thinktanks to supply some of the ideas. The backdrop of tight public finances and rigid self-imposed fiscal rules means they are looking for policies that will be cost-neutral or involve little upfront cost.

Leora Cruddas, the chief executive of the Confederation of School Trusts, said it was important to debate public service reform.

“The report rightly identifies that the role of the state is to be more strategic,” she said. “We think the focus on rebuilding the resilience of public services is absolutely right. And the focus on workforce capacity and investment is most welcome.

“We look forward to a real engagement with, and debate about, the ideas in this report in the coming months in the lead-in to the next general election.”

Penelope Gibbs, a director at Transform Justice, said: “IPPR identifies the need to devolve power across the board. Only through devolving power will we make services, such as criminal justice, focus on what communities need.

“Through localisation of power and budgets, a future good government will be able to shift the balance of spending away from prisons, towards community solutions.”