By the time you are reading this, the 2015 election will be over – and so will the rhetoric, pledges and wooing that has accompanied the frenzy to be in power. The NHS is a vote breaker. Unfortunately, I have witnessed this process for more elections than I care to remember. The promises, the hopes, the reality, the disappointments.
In 2010, the Conservatives promised no more central Department of Health meddling in the NHS – and within weeks introduced the Health and Social Care Act that was the biggest reorganisation to the NHS since its creation in 1948. Before that, Labour gave us the Private Finance Initiative (PFI) that created NHS and private company partnerships, which now demand crippling interest repayments transferring public money into private hands. With my cynicism comes a distrust of politicians. Yet vote we must – or we have no chance to change the government or moan about the way things are.
So what was offered to nurses? What shall we hold the victor accountable for? The good news is that all parties aimed to increase nurse staffing levels, especially in the community.
Labour committed to recruiting 20,000 more nurses by 2020, 3,000 more midwives and 5,000 health care assistants, plus increase training to 21,000 nurses each year. They promise to introduce a seven day service, protect the unsocial hours payments and abide by the pay review body recommendations.
The Conservatives say their track record has secured safe hospital staffing levels with an increase in nursing posts but have been non-specific about nurses pay, citing a sound economy secures an increased NHS budget. In reality there are 6,434 whole time equivalent extra nurses since 2010, an increase of 2% but a 1.3% drop in community staffing. They pledge an extra 10,000 primary and community staff by 2020.
The Lib Dems will commit the full £8 billion increase required by the new NHS Five Year Forward View. They will set up an independent NHS commission to stop the NHS being a ‘political football’ and have promised to give equality to mental health services that have always been the poor relation to physical health provision.
The Greens will repeal the 2012 Health & Social Care Act, abolish NHS privatisation and invest in community services and specialist nurses.
UKIP wants to bring back the state enrolled nurse and do away with degree level nursing.
Nursing has been a political football – and it has been kicked around in this recent election. Now that is over, what do I want the newly elected government to tackle?
More than anything, nursing needs some radical attention and investment if it is to meet the increasing needs of a complex and demanding NHS. There are estimated to be 12,000 whole time equivalent vacancies in England and the Royal College of Nursing has estimated a 48,000 shortage in 2016. The skilled nursing workforce is diminishing through retirement and student attrition, frozen posts are distorting the workload and the downgrading of specialists is demoralising the profession and doing a disservice to patients.
We must urgently match nurse training against demand: poor staffing ratios increase death rates.
We must halt the short ‘termism’ and over reliance on overseas nurses. Three quarters of hospital trusts have undertaken an overseas recruitment drive with an estimated average cost
of securing a nurse to be £2,500 per nurse. Offer that
to indigenous nurses and they may be tempted to join the NHS workforce.
We need to address the use of agency nurses by investing in permanent posts. Agency costs have risen by 150% in the last five years at a cost to the NHS of £980 million per year – a sum that would fund 28,000 permanent nurses.
Last year the new NHS chief executive Simon Stevens indicated his aspiration of having more frontline nursing staff with better working conditions and career progression. He called on nursing leaders to imaginatively and bravely review their workforce and use them cost effectively. He believes nursing holds the financial balance of the NHS – and I think he could be right.
There are 680,000 nurses on the Nursing and Midwife Council register. We are the largest professional group employed in the NHS and are involved in 90% of all healthcare episodes. We are a powerful force. New government please note – and keep your promises to the profession.
BA(Hons) PGCE RN RM RHV FWT NP
Nurse Adviser and Independent Trainer
As well as working on the Nursing in Practice advisory board, Marilyn is also Lead Nurse for a teaching PCT, supporting nurse-led services and the development of practice nurses and healthcare assistants. She enjoys being a respiratory trainer and a nurse opinion leader and is passionate about expanding and blurring nursing boundaries in primary care.
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