on life support
Following last week’s raft of pre-election promises from ‘hey-big-spenders’ Sajid Javid and John McDonnell, and the publishing of the worst performance figures since records began, it’s widely agreed that the NHS is on the critical list. And it isn’t even officially winter yet. At the coal face, with over 36,000 open vacancies (one in eight) and growing, this translates to the humble nurse, the oil in the machine, being daily overstretched, struggling to cope with demand and under the patients’ proverbial cosh. How and why did we get in this situation?
Since the early 1920s, becoming a nurse has involved training for three years and, back in the day, this mainly consisted of taking on a full workload of both cleaning and clinical care, no doubt under the steely stare of matron’s watch. Nursing degrees were established in 1974 and a mixture of both academic and practical training is, given the complexity of modern medicine and technology, rightly recognised as crucial to the successful provision of care. To complement this, more hands-on models of training, including four-year nursing apprenticeships were introduced to loud fanfare in 2016. Sadly, and incredibly, only thirty trainees were signed-up during the whole of the following year. Yep, three-zero. Across the same period, 33,500 nurses left the NHS. Furthermore, factor in that one in three nurses are due to retire in the next ten years and you begin to get some dire idea of the scenario we’re all facing.
When quizzed as to why they’re leaving in their droves, nurses cite the main complaint as ‘working conditions’ exacerbated by staff shortages. Shortly behind is pay, which fell in real-terms by 14% between 2010 and 2017, followed by a lack of flexibility centred around childcare. And in direct response to the ‘too posh to wash’ accusation nurses also resent the lack of continued training: this specific development budget was slashed from £205m to £84m during the two years to 2018. The perfect storm has been created and Brexit is the more recent ill wind that blows.
Before the referendum, there was a net yearly increase in the number of EU nurses registering for work of somewhere between 4,000-8,000. Since the referendum, the number have been in freefall with a net reduction of more than 3,000 in the year to September 2017. And the rest of the world isn’t apparently taking-up the slack with recruitment from outside the EU dropping in response to a global shortage trained personnel. With the chronic short-term and fragmented nature of our planning systems, deemed ‘inefficient and unnecessarily costly’ (via excessive agency and nurse-bank use) by the National Audit Office, this looks set to continue for the foreseeable.
But, wait, not so fast Mr Remoaner, isn’t that a shining knight on his unkempt white steed coming over the hill? Ah, yes, the long-promised Australian points-based immigration system which both Home and Foreign Office immigration experts assure us that, because importing the individuals we need, and want, is both easier and cheaper, is the answer to our post-leave dreams. Now, is it just me that finds this haughty, self-centred ‘supply and demand’ policy (OK, we don’t know ANY of the actual details concerning specific numbers, targets, salary thresholds, employment sectors and language tests, and suspect we won’t until it’s post-election!) THE most singularly colonial-esque, arrogant and obnoxious intention yet mooted by Boris and his Tory cohorts?
Today, the NHS is demanding more foreign medical staff, invariably from countries, and communities, that can ill afford to lose them. But, hey, WTF, let’s throw money at the problem. And there we have it, classic short-term thinking. Tomorrow? We’ll cross that particular brick-built infrastructure project when we get to it as, in the meantime, we have our ‘fix’. The sooner we’re weaned off this particular addiction the better for all concerned.