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OPINION

Kathryn Anderson: 'The damaging reforms to our NHS need to be stopped'

The reforms are considered by many to be a guise for the privatisation of our health service, says Kathryn Anderson

Kathryn Anderson

How can we possibly provide safe care when there isn’t the right skill mix or number of nurses available?

I recently overheard a nurse saying, “NHS reform - that’s a good thing, isn’t it?” to a colleague. I was concerned to discover that neither of them appeared to understand much about how these reforms would affect them or, most importantly, their patients. So what are the reforms about? That’s the billion pound question. Or, in the case of the NHS budget, the £109bn question.

So, what do we know about the NHS reforms and how they will affect you, me - all of us? Regardless of whether we work in the NHS or we are users of the NHS, we will all be affected.

Let’s start with a definition: reform is to make changes in (something) in order to improve it, according to the Oxford dictionary. That sounds reasonable enough. However, if the NHS needs to be improved, these reforms are not the answer.

The NHS was created on 5 July 1948 under minister for health Aneurin Bevan. Without doubt, there have been many reforms of the NHS since that time, most of them needed to ensure the services provided to the population of the UK remained relevant, appropriate and current. Numerous articles, books and theories have been published about the pros and cons of each of these changes. However, never has there been such an incredible out cry of dissent about NHS reform than there is at this point in its long history.

What is it about the latest round of reforms under the Health and Social Care Act 2012, which came into force fully on 1 April that has caused so many learned and knowledgeable people to be so concerned?

In short, it is because these reforms are considered by many to be a guise for the privatisation of our National Health Service. Did you know that with the implementation of the act the health secretary no longer has a “duty to provide” comprehensive national health services, only a “duty to promote”? This is something so fundamental that it effectively amounts to the abolition of the NHS.

The removal of the “duty to provide” healthcare is only the beginning. Most telling is the recent article published in doctors’ journal The Lancet, whose author writes “one might be forgiven for thinking that the current coalition government views the NHS as a failing bank or business. This stance is one of the most cynical, and at the same time cunning, ways by which the government abdicates all responsibilities for running a healthcare system that has patient care and safety at its heart” (17 August). Call me old fashioned, but when a restrained journal like The Lancet uses such language, we should all be worried.

What then does this mean to you and, most importantly, your patients? As a clinical nurse and a manager, my priority is always my patients, with my team members coming a very close second. The first thing that is obvious to me is the reduction in qualified nursing staff in clinical areas. According to Nursing Times (1 March) around 4,000 nurses have lost their jobs in the NHS since the coalition came to power. How can we possibly provide safe care when there isn’t the right skill mix or number of nurses available? Clearly, we cannot.

The NHS reforms will continue apace and the changes will become more dramatic. Before 1948, people lived in constant fear that they or their children would become ill. Unless these damaging reforms are stopped or reversed, those days we thought were gone forever will return.

If you do nothing else, please read, learn and understand what’s happening to our NHS.

Kathryn Anderson is lead nurse at a Foundation Trust and executive member of the National Health Action Party

Readers' comments (27)

  • tinkerbell

    Kathryn,
    Thank you for speaking out about this. I found the article below from a doctors perspective very interesting. I agree with you that if we do nothing else let's at least make the effort to try and understand what this could mean to us all as a society. For those who want a fair society without descrimination on ability to pay there is no neutral ground in such a major moral crisis. We have a duty to inform ourselves because this coalition isn't going to be honest about the risks involved to our nation. Fairness to all whether rich or poor. We shouldn't need to be wealthy to be healthy.We have come so far only to have the progress we have made as a fair society without conflicts of interest sabotaged by an unscrupulous few.
    http://www.opendemocracy.net/ournhs/guddi-singh/asleep-on-job-englands-young-doctors-and-nhs-reforms

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  • it has been maintained by many of the healthcare experts that the NHS was previously functioning well in its current form (pre the new coalition) and such radical reforms were not required.

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  • Well said Kathryn.

    It is important to point out that the Health and Social Care Act 2012 relates only to England.

    The NHS in Scotland was created as an administratively separate organisation in 1948 under the ministerial oversight of the Scottish Office, before being politically devolved in 1999. Health and social care policy and funding remain the responsibility of the Health and Social Care Directorates of the Scottish Government. I think the same applies in Wales and Northern Ireland. What has happened in England should serve as a salutory lesson to us all about how easy it is to completely destroy the health service in the short lifetime of an unelected, cobbled together government. Sadly, those who have stood by doing nothing or willingly jumped on the bandwagon, are equally culpable. Why didn't anyone do anything?

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  • Anyone who has been in the nhs for a period of time would not believe that any real nurse would say that reform is a good thing. The nhs has been the most reformed body in the country. Nursing has jumped on to every single bandwagon launched by whichever government usually with the senior nurses backing the changes. It is this behaviour that has lead to the current position where the nhs has been outsourced to dodgy companies, and perfectly good hospitals are at risk of closure or severe downgrading.

