Rishi Sunak’s pledge to cut NHS waiting lists is going in the wrong direction, a health minister has indicated.

The Prime Minister made cutting NHS waiting lists in England one of his five key priorities in a speech in January.

But the latest figures show a record 7.4 million people waiting for treatment and health minister Maria Caulfield acknowledged that would increase.

Ministers and officials have insisted the focus is on reducing the longest waits for treatment as the first stage to cutting the list.

Downing Street confirmed that Mr Sunak’s pledge applied to the overall numbers, which are likely to head up rather than down.

Mr Sunak pledged to cut NHS waiting lists when they were at 7.2 million.

Ms Caulfield told Sky News: “To patients, what matters is how long they’re waiting. They’re not really worried about who else is on the waiting list.

“They want to know when their procedure or operation is happening, and we’ve significantly reduced that delay. We’ve virtually eliminated a two-year wait.”

Challenged on the 7.4 million figure, she said: “That probably will go up higher because we are offering more procedures.”

But “the length of time people are waiting for their procedures is actually going down and that’s what matters to patients”.

The figures for the end of April, the most recent available, showed 11,477 people waiting more than 18 months to start routine treatment, up from 10,737 at the end of March.

An estimated 371,111 people in England had been waiting more than a year to start routine hospital treatment, up from 359,798 at the end of March.

Downing Street said Mr Sunak was committed to bringing down overall waiting lists but the initial focus was on patients waiting the longest for treatment.

The Prime Minister’s official spokesman said: “We are rightly focusing on those waiting the longest – so those waiting two years, 18 months and now one year, and we are making progress on all of those.

“At the same time, as I think we acknowledged coming out of Covid, we knew that waiting lists would increase before they came down.

“But we are committed to reducing waiting lists overall, but rightly focusing on those who have been waiting the longest.”

Asked whether it was safe to conclude the pledge was going in the wrong direction, the spokesman said: “It’s not new, we have said since the end of the pandemic that we recognised numbers would increase before they came down.

“Of course, we are committed to reducing waiting lists overall but we believe it is right, as does NHS England, to focus on those waiting longest.”

Shadow health secretary Wes Streeting said: “The NHS turns 75 during the biggest crisis in its history, and the Conservatives admit it is going to get even worse.

“The Conservative minister is wrong – people are ‘really worried’ about the record-long waiting lists in the NHS today.”

The Prime Minister’s five pledges set out in January were to halve inflation this year, grow the economy, reduce national debt, “stop the boats” and cut waiting lists.

Inflation has fallen since he made the pledge but not as fast as many observers had expected, forcing the Bank of England to hike interest rates – putting at risk the meagre growth forecast for the economy.

National debt hit more than 100% of economic output for the first time since 1961 in May.

The Prime Minister’s aim of completely halting small boats bringing migrants across the Channel has also run into problems, with the Rwanda scheme ruled unlawful in the Court of Appeal, the Illegal Migration Bill given a mauling in the Lords and 11,433 people detected making the journey from France so far this year.