What kind of campaign do we need – a review of RCN report “Running the Red Light”

This review was written by a member of the 4:1 Campaign. I reproduce it here as its a valuable contribution to the discussion of what sort of strategy nurses need to effect change in the NHS.

Despite growing calls for mandatory minimum nurse-patient ratios, government cuts are reducing the number of nurses on the wards.

In 2013 three high profile investigations (Francis, Keogh and Berwick) identified inadequate nursing levels as a key factor in high mortality rates and poor patient safety. On the back of these findings, the RCN’s Running the Red Light report warns of a critical nursing crisis.

The report finds that 5,870 full-time equivalent nursing posts have been cut since May 2010 and an estimated 20,000 posts are being kept vacant. 27% of NHS employers have plans to further reduce the nursing workforce this year. By the government’s own reckoning there will be a shortage of 47,545 nurses by 2016 (with a worse case scenario of nearly 200,000 shortfall).

Some trusts are now recruiting but there are not enough student nurses to fill the vacancies. Since 2010 there has been a 15% drop in the number of student nurse placements. 22% of trusts are actively recruiting overseas with a further 9% exploring this option.

The report argues that trusts are not commissioning the universities to train the next generation of nurses. But there is also a problem of retention; many newly qualified nurses leave the profession within a few years, driven away by impossible working conditions.

Why Jeremy Hunt wants to cut our pay further (and what we should do about it)

Read this great analysis from Grumbling Appendix alongside this post for a full overview of what lies behind Jeremy Hunt's decision.

Jeremy Hunt, the Minister for Health, has spoken out against the 1% pay rise proposed by the NHS Pay Review Body for NHS staff, and has proposed that NHS staff should not receive any increase, and instead the money "saved" should be spent on "modernisation" of the existing pay structure.

The withdrawl of the pay rise is getting the most coverage, but the main issue is actually the "modernisation" which the government wants to implement.

We do not receive automatic pay rises

At present NHS employees, like many in the public sector, receive what are called increments. This is an incremental pay increase for every year of service, roughly 3.5% per year which moves you from the bottom of your pay band to the top, over a period of about 10 years. After 10 years service, you've reached the top of your pay band, and further pay increases only come with promotion to a higher band or when the government grants them to the whole NHS. Which they haven't for two years, and don't want to do now.

Proposal for a Health worker Website and Bulletin

This is a proposal for the creation of a cross-union health worker activist website and accompanying bulletin, as a necessary element in the development of organisation and politicisation among health workers in Britain. Its purpose would be to aid the development of a network of activists in the health service which can begin to act to transform our unions, spur action against privatisation and cuts, and lay the foundation for the unified national resistance needed to stop the destruction of the NHS as part of the Tory austerity project. 

The level of organisation among health workers in Britain is currently incredibly low. Despite huge attacks, resistance remains fragmented and none of the health unions are putting forward a comprehensive plan of how to reverse the privatisation, secure wage rises or stop the cuts. Health workers are increasingly politicised due to the blatant wage gouging and corporate thievery demonstrated by the government and private health systems taking over NHS services, but there are few organisations for this politicisation to flow into and serve as an outlet for action.

How many reports highlighting staff shortages does the government need before it takes the one concrete action that would make a huge difference?

An article I wrote for Our NHS, with some additional reporting by Caroline Molley.

A shortage of nursing staff has been a chronic problem in the NHS since its inception - and it is getting worse. 

The last few months have seen a stream of reports into poor patient care - first Francis, last month Keogh, and yesterday Professor Don Berwick’s report into patient safety. Each highlights the problem of lack of staff, particularly nurses.

Yesterday Berwick recommended that new guidance to protect patients against “the dangers of inadequate staffing” be set up “as soon as possible.”

It also emerged yesterday that Sir Robert Francis - author of the landmark report into mid-Staffordshire - is now calling for a “benchmark” level of staffing, “below which you cannot be safe”. 

Francis’s intervention is significant because his February report shied away from recommending mandatory minimum ratios of nurses to patients. He told concerned healthcare professionals and patients last week that he had seen evidence that persuaded him to revisit the issue.

We Defend Universal Health Care

Statement by NHS workers opposed to the government's plans to charge non-EU migrants for use of the NHS

We completely oppose the proposals from Health Secretary Jeremy Hunt to charge non-EU migrants for using the NHS.

When the NHS was created on 5th July 1948, one of its founding principles was universal health care. This meant that everyone in Britain had the same access to the health service. Nye Bevan explicitly refuted the argument that foreign visitors should not benefit from the health service funded by UK taxation.

Bevan wrote "How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors? What began as an attempt to keep the Health Service for ourselves would end by being a nuisance to everybody. The whole agitation has a nasty taste. Instead of rejoicing at the opportunity to practice a civilized principle, Conservatives have tried to exploit the most disreputable emotions in this among many other attempts to discredit socialized medicine."

Discriminating against non-EU migrants is racist. It is completely contrary to the medical ethics of clinical staff. On public health grounds, the proposals are a disaster. Health professionals do not want illness to go undiagnosed. They want everyone in Britain to feel encouraged to access treatment, in their own interest and in the interest of everyone's health.

The Conservative-LibDem Coalition's proposal to charge non-EU migrants for NHS care is a cynical attempt to divert people's attention from the real source of the problems affecting the health service. It is also the thin end of a thick wedge.

The real reasons why A&E departments are bursting at the seams

This is an excellent article by Dr Clive Peedell about why A&E services are in crisis.

By Dr Clive Peedell, co-leader of the National Health Action Party

A&E services across England are in crisis, with the Director of Patient safety at NHS England, Mike Durkin, admitting that patients are likely to have been harmed. Health Secretary Jeremy Hunt is trying to pin the blame on GPs. He points to contract changes nearly a decade ago which took responsibility for out-of-hours cover away from GPs. This argument is illogical. How could an event in 2004 cause a sudden crisis in 2013? And, obviously, it was not GPs who designed these changes but the Department of Health, influenced by private sector lobbyists wanting to privatise out-of-hours services.

This scapegoating of GPs suggests that Mr Hunt and the Coalition Government are desperate to distance themselves from blame for the NHS system collapse they themselves have caused.

In summary, there are five main factors which are fuelling England’s A&E crisis after a period of record satisfaction with NHS services just three years ago: massive cuts by successive governments of hospital bed numbers which mean patients end up stuck in A&E beds and can’t be moved onto wards; a lack of community care resources leading to hospital bed blocking; inadequate out-of-hours GP-replacement services; the use of unqualified staff at call centres to screen patients and advise if and where to seek treatment; and the closure of A&E departments. All form part of the overall NHS privatisation set out in last year’s controversial Health and Social Care Act.

UNISON National Executive Council Elections 2013 - Health Results

We lost.

That’s the short of it. None of the socialist candidates for Health seats on the NEC were elected. This is a blow, but to be expected given the level of activism UNISON encourages of its membership, how the union is run and the low horizons and expectations this creates, and the level of participation by members in the unions limited democratic structures. I’d like to thank everyone who put in the hard work leafleting hospitals and other NHS services to get the vote out. We did alright, and there valid reasons beyond our control for the result. There is also a lot we can improve on to make sure we stand a chance of winning next time. More on that in another post. Now for some analysis of the result.