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Seeing Red: Our NHS is ripping apart at the seams

Seeing Red is my regular column in The Isle of Thanet News. This opinion piece was first published on October 10, 2022.

Our NHS is a precious asset to us all. Our NHS staff, each and every one of them, always do their best, go the ‘extra mile,’ little wonder we stood on our doorsteps and vigorously clapped for them during the Covid lockdown. Who amongst us doesn’t feel they deserved a decent pay rise? Yet the Tory Government has dismally failed to put a decent pay award on the negotiating table. Nor are the Tories taking the workforce crisis seriously.

Our NHS workers stepped up for us, now, with industrial action being the last resort, it’s our turn to step up for them.

It’s no surprise to me that the Royal College of Nursing is balloting their 300,000 members on potential strike action for the first time in their 106 year history. I know that every member will give careful thought to the ballot. And no matter what the result and eventual outcome, each nurse will do their upmost to serve patients. But the sad truth is the cost of living crisis has utterly outstripped average nurse earnings. If they can’t afford to live on a nurse’s salary – how can we expect to be looked after when we are sick and need their expert care?

Likewise the Royal College of Midwives “whose members include over 50,000 midwives, student midwives and maternity support workers – is urging its members across Britain to vote in favour of strike action.” They also state, “no action would be taken that puts mothers and babies at risk, with safe services being maintained.”

It’s not unusual to hear of nursing and midwifery staff being so hard up that they are forced to use food banks, or are struggling to afford to pay workplace car parking charges. Safe parking is vital, especially for those undertaking unsocial hours shift work, and not forgetting those who routinely work over and above their contracted hours.

The Conservatives have let the caring professions down. They have taken for granted the hundreds of thousands of women (and men, but women predominant,) and their vocational ‘calling’ and honourable sense of duty. No one ever wants to strike – but when you can’t get the Government to listen, or to offer a decent acceptable wage settlement what else can you do?

Patient safety is being compromised.

Not only have wages dropped in real terms, but staff numbers are in a dreadful decline. Nurses are also taking action to protect patient care – as numbers are dropping alarmingly. Nurses are saying that they are worried about safety in wards and not coping meeting all their household costs. It can’t be right to spend years in university training to end up in employment that simply doesn’t afford a decent standard of living? Or to work on wards with unsafe staffing levels, or even, work in a GP surgery when demand for appointments outstrips supply, as is now so frequently the case, as GP numbers are also in decline.

It’s not just nurses and midwives that are resorting to industrial action. As we are warned by NHS England’s board that demand for GP appointments is at record levels and has outstripped capacity. Dr Farah Jameel, the BMA, British Medical Association’s England GP committee chair, said doctors are “desperate” to provide patients with the care they need. But he said: “We simply don’t have enough doctors.” The Conservatives have failed to remain on track to deliver the 6,000 additional GPs by 2024-25. Without radical action the GP crisis will continue to deepen, and people will continue to suffer.

The recruitment and retention of GPs in the last decade has been truly dreadful. A quarter of GP’s positions could be vacant in just 10 years time. The relationship between GPs and the government is also in a poor state. So much so, that the BMA are establishing a ‘strike fund,’ for the first time in their history. They plan to ballot in January. We all hope that this industrial action is avoided.

However, GP practices currently face the ‘very real prospect’ of having to close temporarily or permanently this winter among rising workload and staffing issues, GP leaders have warned.

“There is currently a shortage of around 4,200 full-time equivalent (FTE) GPs, which is projected to rise to around 8,900 FTE GPs in 2030/31, relative to the number needed to meet the rising need for care. This means that without a change to current workforce trends and policies, close to 1 in 4 of the 37,800 general practitioner posts needed to deliver pre-pandemic standards of care would be vacant. However, if an increasing number of GPs leave the profession due to burnout and if newer roles are not successfully integrated in multidisciplinary general practice teams, the projected shortfall could increase to 18,900 FTE GPs, or around half of posts being vacant, in 2030/31.”

The situation in Kent.

We need more GPs and surgeries right across Kent. The patient demand is there, but appointments in every area are often hard to get. So, four more surgeries in Kent (not in Thanet) are welcome, but fall very short of meeting the true needs of Kent residents. The only way this situation can be improved is by training many more GPs (and other NHS staff,) as fast as we can. That is really the only way we can create more appointments. More appointments mean patients are both seen and referred to specialists quickly. This prevents conditions worsening. Seeing a GP is often vital for accurate diagnosis.

Little wonder that so many health unions covering millions of NHS workers are challenging the Government, “It’s now up to the government to avoid strikes in NHS by putting pay right,” say UNISON as they prepare to ballot over 400,000 members working across the NHS.

Health care impacts us all.

From pre-birth to death, we all depend on good primary healthcare service, and we are quite right to feel we should be able to depend on it. It has been the bedrock of our society for as long as most of us can remember. It is the gateway to almost all other care. Vitally important if you’re suffering from a more serious condition requiring investigation and treatment.

The NHS in general, including General Practice, has been significantly run down. The numbers of GPs per head of population is in decline. Many GPs entering the profession do so knowing they can only cope with the high pressured and stressful role on a part time basis, and as many more women are GP’s, to better combine caring responsibilities.

Closer to home the situation at QEQM is extremely concerning.

Setting aside the difficulties getting GP appointments and dental care, the difficulties I’ve highlighted here may seem abstract – but here is what’s happening closer to home at QEQM. And please bear in mind we aren’t at ‘winter pressure’ stage yet. So Covid, flu, and other factors could make matters quickly very much worse than they currently are.

Currently at QEQM there are 94 vacancies. That means we are 94 people short on our wards, in our A&E, and right across the hospital. I’m hearing that one of the reasons for the shortage of staff is the fact the Brighton Hospital is in the fortunate position of being able to offer three to four times the current going rate of pay. How on earth can QEQM compete with that? Especially during this cost of living crisis? Where are our local Tory MPs? Why aren’t they lobbying for more funding for the local hospital to address this precise issue?

What this means in practice is that patients are not being discharged quickly enough and that’s not only bad for them it’s also bad for the NHS.

I’m hearing of wards covered with only one qualified and one unqualified member of staff, and beds waiting for discharge range from 150 patients waiting to currently 30. Those patients are finding themselves crammed in spaces near to emergency exits and nursing stations but importantly, they are sometimes left without access to suction, oxygen, and emergency call bells. This escalates the risk of emergency! That can’t be right?

I’m hearing that QEQM is so aware of how long patients will be waiting that they are putting inflatable air mattresses on trolleys to prevent patients becoming uncomfortable.

Other hospitals in East Kent are also struggling. I believe the William Harvey is on ‘divert’ frequently as it’s often on OPEL 4 rating – meaning it’s unsafe to receive more patients. And that they have reduced the numbers of staff in theatres from 4 to 3, meaning there’s one less qualified person in attendance.

What a mess. I’m going to be seeking answers at both the HOSC the Kent wide health overview and scrutiny committee, and from our local hospital bosses!

We’re told backlogs are due to Covid – no way!

Even before Covid-19, demand for NHS healthcare was far outstripping supply: there were 4.4 million people on waiting lists in England in early 2020. But the pandemic made things much worse: about 2.4 million NHS operations were cancelled in England and Wales in 2021. GP appointments were greatly restricted. There are now 6.6 million people – over a tenth of the population – waiting for treatment. Around 332,000 have been waiting over a year – 13 times the comparable number from May 2020.

Of course it suits the Conservatives to say the current crisis is due to covid. But that’s simply not the case.

At the next General Election, remember the Conservative Government has failed to look after our NHS well enough to look after us. Support all our NHS staff.