9 Percent of All Workers in England Could Be Employed by the NHS by 2036

NHS workers take part in a march from St Thomas' Hospital to Trafalgar Square, London, as members of the Royal College of Nursing (RCN) and the Unite union continue their strike action in a dispute over pay. Picture date: Monday May 1, 2023. (Jordan Pettitt/PA Media)

One in eleven workers will be employed by the national health service by 2036 under plans to expand the NHS, according to an analysis.

A report released by the Institute for Fiscal Studies (IFS) on Tuesday estimates an upcoming major healthcare workforce expansion plan means that the NHS would employ almost half of all public sector staff.

In June, NHS England published its Long-Term Workforce Plan, which estimates that the NHS in England will need around 60 percent more staff by 2036–2037.

The plan aims to increase the number of staff employed by the English NHS from around 1.5 million in 2021–2022 to between 2.3 and 2.4 million in 2036–2037.

Two hundred and sixty thousand extra doctors and nurses are expected to join over the coming years.

The IFS calculated that 49 percent of public sector workers in England, around one in eleven workers overall, will work for the NHS in 2036–2037, compared with 38 percent in 2021–2022.

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This would be equivalent to an average growth in the size of the NHS workforce of between 3.1 percent and 3.4 percent per year. For context, the Institute for Fiscal Studies estimates that NHS staffing numbers grew by around 1.1 percent per year between 2009–2010 and 2019–2020.

‘Difficult fiscal decisions’

Max Warner, research economist at IFS and an author of the research, said that the plan could mean “difficult fiscal decisions.”

“The publication of the NHS workforce plan and its detailed workforce projections is an important and welcome milestone for the NHS,” he said.

“We estimate that the plan might imply average real-term funding growth of around 3.6 percent per year for the NHS in England. That is by no means outlandish by historical standards, but would nonetheless require difficult fiscal decisions in the current climate of sluggish growth.”

“NHS modelling suggests that even these large staffing increases will only be ‘enough’ to meet future demand if staff productivity can be increased by a highly ambitious 1.5 percent to 2 percent per year,” he added.

“The risk of having a workforce plan but no similarly high-profile plan for capital, technology or management is that higher spending on staffing squeezes out other vital inputs, and makes those productivity gains all but impossible to achieve.”

Soviet Union

Dr. Kristian Niemietz, head of health and welfare at the think tank Institute of Economic Affairs, told The Epoch Times that in principle the NHS Long Term Workforce Plan is “not a bad thing in an ageing society that you have more people working in the healthcare sector.”

Dr. Niemietz has criticised Britain’s health service, in that it could be significantly improved by adopting successful alternative systems that have proven effective in other countries, but a cult-like grip prevents any meaningful debate on the matter.

“The problem with it is that this is a form of central planning, that you have this monolithic employer which is almost synonymous with the healthcare system as a whole,” he said.

“And where you have essentially a bunch of bureaucrats working out we need 12 percent more in this sector, 14 percent more in that sector, it’s a bit like a five-year plan in the Soviet Union,” he added.

He said that the NHS is already in the top ten globally for total healthcare spending as a proportion of the economy, unlike in the 90s, when it was “really true that Britain was spending less on health care and most other developed countries.”

“If we have such terrible outcomes as we have now with the current level of spending, I’m not convinced that just throwing lots and lots more money into the system is going to lead to sufficient improvements and justify those additional costs,” he added.

Population Change

Commenting on the report, Danny Mortimer, deputy chief executive of the NHS Confederation, said: “We know that the workforce plan will require long-term funding if it’s to be rolled out successfully, and health leaders will agree that NHS funding should revert to the long run average growth rate to be in line with the ever-growing demand the NHS faces.

“This investment needs to not just expand numbers but also improve working conditions and reward and accelerate access to careers.

“It also needs to be matched by investment in technology and working environments to support healthcare staff to work effectively and efficiently.

“We have an ageing and growing population, with increasingly complex needs, so it’s vital that funding grows in line with demand.

A spokesperson for NHS England said: “The first-ever NHS Long Term Workforce Plan provides a once-in-a-generation opportunity to put staffing on a sustainable footing and ensure the NHS can embrace the latest technologies and meet the changing and future needs of patients. The number of people aged over 85 is estimated to grow 55 percent by 2037, as part of a continuing trend of population change which outstrips comparable countries, and without the action set out in the plan the vacancy gap could grow to up to 360,000 by 2037.”

PA Media contributed to this report.