Save our NHS!

By a nurse and Unison member

• Fight for inflation-proof pay rises
• Nationalise social care
• For a socialist NHS

“The NHS is collapsing. Patients are coming into danger. Doctors are unable to deliver safe care in many instances. A&Es are completely overwhelmed and patients are being treated in unsafe surroundings, in cupboard’s, in car parks” so said the chief executive of Every Doctor, the advocacy group set up for all medical professionals before the pandemic, Dr Julia Patterson. ”It’s obvious this was going to happen and somehow politicians have managed to ignore it.”

In Scotland the situation is also horrific.

Dr Lailah Peel, deputy chairwoman of the British Medical Association in Scotland, said patients are “absolutely” dying as a result of pressure on the NHS. She said: “There is no shadow of a doubt that is happening.I hear from colleagues every day when I get into work. Everyone is talking about how they just can’t take any more of this, talking about whether they should be leaving, whether we should wait it out, whether there might be a light at the end of the tunnel. We’re seeing more and more colleagues just not turning up to work because they are just broken.”

The Royal College of Emergency Medicine (RCEM) has estimated that – even pre-pandemic – Scotland’s NHS was around 1000 beds short of what it needs. UK-wide, the RCEM warned that the current logjam blighting A&E’s is costing around 300 to 500 lives a week.

winter crisis

The winter crisis of 2022/23 is defining the decades long mismanagement and underfunding of the NHS and social care by the Tories, Labour and the SNP-led government in Scotland.

Underfunding has characterised a period of fragmentation, privatisation and growing health inequalities. Alongside the daily diet of pay freezes and real-terms pay cuts, NHS staff have been left overworked, understaffed and underpaid.

The worse conditions have become the more staff leave – increasing pressure on those that remain. Almost 10% of the NHS workforce across Britain is currently vacant. That’s over 100,000 posts unfilled, the impact on the services ability to meet needs is catastrophic.

In this context the traditionally conservative leadership of the Royal College of Nursing has overturned its own constitution that stated it would never strike, and is part of a host of NHS trade unions and staff associations calling for fair pay in the NHS, for starters.

In reality the wave of strike ballots and industrial action across the NHS in all parts of the UK reflect that staff cannot go on as they have.

It is worth noting that in 2011 the RCN did not join the mass strike against pension reform in the NHS, but 11 years later is taking militant action for the first time in its history in England and Wales and have voted to strike in Scotland (The RCN took strike action in 2019 in Northern Ireland)

This fact alone shows how the mood has changed. NHS staff are taking the action they have as there is no alternative. In Scotland health is a devolved issue in regard to all governance except terms and conditions.

The SNP government have found monies to offer an improved settlement in comparison to NHS England. Unite and Unison have accepted this offer, however the biggest nurse union, the RCN – along with the GMB – is opposed to this deal.

This improved offer is still behind the current rate of inflation and does not meet the pressures being endured in the current cost of living crisis.

This situation speaks directly to the discontent felt by NHS staff, and, moreover, the mismanagement health policy by the SNP government.

In the 15 years since austerity began there has been no co-ordinated response to the massive cuts in funding and services, the pain has been passed on.

The raft of closures and cuts in public sector services has continued apace.

Critically in social care private providers have taken the place of local authorities, and are seeking to provide an essential service whilst being run at a profit.

social care is in crisis

On a UK level 165,000 vacancies remain unfulfilled. Companies pay beneath the living wage in many instances.

Some care workers earn within 30p an hour of the minimum wage, essential, exceptional work is poorly rewarded.

The Tories regard social care as a vocation, but even Rishi Sunak would not answer BBC’s Laura Kuenssberg’s question “would you do a job as a care worker for £18,000 a year?”.

With not enough staff, and still reeling from the pandemic, social care is expected to facilitate the discharge of up to 13,000 patients regarded as medically fit to leave hospital but with nowhere else to go.

A new discharge fund of £500m was announced in September by Chancellor Hunt, with a further £250m released in January by Secretary of State Steven Barclay.

The SNP-led government in Scotland have followed suit and have paid out £8 million for 300 care home beds to allow discharge of patients from hospital.

How much of that is going to private sector care companies?

These monies have been described by the chair of the Independent Care Group, Mike Padgham, as “a small sticking plaster for a huge gaping wound that urgently needs surgery”.

