Dave Prentis looks ahead to what this year will have in store for the health service
This year will be a pivotal one for our NHS and our public services. The general election campaign will polarise around them, which will throw the spotlight on funding and delivery.
It seems only a few months ago that the crisis in world finance was being blamed fairly and squarely on an irresponsible, under-regulated banking system that rewarded risk. We, the taxpayer, have had to bail out those banks to the tune of billions. Now all political parties are talking about how public services must pay the price through spending cuts. The banking crisis has suddenly become our problem, almost our fault.
Publlc pending cuts has become the mantra on everyone’s lips. Labour has already announced its spending plans and how it will balance the books. The Tories have pledged to cut deeper, but will not say where. They mutter about protecting the frontline but have appointed a shadow public services “productivity” board that includes Sir Peter Gershon, who gave his name to a Whitehall “efficiency” review recommending swingeing job cuts.
‘One way to make sure every penny earmarked for the NHS is spent on care is to kick out the private companies who are making a killing at the taxpayer’s expense’
We have argued that public spending cuts are not inevitable in our Million Voices budget, published in December. We shall be pushing that case throughout the year.
It’s always difficult to look ahead and imagine what life will be like in six months’ time. Up until recently, it looked as though the Conservatives would be a shoe-in at the general election and the only question was over the size of their majority. Now, things look a bit different. There’s talk of a hung parliament. And the polls have narrowed. David Cameron looks less assured.
It seems the electorate will face a real choice between the political parties on the NHS. The government recognises it must remain the preferred provider of care, compared with the Tories’ dogmatic attachment to any willing provider model opening the health service up to further private sector incursion. The Tories’ public sector pay freeze is at odds with Mr Cameron’s pledge to increase overstretched midwifery services. If they revert to type, the squeeze will be tighter. Under the Tories, hospitals deteriorated, cleaners were sacked and provision was pared to the bone. Labour used the costly private finance initiative to build new hospitals. We don’t want the Tories to let those hospitals crumble.
Whichever party is in power after the election, it is likely there will be a demand to cut the so called “back office” staff. But a “slash and burn” approach of cutting jobs and services is not the way to make savings. It may save a little in the short term, but the NHS ends up relying on agency staff to fill gaps or scouring the world for qualified nurses, as it did when Labour came to power in 1997. It has taken many years to get nurse training back on track, increase the number of places available and for new recruits to come through and onto the wards.
Cutting support staff, such as those in catering or administration, plays to the gallery but puts pressure on the frontline which, in turn, collapses. The team ethic ensures the health service works more efficiently and delivers quality patient care. The most well equipped army wouldn’t go to war without its quarter master, chefs, cooks, medical orderlies and engineers.
If service quality drops, getting it back on track is more expensive than getting the treatment right the first time. Patients discharged too soon cost more on readmission. In hospital cleaning, fewer staff has led to an increase in infections - not only deadly to patients, but also costing the NHS vast sums of money.
At the time, contracting out, with services going to the lowest bidder, was seen as the easy option. It was a disaster. Hospitals - which should be a byword for cleanliness and hygiene - became synonymous with dirty wards and departments as well as a rise in MRSA and C. difficile.
Nurses knew full well that dirty hospitals were bad for patient health. It is obvious that NHS staff and managers are the key to unlocking the real efficiency savings and great ideas for improving the service. One way to make sure every penny earmarked for the NHS is spent on patient care is to kick out the private companies that are making a killing at the taxpayer’s expense. We should rid the NHS of the millions of pounds wasted on management consultants.
The prospect of tighter finances should not be used as an excuse to expand privatisation or the use of private sector shared services. We will not support a Labour Party manifesto that continues the creeping privatisation of our NHS and public services because experience has shown that it has failed. That is why we welcomed the government’s latest guidance to primary care trusts, stating that the NHS is the preferred provider.
There is no doubt that the NHS will, once again, become a political battleground during the 2010 election. If cuts become embedded in the British psyche throughout the election campaign, all the advances we have made in the past few years will have been in vain. But I do believe the British people will continue to support their NHS and they understand that it has to be paid for, despite the shifting political landscape.
DAVE PRENTIS is UNISON general secretary