Monthly Archives: July 2010

Another great reform

Britain's Prime Minister David Cameron (front C) calls an end to a group picture with his new cabinet in the garden of 10 Downing Street in London May 13, 2010. (L-R) Eric Pickles, William Hague, Tom Strathclyde, Andrew Lansley, George Young, Michael Gove, Nick Clegg, Andrew Mitchell, Sayeeda Warsi, Philip Hammond. REUTERS/Andrew Winning (BRITAIN - Tags: POLITICS PROFILE)

Another Great Reform.

Ha, Ha, Ha finally the management are getting their come-uppance. These people who have oppressed the working nurses for years are all going to be put out of work. After all it’s their fault that the NHS is in the trouble it is. Isn’t it?

Before we celebrate let’s take time for some sober reflection. Having been in the health service for over forty years I have seen many great reforms. From Salmon in the seventies, through the establishment of trusts, the move to the community and agenda for change we have all seen how Government policies have improved the service for workers and patients.

Do we know enough about the work of PCTs and SHAs to be able to judge their worth? Everyone is aware that in some areas there are non-jobs that could be swept away, but could we be chucking out the baby with the bath water? For example, who will commission the number of nurses to be trained from Universities?  If G.P.s are to be given control of huge budgets there must be some questions to be answered before this happens. Are they capable of administering these monies? Do they have the time to balance clinical work with the need to run a business? Given that G.P.s have a personal relationship with their patients will they be able to look them in the eye and say “we can’t fund your treatment”? Will mental health and learning disabilities be given the same priority as neo natal or cancer?

A Government spokesman says that G.P.s can be trained and that they will employ managers to help them. So we are not removing a management tier just replacing it. Plus ça change, plus c’est la même chose.

Finally, we have struggled in nursing for years to get our voices heard; we had great hopes for nurse consultants and modern matrons. With all the power being placed back in the hands of medics where will this leave us? So before we sit back and enjoy the cull of the faceless ones let’s take a long hard look at the alternative. We should demand consultation on this as it is our area of expertise and we should be involved in the process.

NHS radical reform!

 

Simpler days - a fresh faced Staff nurse sets out to change the world (back row 2nd from Left)

Simpler days – a fresh faced Staff nurse sets out to change the world (back row 2nd from Left)

1979

In my life, 1979 saw two important events, firstly it was the year in which I started my nurse training at Hollymoor Hospital in Northfield, Birmingham and secondly, Maggie Thatcher became Prime Minister.

In so many ways, life seemed simpler back then – for example, you knew where you stood with politics and politicians.

My early political understandings were informed by Clash lyrics, the NME and the Anti-Nazi League. Down the road from me, Red Robbo was stirring up the Car workers at Longbridge & UB40 were composing their first album ‘Signing off’. I remember a feeling of pride about working for the NHS.

In the opposing corner was.. Maggie

At least with Maggie you knew where you stood. The Tories were the party of privatisation, anti-Union and we all knew that given the chance they would have liked to run down the NHS. Of course, even Maggie didn’t manage to do away with the NHS, despite attempts to boost the influence of private medicine etc.

Nowadays of course, things are not nearly as clear.

White paper tag cloud1

 (Tag cloud made from White Paper ‘ Equity & Excellence: Liberating the NHS’)

 2010

Apparently the NHS is safe in Conservative hands and they were keen to point this out before the election.

 “We are the party of the NHS today because we not only back the values of the NHS, we back its funding and have a vision for its future.” (Conservative Party Manifesto 2010)

David Cameron has previously stated that the Tories were wrong to weaken the NHS and has been keen to distance his party from it’s percieved anti NHS bias. If you really want more reassurance see  Hector from Abingdon who had never voted for the Conservatives before but was doing so now to protect the NHS.

In common with everyone involved in the NHS we have been talking about the implications of the proposed NHS reforms. Amongst the proposals are plans to hand control of NHS budgets to GP consortia to spend on behalf of patients whilst cutting Primary Care Trusts and strategic health authorities. According to the DOH, the reforms  will ‘Liberate’ the NHS leaving it  ‘streamlined with fewer layers of bureacracy’.

Why am I so worried?

This is what I think is really going to happen:

  • Look out for an increase in Private involvement in the NHS (see Tag cloud reference to ‘consortia’ & ‘choice’)
  • Private companies have to prioritise the interests of their share holders therefore..
  • NHS Job losses
  • Skilled workers increasingly replaced/ supplemented by unskilled workers (this blog details this really well)
  • Foundation Trusts opting out of the NHS, local pay & conditions, reduced entitlement to leave, reduced redundancy payments, pensions etc
  • An increase in (profitable) patients recieving private medical care
  • A decrease in care for less profitable patients, i.e. long term conditions, people with mental health problems etc (see White paper “begin to introduce choice of treatment and provider in some mental health services from April 2011, and extend this wherever practicable”)

I could go on but like to keep posts short – feel free to add your own to the list though.

The RCN campaign ‘Frontline first’ is an attempt to defend patient care – one of the speakers in the launch says that ‘when nurses speak, people listen’ 

 http://www.youtube.com/watch?v=ajSqkjpaKiI&feature=player_embedded

What should we be saying & is anyone really going to listen? I am not so sure they will – hope I am wrong. 

Any comments?