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Nurses' goodwill is being abused, warns RCN leader

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The leader of the Royal College of Nursing has pledged that she will “not stop” until ministers take decisive action to end the workforce crisis.

In her first speech on the opening day of this year’s RCN congress, chief executive and general secretary Dame Donna Kinnair said that the goodwill of nurses that has been keeping the system afloat is wearing thin.

“They must stop the rot and put an end to the workforce crisis in nursing”

Donna Kinnair 

She told an audience of 3,000 members in Liverpool that England must follow in the footsteps of Scotland and Wales, and put safe staffing accountability into law.

“We will not stop until people are held to account for the desperate shortages each and every one of us has witnessed,” Dame Donna warned.

“Politicians must stop short-changing the public,” she said. “They must stop the rot and put an end to the workforce crisis in nursing.”

Dame Donna said that without a government in Northern Ireland staffing shortages combined with low pay levels there represent a “public safety issue”. She said she will ask for public support ahead of a possible ballot on industrial action in the country later this year.

The RCN leader also called on the government to return the £1bn that was “catastrophically ripped out” of nursing education in England when the bursary was cut.

“Rather than only looking at the cost of educating and employing nurses, the government must think about the true cost – financial and human – of not doing it,” Dame Donna said.

“Employers, decision-makers and ministers with the power to change things should not let individual nurses take the blame for systemic failings,” she added.

Appointed chief executive and general secretary on a permanent basis last month, after carrying out the role in an acting capacity since summer 2018, Dame Donna used her speech to pledge to “fight” for the nursing profession.

“The goodwill of nursing staff is being abused and politicians must know it is running out,” she said. “I will not stand by while this profession is denigrated.”

Dame Donna also denounced the Brexit debate as having been “in the gutter for too long”.

“Politicians must resolve this drama and stop letting it dominate politics to the detriment of everything else,” she told delegates.

The RCN congress starts today and runs until Thursday.

Dame Donna Kinnair: Speech to RCN congress 2019

Isn’t it fantastic to be back in Liverpool?

This time I’m deeply honoured to be standing here as your new Chief Executive and General Secretary.

I want to begin with a sincere thank you. Members, you have put your faith in me ….and today, I will extend an invitation to each and every one of you, to join me in rising to the challenge ahead of us.

I feel the great weight of expectation. I’m immensely privileged and proud to be taking on the very best job in nursing -fighting for health care assistants, registered nurses, nursing associates and the future of our profession: the students.

So, what kind of chief executive and general secretary will I be? You have a right to know. Will she be more in the mould of this person or that person who’s gone before. Congress, let me say at the outset of this speech and my time in the job:

I will be my own woman. I got here by standing tall - even though I’m often told I’m vertically challenged, so not always literally - standing tall but proud and speaking as I find.

Never beholden to one group or area of work. But speaking truth to power and friends.

That’s how you do your jobs and it’s how you can expect me to do mine.

The roots of my career can be found in health visiting services…. And there’s nothing like going into people’s homes on their territory to make you see the person in the round.

It’s where I cut my teeth as an activist.

Twenty years ago, I saw the consequences of a fire in a tower block. A single mother with her baby jumped from a window. The baby was caught but the mother ended up paralysed. At the time that’s what they did…put single mothers in tower blocks.

We camped out in a local school until all those mothers were rehoused. I represented nursing staff, new to this country that were exploited by their employers.

I have tackled the practice of female genital mutilation.

I fought off loan sharks who prey on poverty stricken families…taking their family allowance books.

One of my staff sadly died giving care to a gang member.

To keep care givers safe, I went to the courts to fight for what was right then….and I will fight for what is right today.

Congress, these cases got me so angry…. I began training in law to fight these injustices.

But I never left nursing.

My combination of nurse training and law took me into child protection. And this is where I’ve spent a lot of my career - community work and community development.

I was appointed to this job last month but many of you will know I’ve been covering it since August last year.

