The NHS isn’t really the subject of this blog, but once again I find myself compelled to comment. Mainly about the total failure of joined up thinking coming from the Government…
I used to work as a speech and language therapist. I stopped finding it remarkable when I used to go onto wards in the afternoon to find only one trained nurse in charge of 3 bays of 5 beds and 3 siderooms. But with no official guidelines as to what constituted a safe level of care, it was hard to make a case for more staff. The Mid Staffs scandal changed all that. The problems at the Mid Staffordshire NHS Trust shocked us all. Poor patient care, lack of dignity for vulnerable people, deaths which should have been avoided. There have been extensive inquiries, which found, among other things, that inadequate staffing levels played a significant part in the problem. Recommendations were made as to what safe staffing levels might be, and the Government told hospitals to increase the number of nurses on the wards accordingly.
Fast forward three years. The Government is now telling hospitals they need to cut back staffing levels, including nurses on the wards, in order to deal with huge financial deficits in most trusts. Patient safety and high standards of patient care can once again be sacrificed on the altar of balanced books.
Let’s look a little closer at these deficits. Far and away the biggest expenditure in the NHS is on staff salaries. And a significant proportion of the money spent on staffing is spent on agency staff; agency staff who are needed because there are not enough qualified nurses (or doctors) directly employed by the NHS to fill all the shifts required. I think it would be very revealing to ask why people choose to work as a locum or via an agency, rather than taking a regular job. But for whatever reason, there is a shortage of trained nursing staff available to fill posts.
Finally, let us consider one more piece of recent Government policy regarding the NHS. It concerns nurse training. Aha! No doubt this is a policy designed to encourage more people to train to be nurses and so eventually overcome staff shortages! Well, not exactly. It is the decision to scrap bursaries for student nurses and midwives, and instead replace them with loans, making it much more expensive for anyone wanting to train and therefore creating an additional barrier for anyone considering the profession.
Maybe this isn’t a failure of joined up thinking. Maybe it all joins up very nicely, forming a perfect pathway to privatisation, with a few lucrative deals for some along the way.