    Nursing in particular has sat on its hands, and even allowed itself to be taken over by non nurses, the nmc is not a genuine self regulatory body with so many government appointed members, and a code of conduct that is more equal for some than others. Nursing needs to get political, and this needs to start at the top with a change in the nmc, and moving on to education and then to the manner in which nurses are managed in hospitals.

    The nhs needs reform, but in a way that returns it to management by clinical trained staff rather than the current pen pushing bean counters.

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  • Yes, I agree with Kathryn.

    These 'reforms' are corrupt and designed to privatise as much as possible of the NHS until there is no service without some profiteering fat cat creaming off public money for their own benefit.

    Private medicine denies access to those who can't pay or can't get insurance. This is inherently unfair. The US system is morally repugnant, unless you think the only value of health care lies in the amount we are prepared to pay for it.

    Far from making the NHS more efficient or cost effective, it has fragmented services and clinical communication and the costs of the bureaucracy needed to support a purchaser/provider split represent a serious loss of taxpayer's money which should have been spent on direct health care.

    NHS services are under constant threat and we have seen the effects of such 'reforms already in the Mid Staffs debacle where managers and some staff completely forgot what they were employed to do. We've also seen services with unsafe skill mixes and a complete failure of any proper workforce planning.

    There isn't any massive imperative to reduce healthcare costs at the expense of fair access, patient safety, living wages or your job security. It's all an attempt to reduce public services and make sure private health care can pick off services they want to deliver for profit.

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  • What did this lady do about all the clinical job losses that occurred in her "Trust" ?

    All these job losses by definition will have been supported by the "trusts" Chief nurse !

    http://www.bbc.co.uk/news/uk-england-london-12992735

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  • michael stone

    Kathryn has written very clearly - and someone (I hope a future Labour Goverment would) needs to reinstate the Health Secretary's 'duty to provide' healthcare. A duty to 'promote', could be virtually meaningless (which is probably why they changed it - so the thing could falla part, and they could say 'it wasn't down to us - it was down to CCGs !').

    However, as an aside but one of pertinence here, it isn't obvious that nurses can actually change the NHS. When the NHS was established, the goverment of the day consulted with the doctors (whose power they were worried by) but not with the nurses - even if nursing is now an independent profession, it still looks (from my lay observer position) as if what medics say counts for something (but clearly not enough re this current goverment's behaviour) but what nurses say counts for almost nothing ?

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  • michael stone | 20-Dec-2013 2:46 pm

    Very true.

    In 1982 nurses stood up against Thatcher's government and went out on strike. They won a substantial pay rise. Before and since then, nurses have consistently failed to capitalise on the potential influence they have. There are over half a million nurses in this country. Unfortunately, most are sheep happy to be led by ineffectual puppets.

    It is a problem within the uk. Nurses in other countries have been prepared to take action, vey successfully. I suspect that nurses here know that by doing nothing, patients suffer, so it sickens me when they use the excuse that patient care will suffer if they take action against the government. It's cr*p and they know it. What is going on in the NHS is what you get when you do nothing to stop it. How much more do they want their patients to suffer? It is shameful.

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  • The stupidity of some of the posters on this forum is beyond me: who do you think it was that planted the seeds of privatisation in the NHS? Who was it that devised Foundation Trusts - which literally laid the foundations for the reforms we're now moaning about? Which government was it that left many NHS Trusts crippled with debts for unserviceable PFI contracts and for their plat de resistance -before being turfed out - gave us Mid-Staffs?

    I'll tell you who it wasn't: It wasn't the Tory party, it was your beloved Labour Party.

    The only difference between Labour and the Tories (when it comes to the NHS) is the Tories don't pretended to be against private companies providing NHS services whereas Labour do.

    Labour might claim they'll scrap this or stop that were they to regain power, but remember: there are more ways of killing a cat than choking it with cream!

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  • Anonymous | 21-Dec-2013 5:54 pm

    It is obvous there is quite a lot that is beyond you. The ability to accurately reflect history and form a rational conclusion or coherent argument being prime among them. I would expect nothing less of a Tory.

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  • the tories want everything privatised, it makes more money for thier buddies in the private sector, who then give money to these eton idiots

    they dont give a jot about the NHS

    we are not even getting a measly 1% pay rise, but its ok there getting thier 11%

    the quicker we get these morons out and this heath act repealed the better

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  • There's no real difference between the two main political parties: they all want to introduce competition into healthcare.

    The Conservatives are upfront about it, Labour choose to try and disguise what they're doing to ensure the flow of union money doesn't dry up.

    It was Scottish labour MPs that voted-through Foundation Trusts in England; check Hansard if the truth is just too hard to bear.

    I wouldn't trust either party with the NHS.