After all the jobs I’ve done, I never really imagined I’d have an acting career, Congress, but after eight months acting general secretary, I was beginning to wonder.

If Game of Thrones wasn’t ending, our ambassador Emilia Clarke was going to sort me a new leading role altogether.

Congress, this morning, many of you joined us for the Annual General Meeting. The debate was full and frank and you rightly asked the toughest questions of your elected fellow members and the Executive Team.

I couldn’t give this speech without reflecting the difficult time since we met in Belfast.

It did get pretty bumpy for a while didn’t it? Contentious votes; departures from the top team; history being made. Yes, a rumour said that even Theresa May was beginning to feel sorry for the RCN!

There were weaknesses in how the RCN carried out its trade union function in particular. Recommendations were made, and I commit us again to enacting every one of them.

The College is changing. And through this, Congress, we are rediscovering our voice. That voice is the member voice. It is you our members leading the campaigns and lobbying.

There is a genuine commitment to change.

The RCN is each and every one of us.

It is members and staff, shoulder to shoulder, enriching one another with our expertise and passion.

Nearly a year on, we can say clearly and loudly together the Royal College of Nursing is stronger than we’ve ever been.

We held our nerve. Our mettle was tested and we are reforming, growing in numbers too.

Half of you have never been to Congress before…so welcome newbies.

You elected a new president and deputy in Professor Anne Marie Rafferty and Yvonne Coghill.

We have a new Council led by Sue Warner…and this week we open the process for Council elections again so I encourage as many of you as possible to consider standing. And when ballots come later in the year, I urge you all to use your vote.

New faces aren’t limited to the RCN either.

There’s a new head of the NMC….Andrea Sutcliffe

A new Chief Nursing Officer in England…Ruth May. And both are here today. Welcome.

There is a new way of thinking. By working together the challenges facing nursing become easier to conquer.

We didn’t say goodbye to the last CNO for England, Jane Cummings, who’s now chair of our own charity, the RCN Foundation.

The work it does to provide educational and hardship grants is genuinely inspiring.

The money raised by Emilia Clarke last year went to the Foundation and is being used for a new programme of specialist nurse education.

In the year that Learning Disability nursing turns 100, …as we saw at last night’s ceremony,… this field is shrinking.

So it’s especially important that celebrating and supporting colleagues from this area is a key focus for the Foundation work and the wider RCN.

Now, doing this job, there’s a question that comes up all the time…. Not always from members but people outside the RCN too….How do you juggle those two hats, Donna?

How does the RCN juggle what it does on the professional side with its trade union side as well?

Congress, you’ll have heard it too. Do you know what I find is the single best thing to reply with?

Your campaign for safe and effective staffing levels. No other single piece of work better explains the logic of one College with leaders that have professional and trade union expertise.

Getting this campaign right is the most important thing we can do to improve standards of care for patients…and support our members on the frontline.

The RCN might have two arms, but it speaks with one voice.

The challenges are coming at us thick and fast, from all sides. So it has never been more important to stand together, as one body, working for nursing.

So Congress, you ask me my number one priority for the job and I tell you it is this: to get meaningful legislation and investment in every part of the UK to put an end to the nursing workforce crisis.

We… you… will not stop until people are held to account for the desperate shortages each and every one of us has witnessed.

Politicians, you have got to stop short-changing the public.

Every professional is accountable for the care they give.

….There is nothing worse for a health care professional than knowing you’ve made a mistake or weren’t able to give the best possible care.

But there’s now a terrible culture of pushing responsibility and accountability down to the frontline individual professional…and away from the very top – the bosses, the employers, the decision-makers, the ministers.

They need to change the way they think. Rather than just looking at the cost of educating and employing nurses and support workers, the Treasury and other finance departments must think about the true cost ….financial and human… of not doing it.

The World Bank is clear that investing in the health and care workforce protects population health and supports the wider economy.

Getting this right makes a difference to support workers too…who would see the correct skill-mix and proper workforce planning.

