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‘Disinvestment in services was never just about money’

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Stand back, I’m going to look on the bright side. Last month I mentioned the bursary but I think I got away with it – sorry Scotland, yes you still have one, and as a consequence a coherent staffing policy, but we have Michael Gove. Jealous right?

It is almost promising that new health minister Stephen Hammond, in what might be described as a cunning attempt to prove he is not as awful as Jeremy Hunt, has agreed to consider proposals to reintroduce financial support for nursing students. I don’t think that is overly significant at this point. For all we know, students may be invited to deposit body parts at the beginning of their degree in exchange for food tokens and be rewarded with the return of said organs over their length of service. Two years for a kidney, five for a lung, 12 if you want your knees back.

In the lead up to this debate Labour MP and former nurse Eleanor Smith described nursing as “approaching a crisis moment”, which I thought was a bit like me saying “I might be beginning to lose my hair.” Thousands of vacancies, students using foodbanks, high dropout rates, stress, mental health difficulties, we are so far past crisis we need a passport to get back there.

It is also worth noting that the RCN might have left their small terraced cottage over there in 1953 and proposed some plans that let the government think they might be doing something new rather than dressing something old up in a new frock, so well done RCN. Regular readers will know that if you were to take the RCN leadership of the last 25 years and lock them in a lift in a disused building, I wouldn’t mind remotely. But credit where it is due, here they are, doing something potentially useful.

Elsewhere, NHS England are looking to introduce new roles to both better target unmet and growing need and expand the recruitment well for graduates and nongraduates alike. I don’t mean nursing associate roles here, but specialist roles in schools to help young people with emerging mental health needs for example, and physician assistants to support primary care delivery. I realise there are nurses who will say “but we can do that”, but given the pressure on services why must nurses do everything? Why must their role be forever diluted when a broader workforce can make a difference?

So yes, this is me looking on the bright side. Not because it’s nearly Christmas, and not because I am doing that happy clappy, tub-thumping, patronising thing that self-proclaimed ‘leaders’ do – shouting “you’re fantastic! Just keep working yourself into the ground. Thank You!” But because amid the chaos of Brexit, political instability, social unrest and the threat of snow, I wonder if we might be coming to a shift in the political cycle that ‘austerity’ was at the heart of.

The disinvestment in public services was never just about money. It couldn’t have been. We’re more in debt now than we were when it started. It was, I believe (file me under conspiracy theorist whenever you please) about lowering or even fundamentally altering expectations.

The NHS, perhaps public services generally, have been fundamentally reset over the last decade so perhaps – and I mean perhaps – we get to rebuild now the way people do after a hurricane. Slowly, with uncertainty, using whatever is to hand.

I resent that. I think it a punishing way to impose an ideology on a society. I don’t trust the people who mediate it but I confess, I’ll take it. Relief, investment, overdue recognition? We can but hope.

Mark Radcliffe is author of Stranger than Kindness.

Follow him on twitter @markacradcliffe.

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