As it stands the Care and Quality commission reported in the first 3 months of 2022 that more than 2 million hours of home care could not be delivered because of an inadequate workforce.

There are upwards of 1.6m people unable to get care, hundreds of thousands awaiting assessment of their needs, and hundreds joining waiting lists every day.

In Scotland it is delayed discharge that is having the biggest impact on the numbers of people facing long waits in emergency departments. 

There’s been a seismic jump. At the start of 2016 just three patients waited more than 12 hours to be seen – compare that to the equivalent weekly figure for this year and it is more than 2,500. 

It is a perfect storm. An NHS that is not able to release people into other care settings, and provide beds to acutely unwell people, is seeking the emergency help of a social care sector on the brink of collapse after 30 years of neglect, underfunding and massive privatisation.

The Tories and the other devolved governments are trying to dump all the blame for this situation on the specific pressure of managing the pandemic, but we warned before lockdown that the care services across the UK were in crisis, and it is worth recognising that senior Tories looked to profiteer from the pandemic with PPE contracts generating millions that they were able to siphon off as consultants for PPE providers.

Tory peer Baroness Mone is under investigation for her role in promoting a PPE provider to Matt Hancock, that then provided gowns that weren’t safe, whilst taking £69m into a trust fund for her family.

Money is now essential to meet the current emergency but levels of funding pledged by the government will not be adequate and cannot arrest the systemic decline of services. As the SNP have hinted at, but will not deliver, there needs to be integration of services – NHS and Social Care – in reality a revolution in the care we wish to provide to our sick and vulnerable people.

The period of privatisation and cuts have reached its conclusion with what we are seeing before us. A fully funded, socialist, fully nationalised NHS and social care service run under the control of the working class is the only way forward. The trade union movement and a new workers’ party must fight for these policies. 

We spoke to an NHS doctor from Glasgow

“The state of the NHS is the worst I have seen it in my short seven year career. The waiting lists are the longest they have ever been.

GP’s I know are working incredibly hard but are struggling to meet increasing demands. Emergency Departments are seeing the longest waits on record and as a result ambulances are “stacking” outside departments for many hours. 

Patient discharges from hospital while awaiting a care package to be initiated are causing significant issues with hospitals becoming full.

There are reports of patients remaining on critical care units for weeks after being deemed fit for step down to wards, all because the struggling down stream wards have no beds for them. 

Immediate increases to pay for key workers such as nurses, to go some way to compensate for increasingly demanding working conditions is vital.

Taking the care sector into public ownership and creating good quality, fairly paid care sector jobs will help to improve the failing care sector.

As well as an increase in nursing student and other allied health professional spaces in UK universities to address the staff shortages in coming years.

Proper funding to the NHS to allow it to survive these current challenges so that we can have a future of a health service that is free at the point of use and provides good quality care to all citizens is essential.”

The Socialist spoke to a Scottish NHS worker and Unison member

“Staff who are working for the NHS have never felt so undervalued and underpaid. We are facing the largest cost of living crisis for a generation.

Average overall costs to households increased by at least £1,000 in 2022. We are seeing staff having to take on a second job and using food banks.

Moral is at an all time low, exhausted and burnt out. No wonder staff are leaving and finding other employment.

Some are even joining agencies that pay far more than what they are earning at the moment. We no longer can give the time and care that patients deserve and need.

There is just so much work with less staff and its only going to get worse in the next when we will see an increase of people being admitted with winter flu etc.

The pandemic gets blamed for the reason staff are exhausted, but the reality is this has been going on for years now and something needs to done.

Politicians seem to forget the support they gave us coming out onto the streets every week cheering and clapping for staff.

But we wanted the pay we deserved not just during the pandemic but now. With nurses, doctors ambulance workers voting to strike it shows the solidarity that they have to make a change for the future of our NHS.

No one has taken the decision to strike lightly but workers want a fair wage for the work and time that they put into the service.

We need more staff and we can use the right to strike to demand better conditions. Tory PM Rishi Sunak said in an interview although he is registered with a NHS GP he has used private healthcare.

He is also looking to introduce new laws that when workers vote to strike they could be forced to work or face the sack.

These new laws would have a direct attack on working people’s fundamental right to strike to defend their pay terms and conditions.

That’s why we have to fight together and put pressure on the government to protect and save our NHS.”