Those with power, money and authority to change this are too often found unwilling. All too happy to let the individual take the blame for failings that are genuinely systemic.

Congress, we have to stop the rot.

Each country is in a different place on this journey.

Two weeks ago in Scotland, the legislation Nicola Sturgeon first promised to you here at Congress cleared its final parliamentary hurdle.

The work of the RCN members made the legislation what it is. You pushed to extend the scope of it into social care and give it the teeth it really needed. And I know you will keep a close eye on things as the implementation begins.

In Wales, we’re already working with Health Boards and Trusts to support implementation of Europe’s first staffing legislation…and monitor its progress with a toolkit designed by our reps. Members are holding the Welsh Government to its pledge to make sure it delivers on its promise to extend that Act.

In the absence of any form of government in Northern Ireland, campaigning for safe and effective care is uniquely challenging.

But do you think our colleagues have let that stop them? No.

They’ve been part of devising ‘Delivering Care’ a framework that supports safe care in hospital and community settings. And are taking a public campaign around the country right now on both safe staffing levels and fair pay.

Members there deserve our thanks, admiration and support for the tireless way they campaign in the most difficult political environment imaginable. Once a Government is in place, I know our members will be the first at their door.

The RCN’s campaign in England has been running for several months and is being designed like no other campaign the College has tried before.

Members are not just the foot soldiers this time but the campaign’s leaders, designers, tacticians and strategists.

In just a matter of days, 10,000 of you sent long, detailed emails to NHS officials on what must change in England. But this was the gist of it….

Government, make people accountable in law for this situation and put back, into nursing education, the money you so catastrophically ripped out.

Every day at Congress, we’ve got lunchtime fringe events on the campaigns, reflecting on all countries. I know everybody’s competing for your time this week but I’d urge you to try to get to one of these sessions.

That’s the best thing about Congress, isn’t it? It’s the only time of year when thousands of us get together - to debate, to learn, to plan. Even to party a bit.

But when we put our mind to something, Congress, who would dare stand in our way. Let’s think about the debates we had last year.

You condemned transferring staff out of the NHS and into limited companies. After that debate, and more RCN lobbying, the NHS in England began to curtail the practice.

If unsatisfactory pay and conditions drive people out of the NHS, then further undermining them exacerbates the problem. Where they transfer staff out of the NHS, you have my word we will keep opposing them. It is quite simple: wholly-owned subsidiaries…wholly unacceptable.

In Belfast, you called out the Government for its £400 immigration health surcharge and want it waived for healthcare workers.

You pay your taxes, you give your all to the job ….and yet they want extra money off you for the very same services you run. It is heartless, divisive and downright disrespectful.

That battle is not over.

Your debate gave me the ammunition to go into Parliament this year and tell them straight.

You were angered by the disparity in education funding and this year you will have seen our fantastic student members, proudly wearing their blue t-shirts.

Please support the Fund Our Future campaign for investment in the next generation of nurses no matter where in the UK they study.

In Scotland, members won an important victory to increase the value of the bursary - rising to over £8,000 for the new academic year. Ministers in England must take note.

The students went down to Westminster and I saw MPs queuing up to agree that scrapping the bursary in England was wrong.

And you know what?

Ministers know it too.

They know it. They just don’t know what they’re going to do about it.

Well we’ve told them how much money is needed and the Government Spending Review on the horizon is the opportunity to right this wrong.

You debated the dangerous conditions in prisons…and the widespread media attention your stories received inspired a new alliance with other unions to keep raising awareness.

After Congress last year, we joined forces with Safe Passage UK and others to take forward your campaign ideas on unaccompanied child refugees.

And just two months after you voted to decriminalise cannabis for medicinal use, the Home Office announced the law would change.

That is the power of Congress.

And for how many years did we all stand here and say it’s time the Government cracked down on those who threaten, abuse, assault our people?

Well, this year, we made it happen in England and Wales.

