The NHS holds a unique place in British life: a source of national pride, and the single biggest public service in England. This year it’s set to cost over £200 billion, around £3,500 per person, more than we spend on education, defence, justice and transport combined. And yet, despite sustained funding increases and around a quarter of a million more staff than in 2019, concerns about performance haven’t gone away.

Labour came into office promising to get a grip on record waiting times, but progress so far looks limited. The waiting list stands at 7.3 million, only slightly down from around 7.6 million when the government took office a year and a half ago. With winter pressures, flu surges, and resident doctors taking strike action, it raises a big question: what’s actually going on inside the system, and is improvement realistically on the horizon?

In this episode, Helen is joined by IFS colleagues Olly Harvey-Rich and Max Warner to unpack the data and the trade-offs. We look at winter pressures and capacity, what the latest performance metrics tell us, and the real constraints facing the NHS in England - money, productivity and system design. Finally, we look ahead to the rest of the parliament: should we be hopeful about meaningful change, or are the obstacles bigger than the plans?

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