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'If we are edging closer to a US model of healthcare, no one is going to rescue nursing'

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In the second of a series of blogs about how contemporary events in politics are affecting nursing and the work nurses do, Chris Hart reflects on the collapse of the Labour vote, the NHS crisis and the implications for nursing, with a few thoughts about the latest episode in the Donald Trump saga

With Brexit threatening to derail everything her government wants to do, while the vicar’s daughter has to prepare for making the horror show that is Donald Trump her new best friend, you’d be forgiven for thinking Theresa May would welcome a little distraction. But, another winter, another NHS crisis. And this year’s version sees Simon Stevens, its chief executive, effectively accusing her of lying about its funding, noting it receives less than she says it does and will actually see a cut in real terms spending in 2018-19.

A falling out like this always ends in tears and it’s far more likely Mr Stevens will be taking a long walk into the winter snow than the Prime Minister. But it gives a far more accurate picture of Ms May’s attitude to our health service than her fine words about mental health – which, of course, came with no additional money attached.

Meanwhile the Red Cross describing 425 people having to stay on trolleys in hospital corridors a “humanitarian crisis” further engaged her. At least the leader of the Labour Party gave her cause for cheer.

“Corbyn provided contradictory messages on immigration”

Jeremy Corbyn and his close advisors decided January was the perfect time to relaunch him as a populist leader who will reach out to the British people in the same way he has Labour’s membership, making it the biggest political party in Europe. Why not? There’s nothing else happening politically at the moment.

As it was, the ‘relaunch’ ended in confusion, with Corbyn providing contradictory messages on immigration and holding down senior exec’s pay. Which, to the Tories’ delight, took the NHS off the front pages, at least for a couple of days.

Labour’s incompetence was matched only by its timing. A half decent opposition would have the government on its knees at the state of our healthcare system. But, then, it has missed similar opportunities on the failure to fund social care, the shambles of George Osbourne’s last budget, tax credits and, of course, Ms May’s ongoing problems in developing a coherent policy on Brexit.

“Andrew Lansley’s disastrous reorganisation and the austerity measures that created the lowest funding levels the NHS had endured for years”

It’s all very well for the Lib Dems to ring their hands now, having ensured the Coalition could both legislate for Andrew Lansley’s disastrous reorganisation and the austerity measures that created the lowest funding levels the NHS had endured for years.

And what of the Conservatives? The decision, by Ms May in her last reshuffle, to keep Jeremy Hunt as Health Secretary seemed perverse given his handling of the junior doctors’ dispute and NHS crisis. But this multi millionaire son of an Admiral is a thick skinned survivor, coming through scandals related to his dealings with the Murdoch media empire in 2012, and having to repay over £9,000 in parliamentary expenses. He has the remarkable ability to talk of the NHS’s problems as if they’re nothing to do with him, always the embodiment of reason. If the English NHS does follow the political shift towards America, Hunt has the temperament to shrug off the political flak and keep going.

“He has the remarkable ability to talk of the NHS’s problems as if they’re nothing to do with him”

Moreover, having already seen nurses’ salaries fall in real terms by 14% since 2010, his determination to enforce the junior doctors’ contract could relate to further plans for nursing. The prize from withdrawing nurses’ unsocial hours’ payments or even ending incremental rises would far outweigh the financial benefits, and be much easier, were a precedent set by changing junior doctors’ contracts.

Seen in the context of this kind of paradigm shift, ending student nurse bursaries makes perfect sense. The idea that thousands of brilliant potential students are queuing up to saddle themselves with tens of thousands of pounds of debt is ludicrous. But running a cheaper service with far fewer registered nurses overseeing the work of associate nurses and HCAs, similar to the American model, fits. As does dismantling nursing structures at a national level and allowing criticism of an underfunded NHS to mount while the private sector is encouraged to take up the slack.

“Leaving the single market and ending the free movement of people will spark an exodus of EU citizens working in the NHS”

If the Tories get over the impending constitutional crisis, enact Article 50 and actually leave the EU, nursing faces difficult questions. Will the Working Time Directive and our trade union rights – already among the weakest in Europe – survive? Will EU citizens be expelled? Leaving the single market and ending the free movement of people will spark an exodus of EU citizens working in the NHS. How would that vacuum be filled? Is the wider pool of NHS staff from outside the EU safe?

Both May and Trump claim “the people have spoken” and they have a popular mandate to do what they like. But less than a third of the UK electorate voted to leave Europe and Trump lost the general election by almost 3m votes and would have lost the Electoral College had a mere 72,000 voters across three states voted for Mrs Clinton.

But one thing seems certain. The Labour Party will play little part in this debate. It’s no accident its collapse coincides with Brexit. Rather like the Democrats in the United States, its relationship with its working class base is broken. Similarly, Labour’s trade union partners have suffered a dramatic fall, both in numbers and influence.

“With so much at stake, a viable, convincing political opposition is essential”

Corbyn’s election as leader was a symptom of Labour’s collapse rather than the cause. His ideas, particularly his anti-austerity stance, resonate with many feeling disenfranchised within the current political debate but the party is completely adrift in the new political landscape, split between its recent neoliberal past and ideas of building a mass protest movement outside parliament, pressuring government on key issues, gaining momentum until politics itself is changed. Corbyn and McDonnell’s inability to connect with the wider electorate matters less if the long term strategy is to transform the party, even at the cost of seeing no Labour government in the next 10 years, possibly longer.

But this fails to recognise the urgency Brexit demands. With so much at stake, a viable, convincing political opposition is essential and Labour’s abdication of this position is unforgivable.

Mainstream media hasn’t helped. Instead of Trump’s lies being reported as just that, the content of what he said became news and was then reported frequently enough to hammer it into the national consciousness and make it ‘true’. Here, Gove and Johnson’s lies gave a veneer of credibility to Farage’s dark, narrow vision and, again, the media reported it all with barely a question.

Trump built his reputation as a second rate Vaudevillian actor playing the part of a successful businessman. But in his role as President-elect, the world watches, open mouthed, as scandal collides with catastrophe, including immediate steps to dismantle ‘Obamacare’, American healthcare’s most progressive legislation in decades, while we speculate about whether the Russians interfered in the US election in Trump’s favour to see a political ‘friend’ elected or simply to subvert their entire political system.

“If we are edging closer to a US model of healthcare, no one is going to rescue nursing”

If we are edging closer to a US model of healthcare, no one is going to rescue nursing. There will be no change of government for the foreseeable future. Jeremy Hunt won’t suddenly become the nurses’ friend. Mrs. May dogmatically continues her predecessor’s damaging policies. But it’s no good simply criticising any of them. They’re acting in their best interests. They may not be doing what nurses want but, as we shall see, it’s only nurses who can change that.

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Readers' comments (1)

  • The NHS as a business is an American idea. The format and wording form I had to fill in the other day to go on a study day was so much of a business type. My heart sank I realised that the Americans tell my country how to run the show there, now their system has infiltrated the British NHS. Wherever there is money or influence to be had the Americans will reach out for it.
    I do hate their greed and their love of power, but I do not hate them.

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