This article originally appeared on CapX on November 16, 2022.

By Nicole Sykes, PBE's Director of Policy and Communications

From heart disease to mental disorders, charities helping tackle almost every imaginable illness have been sounding the alarm about NHS backlogs for months now. They rang that bell again last week as new figures laid bare the extent of just how badly clogged the NHS is, with a staggering 7.1 million people in England waiting for treatment to begin.

Of course, those charities are calling for action to help the people they are set up to support. But those organisations are also directly feeling the effect. In the absence of any progress by the NHS, patients turn to charities, and the number doing so is spiralling upwards.

And it's not just in the NHS where people are trapped in limbo. In the family courts, there’s a backlog of almost 110,000 cases, a jump of 2,000 in September. There are almost 100,000 households stuck in temporary accommodation, near enough double the number there were in 2011. Lengthy waits for special school places mean that the number of vulnerable primary school pupils in alternative provision has risen by a quarter, while the number of children waiting for a place at a secure children’s home on a given day doubled between 2021 and 2022.

The list goes on and on. Even picking up the phone at HMRC takes three times longer than the pre-pandemic target.

Inevitably, people are more likely to be caught up in Britain's backlogs if they are more disadvantaged – unable to pay for private healthcare to skip the hospital queue, or to afford a roof over their heads without help. Some are society's most at risk. Recent Freedom of Information requests have revealed that modern slavery survivors are now waiting an average of 452 days for decisions on their cases, an increase of 72% year on year. These are individuals who are overwhelmingly likely to have been victims of serious exploitation and are unable to move forward with their lives until the government decides on their status. Meanwhile, the inability of the Home Office to process asylum applications in a timely manner is a significant factor behind the crisis at Manston immigration centre.

The gummed up gears of our public services and the backlogs this has caused are not just holding back individuals; they are suppressing our economy. Ill health is the main reason given by 2.6mn people who have fallen out of the labour market. Most refugees and modern slavery survivors are forbidden from working while their cases are being processed, prevented from paying their way. And when millions of school children are struggling with their mental health, exam results take a hit and so the lifelong earning potential of children living in these circumstances can be permanently scarred.

When the state puts so much of the population on hold, for months, charities are often the only organisations able to help. While victims of crime are bounced from pillar to post, charities step in to help them navigate the system, and offer counselling to deal with the stresses of protracted battles for justice. While patients wait for treatment, charities provide help with money worries for those who can’t work due to their illness, hydrotherapy and exercise classes for those in need of a hip replacement, and care for those in need of extra help at home.

Yet charities are reporting record levels of demand in light of the cost of living crisis. Unending backlogs in public services add even more pressure. The longer the waits, the longer charities provide support for. The more people waiting, the more people seek out their help. Take the sight loss charities which have recently reported a 59% increase in demand in 2022 compared to 2020, and have directly blamed NHS delays to the treatment of glaucoma cases as the cause. Citizens Advice is another example. The organisation has reported up to 150 people an hour an hour getting in touch for help due to the government backlog in processing independence payments for people with disabilities and chronic ill health.

There are serious concerns about how much further this charitable support can stretch. With donations likely to dry up as people tighten their belts, and running costs rising as inflation persists, the tension is starting to show.

Politicians have promised to deal with the backlogs, but the Autumn Statement’s promised spending restraint means it’s hard to see how. Until action is taken, charities will continue minding the queues, doing the best they can to support those stuck waiting. But nothing about this situation is sustainable, and the pressure on public services and charities alike is only set to rise as winter sets in.