Ministers are facing growing political pressure after it emerged that hospitals are being paid millions of pounds each month to remove patients from NHS waiting lists, a move critics say allows the government to trumpet falling numbers without delivering a corresponding rise in treatment.
Keir Starmer and Health Secretary Wes Streeting have repeatedly pointed to reductions in waiting lists as evidence that Labour is turning around the health service. But analysis of NHS data suggests that much of the apparent progress has come from administrative removals rather than extra operations or appointments.
The practice, known within the health service as list cleansing or validation, involves consultants reviewing backlogs to identify people who may have died, sought private treatment, or no longer want or need the procedure they were waiting for.
Between April and September last year, NHS England paid hospital trusts £18,818,566 to carry out such exercises. Officials said trusts were paid roughly £33 for every patient taken off a list, implying that more than half a million people were removed in just six months.
Critics have seized on the figures as evidence that Labour is massaging the statistics. A source from the previous Conservative administration told The Times that a similar proposal had been blocked by Rishi Sunak when he was prime minister because it amounted to paying the NHS for “doing something it should be doing anyway”. The source added that “artificially” shrinking the waiting list risked misleading the public about how the service was really performing.
Health policy specialists have also voiced unease about the approach, warning that some patients could be removed even though they still require care.
Two weeks ago, the Prime Minister claimed official figures showed waiting lists had fallen by “more than 86,000”, calling it the “largest fall in a month for over two years”.
“These aren’t just numbers, it is thousands of people getting the care they need,” he said.
Yet NHS data suggest the headline figure was driven largely by validation rather than a surge in clinical activity. In November, the month cited by Sir Keir, 346,300 people were removed from waiting lists, about 82,000 more than in October and close to the entire reduction ministers highlighted.
Over the same period, hospitals carried out about 10 per cent fewer operations and appointments than the month before, indicating that fewer patients were actually treated.
Sarah Scobie, deputy director of research at the Nuffield Trust, said the overall balance between referrals and treatments had barely shifted. “It’s likely that a big proportion of recent waiting list reductions have happened due to reasons other than the NHS boosting activity,” she said. “One example of this is data cleaning exercises. A lack of transparency about this can sometimes create an illusion that the NHS is delivering more care than it is.”
Sarah Woolnough, chief executive of the King’s Fund, said the NHS routinely carried out such reviews but warned ministers against portraying them as a solution to entrenched backlogs.
She told Times Radio, “I think the question is, are the Government over claiming? And this is no long term strategy. These exercises are kind of one off that you do reasonably every few months, but they’re no substitute for increased activity levels to actually bear down on the wait list.”
Ms Woolnough added that the process had to be handled “incredibly carefully” to ensure legitimate patients were not wrongly removed and criticised Labour for overstating incremental progress.
“This is the Government’s flagship policy to fix the NHS,” she said. “It’s promised to re meet the constitutional standard, this is the big promise, to make sure that the vast majority of people on a wait list are seen within 18 weeks, and it’s nowhere near that. The dial has to shift, whereas at the moment there’s a very incremental decline, partly driven by this validation exercise.”
In Parliament, health minister Karin Smyth defended the payments, saying, “Validation is a well established component for the effective management of waiting lists, ensuring that the patients who are on the list should still be there.
“While we have significantly reduced the size of the total elective waiting list by over 206,000 since the Government took office, a large list requires consistent validation in order to ensure that all patients on the list still require care, and all appointments are of optimum value for patients and clinicians.”
NHS insiders have argued that the reviews can identify people who would benefit from alternative treatments, such as physiotherapy, and help free up capacity for others.
Public reaction has been far less forgiving. Online comments have accused Labour of manipulating figures and masking systemic problems, with numerous readers claiming they or relatives had been removed from waiting lists without explanation or had appointments repeatedly cancelled while ministers boasted of progress.
Opponents say the episode undermines Labour’s claims to be fixing the NHS, arguing that headline grabbing reductions driven by administrative exercises amount to little more than political spin while millions of patients continue to wait for treatment.
