On the same day that Jeremy Hunt was reappointed I gave an interview on LBC radio regarding the staggering drop in the number of applicants for nursing jobs from the EU since the result of the referendum.
At the end of the interview I was asked if I thought Jeremy Hunt should have been sacked. My view was that he should not. All this would have done is to give many people some short-term shadenfreude and also some air cover for the new secretary of state to plead for time whilst he or she gets on top of their portfolio.
“I cannot envisage a queue of Tory MPs lining up wanting Jeremy Hunt’s job”
By keeping Jeremy Hunt in post the focus remains on the state of an NHS under severe pressure during his tenure. It also gives Jeremy Hunt some muscle power with his cabinet colleagues to demand more money for the NHS; he is best placed, in the privacy of the cabinet room to say that flat lining the budget of the NHS is the main reason the NHS is in such a precarious position. If I was Jeremy Hunt I would say ’give the NHS the money it needs or I’m off’. I cannot envisage a queue of Tory MPs lining up wanting to have his job.
Following my interview, a number of people contacted me to express their surprise at my comments on Jeremy Hunt’s position and to seek my views on what I think should be on his agenda for the health service. I have five priorities on my list.
The first thing would be to have an honest assessment and understanding as to the current state of the NHS. Playing with figures and statistics will not reassure the public, let alone the staff who hold the service together.
“It is indefensible to starve the NHS of the funds it so desperately needs”
Secondly, as already stated, get the cabinet to put money into the NHS. We are the sixth wealthiest country on the planet and it is indefensible to starve it of the funds it so desperately needs.
Thirdly, scrap the Agenda for Change NHS pay system. It has had its day and is far too rigid a structure. By adopting a more flexible approach it will allow the bespoke targeting of difficult to recruit and retain groups. This will not only help with the crisis in retaining nurses but also some other disciplines. A pay award now will do so much to help ameliorate the sense of being undervalued.
Fourthly, workforce planning. It has been lamentable for years. In some respects I have sympathy for ministers, as they appear to have been continuously let down by their civil servants and others who should know better. It’s all very well saying how much you admire nurses but have the same people been prepared to say to successive secretaries of state that cut backs in nurses will stack up long term problems.
For example, in 2004 we had 12,000 district nurses in England alone. This has now dropped to 6,500. A drop that commenced when Labour were in power and continued during the coalition and then under the last Tory government.
Have the leaders of nursing been bringing this to the attention of the six holders of the office of secretary of state for health during this period? If they have, fair play to them, but if they have not, then why not?
A further example is the cut back on student nurse commissions. In 2011, NHS London cut its number of nursing posts by 500. This meant there were just 2,000 new nurses being trained each year in the capital which was barely enough to keep pace with rising demand and year on year retirements.
London is now suffering badly as a result of those cut backs. Were they brought to the attention of those in power?
Finally, EU workers. It is only a matter of time before an announcement is made that workers from the EU who are already here will have security of tenure and that we will welcome further applicants for many years to come. Without this announcement the crisis in the shortfall of nurses will only deepen so why not get on and make it now?
A failure to do so may result in a change of health secretary but at what cost to the NHS?
Sacking Jeremy Hunt may give comfort to those who will have the short-term glow of a sacrificial head, but it will be unlikely to lead to a lasting solution for the NHS.
Dr Peter Carter OBE, former chief executive of the Royal College of Nursing