Fresh blow for Reeves as NHS bosses warn of longer waiting times if they don’t get extra £3bn

NHS leaders have warned of longer waiting times and rationing of care if they do not receive an extra £3billion, in a fresh blow for Rachel Reeves.

They have told the Chancellor they will be forced to cancel some weekend and evening surgery if she fails to stump up the cash, hitting efforts to speed up treatment.

Some procedures considered to be of ‘low clinical effectiveness’ could also be axed because they are not a good use of limited resources, they added.

This includes things such as removing painful bunions, which can restrict mobility but are not life-threatening.

The £3billion is needed to cover NHS redundancies, strike action by resident doctors and higher drug prices.

The demand poses a major problem for Ms Reeves as she tries to find ways to fill an estimated £30billion hole in the UK’s finances in her budget.

The NHS is already due to receive £196billion of the £211billion health budget for England this year.

But health bosses argue all three cost pressures they want covered have arisen since their funding settlement for 2025/26 was finalised.

The NHS Confederation and NHS Providers, which represent the 215 health trusts in England, say Labour’s pledge to cut waiting lists will become even harder to deliver without the extra money.

Waiting lists for non-urgent care stood at 7.6million when Labour came to power in July 2024.

The figure fell for six months but has risen again in the past three and remains at 7.4million, despite Labour’s claim to have delivered an ‘extra’ 4million appointments.

The NHS’s 42 integrated care boards (ICBs) in England are due to make up to 12,500 of their 25,000 staff redundant as part of a cost-cutting drive announced by Keir Starmer in March, with a likely upfront bill of more than £1billion.

A five-day strike by resident doctors – formerly known as junior doctors – cost the NHS £300million in July, with another five-day walkout planned for next month.

And President Donald Trump’s efforts to lower drug prices in the United States is expected to lead the UK paying more for its medicines, with the NHS potentially needing to part with an additional £2.5billion.

The situation is said to have left health secretary Wes Streeting in a ‘standoff’ with the Chancellor over who will foot the unexpected cost.

Matthew Taylor, the chief executive of the NHS Confederation, said: ‘The threat from unbudgeted redundancy payments, higher drug prices and renewed industrial action risks derailing progress on key waiting time targets and the wider reforms that are essential to getting the NHS back on track.’

One NHS trust chief executive said additional operating theatre lists ‘are the easiest things to stop when money is difficult, but they have an immediate impact on waiting times’.

Hospitals will also do fewer ‘procedures which impact quality of life but aren’t life-saving’, they added.

Richard Sloggett, a former special adviser to the Department of Health and Social Care under the Conservatives, told the Guardian: ‘This £3billion demand by NHS leaders is a dramatic intervention that leaves health ministers exposed.

‘The rushed decision in March to announce a massive NHS reorganisation – without clear funding and plans attached to deliver it – has led us to this point.

‘Add strikes and rising drug prices and the government is facing a perfect storm of issues on its number one public service priority.’

Daniel Elkeles, the chief executive of NHS Providers, defended the £3billion demand, saying: ‘As the government prepares its budget it’s time for an honest assessment and discussion about what the NHS can really achieve this year in these challenging financial circumstances, and about what is ‘doable’ to meet ministers’ ambitions in their 10-year plan for health.’

Shadow health secretary Stuart Andrew last week told MPs in the Commons that Streeting ‘is very good at making promises, but the facts are that he is presiding over a reorganisation that has stalled, creating uncertainty for staff’.

The Department of Health and Social Care said: ‘This government has delivered a record-breaking £29billion investment in our NHS – demonstrating our unwavering commitment to properly funding the health service that we all rely on.

‘We know needless strikes will divert money, time and resourcing away from the frontline.

‘That’s why the health secretary has urged the BMA to stop being selfish and start putting patients first.

‘However, investment alone isn’t enough – it must go hand in hand with reform.

‘That is why we’re doing things differently: not just fixing the NHS but moving it forward through our Plan for Change.

‘And it’s already working. We’ve taken over 200,000 people off waiting lists, delivered 5m more appointments and GP satisfaction is finally going up.’