“The target was never particularly ambitious,” says the Institute for Fiscal Studies (IFS) about Labour’s plan to add two million extra NHS appointments during their first year in power.
In February, Health Secretary Wes Streeting announced they had achieved the feat early. He recently described the now 3.6m additional appointments achieved in their first eight months as a “massive increase”.
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But new data, obtained by independent fact checking charity Full Fact and shared exclusively with Sky News, reveals this figure actually signalled a slowing down in new NHS activity.
There was an even larger rise of 4.2m extra appointments over the same period the year before, under Rishi Sunak’s government.
The data also reveals how unambitious the target was in the first place.
We now know two million extra appointments over the course of a year represents a rise of less than 3% of the almost 70 million carried out in the year to June 2024.
In the last year under Mr Sunak, the rise was 10% – and the year before that it was 8%.
Responding to the findings, Sarah Scobie, deputy director of independent health and social care think tank the Nuffield Trust, told Sky News the two million target was “very modest”.
She said delivering that number of appointments “won’t come close to bringing the treatment waiting list back to pre-pandemic levels, or to meeting longer-term NHS targets”.
The IFS said it was smaller than the annual growth in demand pressures forecast by the government.
What exactly did Labour promise?
The Labour election manifesto said: “As a first step, in England we will deliver an extra two million NHS operations, scans, and appointments every year; that is 40,000 more appointments every week.”
We asked the government many times exactly how it would measure the pledge, as did policy experts from places like the IFS and Full Fact. But it repeatedly failed to explain how it was defined.
Leo Benedictus, a journalist and fact-checker at Full Fact, told Sky News: “We didn’t know how they were defining these appointments.
“When they said that there would be more of them, we didn’t know what there would be more of.”
Leo Benedictus, journalist at Full Fact
Even once in government, initially Labour did not specify their definition of “operations, scans, and appointments”, or what the baseline “extra” was being measured against.
This prevented us and others from measuring progress every month when NHS stats were published. Did it include, for instance, mental health and A&E appointments? And when is the two million extra comparison dating from?
Target met, promise kept?
Suddenly, in February, the government announced the target had already been met – and ever since, progress on appointments has been a key boast of ministers and Labour MPs.
At this point, they did release some information: the definition of procedures that allowed them to claim what had been achieved. They said the target involved is elective – non-emergency – operations excluding maternity and mental health services; outpatient appointments and diagnostic tests.
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However, we still did not have a comprehensive baseline to measure the two million increase against.
The government data instead relied on a snapshot: comparing the number of appointments carried out from July to November 2024 with the number from July to November 2023, and adjusted them for the number of working days in each period.
This did not tell us if the NHS had already been adding appointments under the Conservatives, and at what pace, and therefore whether this target was a big impressive ramping up of activity or, as it turns out, actually a slowing down.
Since then, a number of organisations, like Full Fact, have been fighting with the government to release the data.
Mr Benedictus said: “We asked them for that information. They didn’t publish it. We didn’t have it.
“The only way we could get hold of it was by submitting an FOI request, which they had to answer. And when that came back about a month later, it was fascinating.”
This finally gives us the comparative data allowing us to see what the baseline is against which the government’s “success” is being measured.
Full Fact passed the data to Sky News because it had seen our reporting about how the information published by the NHS in February was not sufficient to be able to assess whether things were getting better or worse.
What the government says now
We put our findings to the government.
A Department of Health and Social Care spokesperson said: “On entering office last July, the secretary of state [Wes Streeting] was advised that the fiscal black hole meant elective appointments would have to be cut by 20,000 every week.
“Instead, this government provided the extra investment and has already delivered 3.6 million additional appointments – more than the manifesto commitment the British public voted for – while also getting more patients seen within 18 weeks.
“In the nine months since this government took office, the waiting list has dropped by over 200,000 – more than five times as much as it had over the same period the previous year – and also fell for six consecutive months in a row.”
Health Secretary Wes Streeting. Pic: PA
We put this to Jeremy Hunt, Rishi Sunak’s chancellor during his last two years as prime minister, and health secretary for six years under David Cameron and Theresa May.
He said: “What these numbers seem to show is that the rate of appointments was going up by more in the last government than it is by this government. That’s really disappointing when you look at the crisis in the NHS.
“All the evidence is that if you want to increase the number of people being treated, you need more capacity in the system, and you need the doctors and nurses that are there to be working more productively.
“Instead what we’ve had from this government is the vast majority of the extra funding for the NHS has gone into pay rises, without asking for productivity in return.”
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Edward Argar, shadow health secretary, accused the government of a “weak attempt […] to claim credit for something that was already happening”.
“We need to see real and meaningful reform that will genuinely move the dial for patients,” he added.
Is the NHS getting better or worse?
New polling carried out by YouGov on behalf of Sky News this week also reveals 39% of people think the NHS has got worse over the past year, compared with 12% who think it’s got better.
Six in 10 people say they do not trust Keir Starmer personally on the issue of the NHS, compared with three in 10 who say they do.
That is a better rating than some of his rivals, however. Just 21% of people say they trust Nigel Farage with the NHS, and only 16% trust Kemi Badenoch – compared with 64% and 60% who do not.
Ed Davey performs better, with 30% saying they trust him and 38% saying they do not.
Ms Scobie of the Nuffield Trust told Sky News “the government is right to make reducing long hospital treatment waits a key priority […] but much faster growth in activity is needed for the NHS to see a substantial improvement in waiting times for patients.”
The government is correct, however, to point out the waiting list having dropped by more than 200,000 since it’s been in office. This is the biggest decline between one July and the following February since current waiting list statistics were first published under Gordon Brown.
The percentage of people waiting less than 18 weeks for treatment is also falling for the first time, other than a brief period during the pandemic, in more than a decade.
There is still a long way to go, though. Figures released last week showed the total number of people waiting for NHS treatment in England had risen again in March, following six months of positive progress.
The latest figures show 6.25m people waiting for 7.42m treatments (some people are on the list for more than one issue). That means more than one in 10 people in England are currently waiting for NHS treatment.
There continues to be a fall in the number who have been waiting longer than a year. It’s now 180,242, down from almost 400,000 in August 2023 and over 300,000 in June 2024, the Conservatives’ last month in power.
But that number is still incredibly high by historical standards. It remains over 100 times higher than it was before the pandemic.
The government has a separate pledge that no more than 8% of patients will wait longer than 18 weeks for treatment, by the time of the next election. Despite improvements in recent months, currently more than 40% wait longer than this.
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.
