A paltry 1% is all you can afford for nurses, and that at the price of incremental payments. So where has all the money gone? There has been quite a lot of it, hasn’t there?
Mr J Hunt MP
Minister of Health
House of Commons
25th November 2014
Dear Mr Hunt,
A paltry 1% is all you can afford for nurses, and that at the price of incremental payments. So where has all the money gone? There has been quite a lot of it, hasn’t there? For instance, despite your government’s promise that there would be no more expensive top-down reorganisations, it has spent the considerable sum of £3bn on yet another.
Your government denied that the 2012 Health and Social Care Act represented privatisation by the back door. In the year after the new competition regulations were brought in by the Act, health service contracts worth £13.5bn were given out, a three-fold increase on the year before. From April 2013 to 2014 68% of such contracts went to commercial companies, existing firstly to make a profit. Companies are allowed to convert beds to fee-paying private ones. This when the government has been steadily closing beds for years, against professional advice, to the extent that patients suffer from being pushed around wards and hospitals. (I know the distress caused me by such moves, I complained to the CQC as a result.) This is particularly distressing for the mentally ill and the elderly. There is no intent whatever for a reversal of this policy by a ministry which, one must therefore assume, is completely uncaring and totally lacking in compassion.
This contracting out is expensive in itself, isn’t it? Perhaps you would tell us how much your department has spent on advertising and recruitment? Maybe, in addition, you could say how many millions (or is it billions?) you have put into the coffers of legal firms. Many firms have been on the make. You employed McKinsey management consultants to identify where savings could be made in the health service. Yet, through incompetence or self-interest (I wonder which?), it failed to identify the possibility of making considerable savings out of the £350m-£600m spent annually on independent consultancies, like McKinsey. Then we have that inspired method of encouraging large profits to be made, the Private Finance Initiative (PFI). There is no shortage of hospitals which are struggling to pay large amounts owed through PFI agreements, which usually continue relentlessly for 30 years. The government is not prepared to renegotiate contracts, except that it has bailed out a certain private company called Circle, which you no doubt know all about. With company profits and interest payments, a hospital initially costing £8bn to build under PFI, will cost as much as £53bn at the end of the agreement. Where are all these profits going? To none other than those very banks that were bailed out with extremely large amounts of tax payers’ money.
Of course, the government is selling off the health service. I do not use the term National Health Service as the NHS no longer exists. It has been completely dismantled and the co-operation that marked it previously has been replaced by harmful competition. Much is hidden behind commercial interest, and the basic interest is to make money. This madness started with Labour and has been continued with enthusiasm by the Coalition.
The facts must stare you in the face, if wards are understaffed, as they are at present owing to the number of nurse ‘redundancies’, nurses will inevitably be over-worked, stressed out and very low in morale. This results in a rise of mistakes such as the development of bed sores (the prevention of which require two nurses at least two-hourly; on an understaffed ward this may prove near impossible), urinary tract infections, blood clots, and hospital falls. I have done an extensive study on stress in nursing and have files full of articles on the subject. I would be happy to inform you further.
Your stating that the health service could afford to hire tens of thousands more nurses if such errors did not occur, looks rather like an attempt to blame the nurses in work for the fact that others are out of work. To say that solutions like effective training would not need additional funding (Daily Telegraph, 18.10.14) suggests a lack of appreciation of what such training really costs. Enough staff is needed if you are to release others for training. In addition, quality training costs money. If poor training is a problem, you will not be able to solve it on the cheap. Get nurses to pay for training and do it in their own time? Even nurses have their limits, and at present you are pushing them dangerously close. They have been treated with contempt by successive governments but they will not go on enduring it forever.
I have a first class degree from Durham University, with which I could easily have started on a very successful and profitable career. I decided, however, to go into nursing. I am a qualified general nurse, in which capacity I have worked as a nursing sister in two nursing homes for the elderly. In both of which there was exemplary care by care attendants. I am also a qualified neonatal intensive care and paediatric nurse. I have worked in two of the major hospitals in Oxford and at Great Ormond Street Hospital, London.
As a neonatal nurse I have gone directly to the consultant when a junior doctor has refused to either take my advice or get a senior medical opinion, allowing a dangerous situation to develop. On each occasion the consultant concerned endorsed my action. I could not make such judgements without being familiar with the very specialised anatomy and physiology of the neonate. I know what ventilator settings to alter in response to particular changes in a blood results. Do you know the difference between foetal and adult haemoglobin? Did you know that there was such a thing as foetal haemoglobin? Have you any idea of what changes normally occur in the blood, heart, lungs and circulation of a neonate at birth? Are you aware that any changes occur? I do not suppose you have the faintest idea of what you would need to do if you were in charge of the unit and a tiny, ventilated neonate collapsed, necessitating you to take charge of the resuscitation. A baby’s life depends on the immediate action taken by the nurse.
If you see young parents, at the request of a midwife, because their baby has been stillborn, what do you say when you are sat in front of them? What do you not say? I did something for the parents of a baby born dead, that resulted in a change in the way such cases are managed. What I did was disapproved of at the time by the Stillbirth and Neonatal Death Society. My instinct, borne of long experience, made me go against the accepted practice. By doing so it was demonstrated that, far from being something that caused distress, it was beneficial in helping bereaved parents cope.
There are many highly specialised nurses whose skills, experience and expertise would allow them to earn a much higher wage in some other career. Like me, however, they decide to use their skills in nursing, despite the total lack of reasonable reward or respect given them. Modern nursing requires intelligent and well-qualified personnel. You would not expect to get quality service on the cheap from others (such as management consultancies, they are not exactly cheap are they?) so why expect to get nurses for practically nothing? What will happen is that those intelligent and well-qualified people who now go into nursing, seeing that they will not be able to earn a sufficient wage to support their families, will simply go elsewhere. Nursing will be put back decades. This will also result in an overload on doctors. Have you any idea how much doctors rely on competent nurses? Your modern health service will collapse. Educated nurses will not go on putting up with being treated with contempt, while the government is throwing very large amounts of money at private firms, to allow them to siphon off money from the health service that should be used in patient care. You simply cannot deliver quality patient care without sufficient quality nurses.
Why, when so much money is being wasted elsewhere, do you imagine that nurses will go on being exploited? Do you think there is anything at all moral about spending so much money on privatising the health service (which is what is happening) while well-qualified and competent nurses are paid a pittance? This government is morally corrupt.
Why do you not spend a day with a nurse clinical specialist? Then tell us we are only worth 1% while you are paying out millions to management consultants; consultancies that deliberately tell you less than the whole story in order to protect their profits, and that of similar firms. On the subject of profiteering from the privatisation of the health service, how many MPs are making nice profits through their involvement in firms taking over the health service? I hear a rather prominent member of the government can be counted among them. It is no wonder Conservative MPs are so keen on the involvement of private companies. Why care about nurses? I’m all right Jack.
I have not normally been opposed to MPs receiving reasonable pay rises, but 10% of a MP’s salary compared with 1% of a nurse’s? There is no justification for this situation.
Veronica M Burton BAHons (Dunelm), RGN, RSCN, ENB 405 etc
cc John Glen, MP for Salisbury
Peter Carter, General Secretary, RCN
Jenni Middleton, Editor, Nursing Times