Boris Johnson will put repairing the NHS at the heart of his next programme for government, as his team draws up plans to lock in the huge local election gains in the north of England and Midlands. With more NHS funding inevitable after the damage and delays caused by Covid-19, Downing St wants to neutralise an issue that could undermine progress among voters who have switched to the Tories. The NHS England head, Sir Simon Stevens, has already said cancer care and extra funding needs to be a priority. NHS waiting lists are seen as one of the government’s major vulnerabilities. “We have to be honest with the public about the damage done to the NHS by coronavirus and the scale of the challenge ahead,” a No 10 source said. “Now, more than ever, the NHS is the government’s priority – and recovery of patient services is at the heart of that. We need to achieve a national recovery that spreads opportunity and transforms the whole UK, and this Queen’s speech will have that ambition at its core.” There were 4.7 million people in England waiting for routine operations and procedures in February, the highest figure since 2007. Demand will grow as routine check-ups return this year. The government is providing £325m for diagnostics and £1bn to kickstart elective services. Meanwhile, a debate is emerging among Tory MPs over whether Johnson should back an early general election, after sweeping gains in the local elections suggested it could make further inroads into traditionally Labour seats. The next election is due in 2024, but some argue that bringing it forward a year could allow the party to make gains before many of the big tax increases and spending cuts kick in to repair the economic damage of the pandemic. Some Tory MPs said the next election could not come fast enough. “Why wait until 2023? Why not 2021? Bring it on,” joked one MP. Another former minister said that, while it was too early to be backing an early election, “four-year terms were always the norm for strong governments under Thatcher and Blair”. One complication of an early election spotted by party figures is that boundary changes, which could additionally benefit the Tories, may not be ready until the end of 2023. Others are urging the party to hammer home its advantage before the debate over an early poll is allowed to take off publicly. “This is in part a vaccine afterglow,” said one former cabinet minister. “Let’s see how people feel when they are properly back at work. We have to make the most of our Brexit freedoms now, which will be down to cabinet competence.” Another MP said: “Let’s focus on getting on with the manifesto pledges and rebuilding the UK after the pandemic and not worry about a general election for now.” New MPs in so-called “red wall” seats said that Labour’s leader, Sir Keir Starmer, was falling flat in their areas and urged the leadership to push harder on issues such as immigration reform that their constituents had raised during the local elections. Richard Holden, MP for North West Durham, compared Starmer unfavourably with the former Tory leader Iain Duncan Smith. “The difference is that IDS did well in rebuilding his party in local council elections,” he said. “These results show real confidence in the prime minister, and in the local MPs in constituencies like mine and across the north-east, and show we can go further in the future, too.” Commitments on the NHS will be part of a Queen’s speech on Tuesday that the Tories will frame around the theme of “building back better” after the pandemic. It will also include tougher laws for attacks on emergency service workers, and longer sentences for serious sexual and violent offenders, as part of a toughening of law and order measures. Johnson said: “The impact of the pandemic on people’s lives has been unique in our history. My government is still focused on beating this disease, saving lives and livelihoods and rolling out vaccines, but I am also determined that we look forward and get on with fulfilling the promises we have made to the British people. “Not only will we address the legacies of the pandemic, we will go further to unite and level up the country, fight crime and create opportunities for businesses and families to build brighter futures.” Join a Guardian Live discussion about how the NHS has performed during the pandemic, amid new government plans for another reorganisation. With Denis Campbell, Dr Rachel Clarke and Sir David Nicholson on Wednesday 12 May, 7pm BST | 8pm CEST | 11am PDT | 2pm EDT. Book tickets here.