New laws you secured mean that custodial sentences can be given. And it isn’t just those of you working in emergency care - your campaigning, led by the safety reps, got it extended to all areas of care too.

Real progress, real challenges, real solutions.

Colleagues, well done.

Last year, you said the top priority for the College must be education and learning. ….And we’ve spent the year expanding our offer.

So high was the demand for our new course on Infection Prevention Control, we’re soon running it again and giving more members and non-members this opportunity.

Whether you’re a support worker or senior nurse, our leadership programmes will support you as tomorrow’s leaders…

…Thousands of you are members of forums covering all those areas and more. And the ideas and work they drive has to be seen to be believed.

I cannot cover all of them but will mention just a few.

Our Children and Young People’s experts have focused on new resources around sepsis detection.

The RCN proudly led the development of the first intercollegiate adult safeguarding document with 25 other royal colleges, covering the whole UK and stretching far beyond the NHS. And our equivalent work for children, has received praise and recognition from around the world.

Earlier this month, we held a week of action to raise awareness of glove use and protecting your hands. When a thousand professionals develop work-related contact dermatitis every year, it’s important to get this right.

We held live and online events on best practice and, members, these are free resources for you and your workplace.

This week, we’ll release yet more world-class guidance, analysis and support.

We have collaborated with the Queen’s Nursing Institute to expose what has happened to district nursing services in recent years and offers a way forward.

And today we’ve released a report on how we can close the 20-year gap in life expectancy for people with mental illness - largely caused by the neglect of their physical health. Another example of nursing setting the agenda.

You have led suicide awareness campaigns with a recent focus on BAME teenagers and attempts to reduce the use of the Mental Health Act in those communities.

Our Network is championing a career in this field and we want full recognition of our work in the government’s review of the Act.

Congress, by the time we meet next year, the RCN and our colleagues on NHS Staff Side will be ready to enter into fresh talks on pay levels with the Government and Employers.

The three-year deals we have at present will be in their last year. It will be the moment for a set of fresh faces from the RCN to make our case for why the pay of nursing staff, no matter where you work, must be boosted.

Whether you’re in the NHS or the independent sector, the RCN fights your corner.

We have recognition agreements with over thirty independent sector organisations, including some of the very largest, and we undertake annual pay bargaining on behalf of these members. And where agreements aren’t in place, we provide advice on negotiations.

Social care has more beds than the NHS and is the largest nurse-led service in the country. But the neglect of care services and the vulnerable people who need them remains an outrage in too many places. We are giving all the support we can to members working there. In some parts of the country, the RCN is even running an innovative ‘adopt a care home’ programme for senior nurses to share their knowledge.

Your powerful voice has been sought by the all-party parliamentary panel looking at social care funding and Welsh members went in person to the Assembly to share their expertise.

Lobbying by the RCN forced the Government to make funding available to several independent sector employers in England too. Places where our members are on Agenda for Change, and provide services to the NHS, must be paid increases in line with the NHS. Without your work in this area, employers would have succeeded in taking members off those Agenda for Change contracts.

That’s the difference we make.

Congress, I’ve been a proud union member for 35 years and leading our fight for pay, terms and conditions is as much my mission as what we achieve on the professional and clinical side.

Be in no doubt at my belief in what we can achieve by the strength of our common endeavour.

I will take personal responsibility for any talks or formal negotiations we enter.

No ifs, no buts; no caveats or qualifications.

Colleagues, I will work closely with the members you elect to the Trade Union Committee.

And let’s be clear: if you the members want it, industrial action - strike action - must always be on the table too.

In just the last few months, RCN members have led the way on this front.

Pay of nursing staff in Northern Ireland is falling further and further behind our colleagues in the rest of the UK. 2,500 jobs are vacant. The agency bill is soaring.

Congress, this is a public safety issue which we as nurses will not be silent about.

Members there are touring the country this month saying that in no uncertain terms. We’re asking for public support for any forthcoming ballot on industrial action that the RCN Council approved.

