The huge issue completely missing from the leadership debate

HANLEY, ENGLAND - JULY 25:  Rishi Sunak and Liz Truss take part in the BBC Leadership debate at Victoria Hall on July 25, 2022 in Hanley, England. Former Chancellor Rishi Sunak and Current Foreign Secretary Liz Truss go head-to-head in the BBC Conservative Leadership debate in their bid to win the contest and become the UK's next Prime Minister. (Photo by Jacob King - WPA Pool/Getty Images)
Rishi Sunak and Liz Truss went head-to-head in a televised debate on Monday evening. (Getty)

After a week of public jibes and in-party squabbling, Liz Truss and Rishi Sunak came head to head in their first televised debate on Monday evening.

After an awkward opening when the pair stood grinning side by side, so motionless that viewers questioned if they were actually cardboard cutouts, the gloves were firmly off as the pair clashed over issues including tax and foreign affairs.

One key issue, however, was all but completely absent from their animated debate - the future of Britain's healthcare system.

Questioned by an audience in Stoke-on-Trent, a former Red Wall constituency that fell to the Conservatives in the 2019 election, Truss and Sunak constantly interrupted each other - with Sunak accused of 'mansplaining' as he sought to gain an advantage - when setting out their intentions for the country.

There was only an incidental mention of the NHS during the hour-long debate as Sunak accused Truss of wanting to put the COVID debt burden onto a 'credit card' for future generations, and asked whether it was “moral” to leave debt to be paid off by children and grandchildren.

"We all took a decision to protect the economy and support the NHS through COVID," he said. "So the question is, should we pay that bill ourselves? Or, do we put it on the county's credit card and pass the tab to our children?"

Liz Truss and Rishi Sunak before taking part in the BBC Tory leadership debate live. Our Next Prime Minister, presented by Sophie Raworth, a head-to-head debate at Victoria Hall in Hanley, Stoke-on-Trent, between the Conservative party leadership candidates. Picture date: Monday July 25, 2022.
Our Next Prime Minister saw Truss and Sunak exchange jibes and even rare compliments, but neither put forward any plans for resolving the crisis facing the NHS. (PA)

Truss retaliated by saying again that COVID was a once-in-a-lifetime event, and that no other major economy was trying to raise tax to pay off the debt so fast.

The former chancellor accused Truss of adopting 'non-conservative' policies, with her firing back that he was trying to instil a "project fear" to justify his financial plans.

And while the environment, economy, war in Ukraine, and even TikTok all got a mention, there was no talk of investment in recruiting healthcare staff to keep the country cared for.

The pair even took a moment to discuss each other's perceived strengths, with Truss saying Sunak had good dress sense following a Tweet posted by her ally Nadine Dorries earlier in the day questioning the price of his wardrobe, contrasting it with Truss's budget earrings. And Sunak conceded that he "admired" Truss.

But still no talk of the NHS - and the absence didn't go unnoticed.

Lib Dem leader Ed Davey questioned why neither leadership hopeful brought up the issue, while shadow health secretary Wes Streeting said there was "barely a mention from Sunak and Truss".

He tweeted: "Biggest crisis in the NHS’s history. 6.6 million people waiting. 100,000 staff short. 24 hours in A&E a reality - not just TV. Heart attack and stroke victims waiting an hour on average for an ambulance. Barely a mention from Sunak and Truss."

Lib Dem leader Ed Davey questioned why neither leadership hopeful brought up issues with the NHS (Twitter/Ed Davey)
Lib Dem leader Ed Davey questioned why neither leadership hopeful brought up issues with the NHS (Twitter/Ed Davey)

The scale of the crisis facing the NHS was laid bare on Monday when a health and social care committee report said Britain's healthcare workforce strategy must be a top priority for the new prime minister.

The report slammed the “absence of a credible government strategy” on NHS-wide understaffing, and criticised ministers for delaying a blueprint it said is urgently needed to address critical gaps in almost every area of care.

The damning report included evidence showing that the staffing crisis in the NHS in England is even worse than official figures suggest, and criticised the government’s “refusal to do proper workforce planning” and “marked reluctance to act decisively” despite the seriousness of the situation.

LONDON, UNITED KINGDOM - 2022/07/25: Medical students hold placards expressing their opinion during the demonstration outside the Department of Health and Social Care. NHS doctors, nurses, and other allied healthcare professionals gathered outside the Department of Health and Social Care, demanding a pay rise to match the inflation rate. The crowds later marched to Downing Street and demanded the government respond to their demands or else will plan for industrial actions in the coming months. (Photo by Hesther Ng/SOPA Images/LightRocket via Getty Images)
The debate took place on the same day as a demonstration outside the Department of Health and Social Care where NHS doctors, nurses, and other staff gathered to demand a pay rise to match the inflation rate. (Getty)

Former Conservative MP Anna Soubry said: "Watch in disbelief & horror. They barely mention #NHS, no realistic plan to rebuild our economy, and nothing on education. A lack of a vision."

Chris Thomas, head of the Commission on Health and Prosperity at the IPPR think tank, added: "The NHS has been the most consistent top priority for the public since 1987. MPs today said worst NHS workforce crisis ever. Not mentioned yet..."

'Serious risk to safety'

NHS Digital figures suggest that the service has vacancies for 38,972 nurses and 8,016 doctors. However, the real figures could be as high as 50,000 and 12,000 respectively, according to estimates the Nuffield Trust prepared for the MPs.

At the weekend Sunak highlighted the 6.6 million-patient backlog of NHS care, long delays patients face getting care and growing numbers of people forced to pay for private treatment “with a gun to their heads”. He said the state of the health service now constituted a national emergency and that its increasing inability to provide prompt, high-quality care is so serious that the service could “break”.

Truss has pledged to scrap the 1.25% rise in national insurance – the “health and social care levy” – that began in April and is expected to yield £12bn a year, mainly for the NHS. Her pledge has raised questions about how the government would fund the service properly.

Paramedics work inside an ambulance parked outside the Royal London Hospital in east London on January  7, 2022. - Britain will deploy troops to hospitals in London to alleviate severe staff shortages caused by the Omicron outbreak, the Ministry of Defence (MoD) said Friday. (Photo by Daniel LEAL / AFP) (Photo by DANIEL LEAL/AFP via Getty Images)
A damning cross-party report has criticised the government’s 'refusal to do proper workforce planning' for the NHS (Getty)

But neither made comment on the situation during the live debate.

The committee’s findings make for uncomfortable reading for both candidates, especially the warning that a chronic lack of staff is a threat to both patients and health professionals.

“The persistent understaffing of the NHS now poses a serious risk to staff and patient safety, both for routine and emergency care," it continued.

A snap poll by Opinium, based on a sample of 1,032 voters, found 39% believed Sunak had performed best during the debate, compared to 38% for Truss.

The winner of the leadership battle will be announced on Monday, 5 September, when either Truss or Sunak will become leader of the Conservative Party and the new Prime Minister.

Watch: Sunak and Truss go head-to-head on taxes, inflation, China