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  • Anonymous | 22-Dec-2013 9:38 am

    "The Conservatives are upfront about it.."

    That'll be why they promised NO TO DOWN REORGANISATION TO THE NHS and then set about doing just that, eh?!

    Don't even start about Scotland. The country that had policies and laws imposed upon it for years by an English Tory government despite the fact that the Scots did not elect a single Scottish Tory MP. Didn't mention that did you? Check Hansard if the truth is just too hard to bear!! If I were them, I'd vote to get away from us for their own safety.

    No party is upront about their plans for the NHS. I trust none of them. But Tories are the worst. Thatcher introduced the business model into the NHS and began privatisation by putting out housekeeping services to tender. In the 1980s, she had plans to dismantle the welfare state and NHS, denied it for years and now the documentary evidence has come to light to prove the lies and deceit of your beloved Tories. You are all the same and defending any of them is reprehensible!!

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  • tinkerbell

    http://www.telegraph.co.uk/health/healthnews/8779598/Private-Finance-Initiative-where-did-all-go-wrong.html

    The above article might help out with who did what to whom but the bottom line is that we, the public, have been well and truly taken to the cleaners by the private sector, (New) labour and condems. Why should we have any loyalty to any party who have squandered our trust in them to do the right thing on our behalf. As George Galloway succinctly called them '3 cheeks of the same arse'. They're all at it!

    Do we really now trust private providers to take over NHS healthcare too given their track record so far?

    At the next election we need to vote wisely if we really want to save what's left of what was our nhs.



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  • A great piece and some interesting comments. An apolitical nursing workforce means that we moan, but collectively allow the gvt to do it's worst whilst moaning from the sidelines. With some leadership from our unions we could stop this....with leadership.

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  • Anonymous | 22-Dec-2013 10:47 pm

    Agree totally about the leadership. However, the union membership has a very poor record in showing any sign of being prepared to vote for and support action. Nothing less than organised, sustained, collective action will do.......but it would work.

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  • Anonymous | 23-Dec-2013 0:03 am

    I'm sorry, but I don't buy this 'blame the union membership' nonsense. I blame the union leadership for their saccharin sycophancy in rubber-stamping all the deleterious changes to our terms and conditions etc.

    I've witnessed first-hand how useless the RCN is when 'fighting' for their paid-up members T's & Cs for a soon-to-be privatised NHS service. I can't put into words just how lacking our representation was.

    Strong, decisive leadership encourages an engaged and active membership!

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  • Peter Carter came and spoke at my trust a few years ago when the Government first stole our pensions ( they'll be back for the rest soon to reduce the highest tax band back to 40%), the man doesn't give a chuff, a manager with a nurses qualification rather than a nurse with a managers qualification. Already got an OBE, this QUISLING is just waiting for his peerage. Doesn't give a toss about US.
    Remember when they said the pensions HAD to change because the country was in so much debt ( there is a big difference between £1.2 trillion debt and $1.2 trillion deficit btw). Not a hoot from the RCN because it{ the reforms} wouldn't affect those within 10 years of retirement ( like good old Pete) i.e. > 50% of the nurses at the time.' Don't agree with the reforms? We'll make them affect all of you!' ' Ok, we'll pull the ladder up!' said the cowards!
    Peter Carter is a gamekeeper with poachers clothes on.

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  • Anonymous | 23-Dec-2013 2:42 pm

    "I'm sorry, but I don't buy this 'blame the union membership'....."

    February 2012
    Results of ROYAL COLLEGE OF NURSING MEMBER VOTE:

    Yes, I want the RCN to accept the
    Government’s pension proposals .................................... 24,533
    No, I want the RCN to reject the
    Government’s pension proposals ................................... 41,009

    Voter Turnout: 16.7%

    Less than one fifth of the MEMBERSHIP could be *rsed to vote!!! Unison had only slightly better turnout.

    I do not defend the actions and inactions of the leadership, but they are elected to their positions by the MEMBERSHIP.

    That is the problem with your type isn't it? It is always the fault of someone else. Now give yourself a slap in the head and stop talking nonsense. Get off your *rse and do something. Bet you don't.

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  • Anonymous | 24-Dec-2013 11:01 am
    i'm in unite and i went on the day of action in 2011 over the pensions issue. most of my colleagues are in the rcn. so there were only a few of us went on strike. even fewer went on an organised march or stood at the hospital gates with other nhs colleagues. most striking nurses stayed at home or went shopping.......because it was raining! i also remember the rcn ballot and thinking that finally the rcn and all their members would back us. look what happened to our pensions!!
    if the rcn is so bad, then why do people continue to be members?? we are all responsible for our own actions. nurses are good at moaning, blaming everyone else and behaving like sheep. the leadership are pants but it's the membership who keep them there. i can't believe that they tolerate carter and his henchwomen, but they do. maybe they just keep them to deflect the blame away from themseves.

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