Nursing Times blogger Martin Jones on the emergency budget and what George Osborne’s proposals mean for nurses.
A world weary nurse tutor said to us during our basic training, “nobody enters nursing to get rich. If you want to get rich, you’re in the wrong job”. In the week of the coalition government’s emergency budget, as a nurse, how do I feel about George Osborne’s proposals?
Firstly, I’m not sure that I buy into the assumption that our national finances required ‘emergency’ treatment, let alone that the treatment must be so severe. I trusted that the economy was in safe and experienced hands under ex-Chancellor Darling and ex-Prime Minister Brown.
Secondly, as a socialist voter who voted tactically – and successfully - to help defeat a sitting Tory MP, am I satisfied that the Liberal Democrats are applying an effective brake on the most excessive tendencies of Conservative politicians? If Cameron had won an outright majority on 6th May would public services have suffered even greater cuts in an emergency budget? It’s hard to know.
And is it fair that public sector workers should be paying for debt caused in the banking sector? While bankers continue to reap the rewards of their bonus culture, nurses earning more than £21,000 are subject to a pay freeze, with a review of NHS pensions due later in the year. The latter is expected to mean paying more or receiving less.
Compared with other departments in the public sector the NHS appears, at first glance, to have escaped lightly with no change in overall spending. However 20% VAT will affect NHS purchasing, effectively lowering budgets. And more people are likely to require our services. The population continues to age and the consequences of social exclusion on health have been largely ignored. For the same money we’ll be expected to meet greater demands on our services as old age and poverty propels more people into worse health.
But its worst effect will be to increase the gap between rich and poor. Millionaires like the Prime Minister, nurses, teenagers spending pocket money, the unemployed… All will have to pay the same 20% VAT making this a socially divisive tax. As Richard Wilkinson and Kate Pickett demonstrated in their study, ‘The Spirit Level: Why More Equal Societies Almost Always Do Better’, inequality in industrialised countries is at the root of higher morbidity and mortality amongst their poorest citizens.
Failure to increase tobacco and alcohol duty will leave nurses dealing with the well-documented consequences of both. In the sexual health clinic we will expect to treat more patients who had risky sex after drinking alcohol. This in the week that our clinical meeting discussed introducing the Fast Alcohol Screening Test (FAST) during consultations. To use one of New Labour’s better pieces of jargon is this the end of ‘joined-up thinking’?
Going back to our cynical nurse tutor, I didn’t come into nursing in order to become rich and don’t expect to. However I am concerned that helping some of my most vulnerable patients with their social needs may have become even more difficult. And that the poorest in our society may end up with the greatest health needs.
About the author
Martin Jones, Clinical Nurse Specialist HIV, East Sussex Downs & Weald.
Martin Jones has worked in sexual health and HIV since 1986.