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June 1, 2017

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The NHS: Flogging A Dead Horse Or Selling The Silverware?

It's been almost seven years since I left the nursing profession, the latter years of which I spent in hospitals in Yorkshire, Middlesbrough, and Surrey. Universally there was knowledge that staffing was even then critically low, with senior clinical staff covering any and all sickness to the point of their own exhaustion on many occasions.

 

 

Lunch “break” was a luxury amongst nurses, and I regularly inhaled a sandwich at breakneck speed; and as for the junior doctors, I remember one of my friends walking past with the “thousand yard stare” having done a day shift, night shift on call and a further day shift. I sat him down before he fell down and got some food and a cuppa into him. He looked like he didn't quite know where he was, and was practically exhausted. Yet this guy carried with him the pressures of making life and death decisions about patient care and treatments, whilst being so tired he would not even be allowed to drive via uk transport law.

 

Doctors and nurses are after all human, they have limits. I was once told (by a senior hospital nurse manager) at the start of  my night shift that there were no special care staff available for a vulnerable old lady who kept climbing out of bed due to dementia. My retort of: “ok, I'll fill out the incident form for a broken leg now then, shall I?”, whilst pointing out that it wasn't my problem to deal with but hers, landed me with a reputation of having “an attitude”.

 

Unsurprisingly perhaps, I'm no longer in nursing, or even health care. Those of my friends who are speak of stagnation, lack of pay, recognition and resource, and those who nurse are paying more than ever for their professional registration fees, whilst getting less in the return, and enduring real-world pay cuts.

 

We read of the £8bn that Theresa May says is going into the health service, though even she doesn't seem to know where from. This is “extra” apparently, and yet it is the bare minimum needed to fund the status quo. As I can attest to, the status quo wasn't good enough seven years ago and I'm pretty sure it hasn't magically been fixed since that point.

 

Being ex-forces, I never worked “for” the NHS but I did work “within it”. Casting my mind back to the overseas hostilities of the last fifteen years, one has to wonder at the brazen stupidity of the accountants and the politicians. When UK forces deployed, the military medical personnel that went with them, having been embedded in civilian hospitals, needed to be covered. Obviously the NHS picked up the agency bill for this lack of nursing cover, and obviously at huge cost.  Similarly at this time the UK military medical chain was restructured, and shortened, meaning earlier use of the civilian hospitals as part of that chain of events, yet these civilian hospitals were stretched as it was. And ironically some had “lost” surgical expertise since their resident surgeons were in the military reserve forces and had been deployed to a foreign country!

 

It takes a special kind of stupid to organise your ship in such a way that in the advent of a demand being made on the service, you deplete your method of dealing with that demand in order to initially contain it.

 

But I digress. My point is that the NHS and the military are both government institutions. Private finance is all well and good, and in some limited cases yes, it can work. But the bottom line in both health care and security should never ever be measured in pound notes. And I believe a certain Labour party member said something similar recently in a speech; After all, I'm sure we wouldn't send soldiers into battle with the retort: “Sorry mates, we can only afford to give half of you enough ammunition, and the other half get to go on waiting list till the next quarter...”

 

Whilst in the military, I received free health care. Everything was taken care of. This isn't some holistic and virtue-based decision on the part of the government, but a business one. Soldiers need to be in a physical condition commensurate with their job role. Thus keeping them so is akin to servicing a fleet of trucks in a haulage company. And likewise has a cost. “Free” health care for soldiers is an acknowledgement of this truth by the governments of the day.

 

The NHS will never make a monetary profit, and nor should it. By a similar token to the military model, it exists to make sure other sectors of society remain profitable. 2015/16 figures from HSE reported a total of 30.9 million working days lost to illness and injury. That is a monumental amount of time, some of which could be recouped via shortening lead times on recovery, by investing in a fully funded and properly accountable NHS. Accountable, that is, to the patients and the society is serves, not its shareholders and spurious performance indicators.

 

So the current establishment wants us to believe the dead horse of the NHS needs flogging off to make way for the private sector en mass, and that it “cannot” be resuscitated. Yet to do so is a false economy, since adding in a cost at point of use and introducing market forces will lead to yet longer lead times for recovery when ill or injured people cannot afford to do what they must, and as a result the tally of sick days goes up and productivity down.

 

Our NHS, for it is ours, broken as it undoubtably is, must be fought for. It is a world-leading model. Not for its KPI's and rates of return, but rather on the ethical principles upon which it was built. Its ethos, the very idea is what makes it great.  To allow a government of whatever colour to dismantle that idea and sell it off like the family silver for short term gain would be our greatest failure as a nation.

 

 

“Socialism” isn't “just” a political party, or persuasion. Much like Aneurin Bevan's idea, it is the ethos of caring for one's fellow man; of taking a collective responsibility for the society in which we live, and also for making the one in which we want to live.  We need to replace the NHS's priorities back to where they should always have been. On the provision of patient care, and a safe, effective service for society, and not on the balance sheet.

 

So, in just a few short days, you have a voice. How will you use it? Where do you want to live?

 

 

 

Sarah Jayne Ellis for Political Provocateur

 

 

 

 

 

 

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