This is new territory for the RCN, as Sue explained this morning.

This year started with RCN members on Jersey rejecting their pay offer.

RCN Council gave unanimous backing to an application for an industrial action ballot.

The march and rally that followed saw members travel to Jersey to show support.

It should not have taken these steps to get the new and improved offer. But without that show of strength, we simply wouldn’t have got it.

We are learning from other unions - including our colleagues in the Republic of Ireland.

This is what we can achieve together when members get active in the College. And it is a priority for me to overhaul the way we communicate with you and engage you in our work.

But there are core parts of the RCN’s offer to its members where the figures already speak for themselves.

Last year, the RCN’s legal team managed to recover a staggering £7.5m in compensation for our members – that’s more than double the amount the year before and covers both employment cases and personal injury.

And from this year, that personal injury offer isn’t just there for you but your friends and family too.

This year saw a long-awaited victory on indemnity cover in England and Wales.

It was 4 years ago we brought the head of the NHS to the RCN to hear our GPN’s request to fix indemnity in General Practice.

We worked with Government on a new scheme for those of you working there - no longer will you be left at the mercy of your employers’ arrangements nor expected to cover it yourself.

The support given to members in a difficult period, by our lawyers and our reps, is so strong that the statistics show something stark.

Nurses represented by the RCN in an NMC case are more than 20 per cent more likely to be told there is no case to answer than if they had other representation or no representation at all.

Now, members who use that service leave countless thank you messages…..But there was one shared with me recently.

It was sent in late one night. Let me read you a little bit:

…”Whilst I knew I had nothing to be concerned about, the experience was horrendous. There were times that I was going to give up on my nursing career, I lost my confidence. Thank you for boosting it and having faith in me.”

So I want to pass on her thanks and those of countless others to all our reps, stewards and experts who go to extraordinary lengths to support their fellow RCN member.

Your work, often unseen or without much reward or recognition….but I know how much of it you do….and I offer you my personal thanks.

It’s the bread and butter of the RCN and the essence of what it means to be part of this family.

The nursing family is truly global. Through all of our international relationships, alliances and networks, we are proudly carrying the call not just for legislation but for funding, education and nurse leadership.

Next year, Florence Nightingale turns 200. No, she isn’t still alive. But we will mark that moment with the international community.

The World Health Organization has called 2020 the ‘Year of the Nurse’ and is preparing a significant piece of work on the state of the workforce globally.

This is only happening - for the first time in a decade - because the WHO rightly brought back the job of the Chief Nursing Officer.

Nurses the world over are getting organised. And it is vital that we keep British nursing on that international stage especially when you know what is happening.

I almost wasn’t going to even mention it. Brexit - what is left to say?

Congress, no matter your view - and I respect each and every one of them - this country has got to raise the standard of its political debate.

It’s been in the gutter for too long.

This tweet a few weeks ago summed up my thoughts.

“We have less than six months to radically change the way we debate Brexit.

….I’d like to hear more female voices.

….I’d like to hear more ethnic minority voices.

….I’d like to hear less Latin and less poetry.

….And what’s more, I’d like to hear all the non-evidenced assertions challenged.”

Politicians, get your priorities in order.

Resolve this drama and stop letting it dominate politics to the detriment of everything else.

This single issue politics must go.

Wherever in the UK they are watching us this week, politicians will be in no doubt at the strong voice of nursing in the UK.

It’s not for nothing that we are the most trusted profession.

Those at the bottom of that list can’t speak down to us.

Your goodwill, so abused, is running out.

The RCN shouldn’t have to battle to be heard.

Congress, we might not be angels. But we are certainly spirited. ….Underestimate us at your peril.

This College and our profession deserves a level of respect that has been missing for some years.

And I will do all I can to see it restored. Not standing by while our profession is denigrated.

Congress, the stakes are high. But so’s our determination. So, what are we waiting for? Work together and we will win.

Thank you.

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