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Difficult times ahead for the health service?

Lynn Young
Primary Healthcare Adviser for the RCN

Welcome to the land of financial meltdown and widespread bankruptcy. The current financial state of the country will surely at some time have a huge impact on healthcare services. It is always the case that when a nation's economy suffers, so too do the infrastructure and quality of public services. Having enjoyed almost 10 years of unprecedented spending, the NHS is facing a far leaner time, during which painful cuts in services and, therefore, nursing posts will be made.

We are not at this point yet; but Prime Minister Brown seems to be growing in stature and gravitas as he makes momentous decisions regarding the UK economy. Estate agents are closing, high-earning city workers are being told to clear their desks and we wonder about escalating unemployment levels, housing repossessions and increasing levels of anxiety and depression among the population.

Community and general practice nurses are bound to feel the impact of rising unemployment rates and the distress this brings to families. Many years ago, Florence Nightingale remarked, "All it takes for a family to keep healthy is for it to have one secure breadwinner within it". Long-term unemployment is a terrible thing and is a major cause of health inequalities. The working environment brings comradeship, self-esteem, fun, interest, stimulation and a sense of financial security, which is certainly missed when the world of employment turns its back on good folk.

Politicians must be struggling at the moment to explore what action they can take to help ensure that workplaces remain vibrant and positive during these rather strange days. Some readers may remember the late 1980s and early 1990s, when unemployment was horribly high and certain people's health took a downward slide. Since the mid-1990s almost full employment has been enjoyed, and we wish to see such a state continue. Many healthcare organisations are telling the Royal College of Nursing that difficulties in recruiting nurses are increasing, but that the Darzi reforms promise more and higher-quality services for all.

Quite frankly, the world is looking ever more confusing and bizarre. Nurses may be confronting extremely uncomfortable and bewildering times, along with the rest of the population. History shows us that the nursing profession is capable of facing up to adversity and hardship, and nurses have been at the frontline of battles and right in the centre of communities suffering the impact of poverty and deprivation. Brave nurses are caring for wounded soldiers in Afghanistan and Iraq, and doing a most magnificent job of it. While no one would wish for a situation that severely tests the stoicism of the people involved, it does seem that every generation, at some time, has had to face up to difficulties and challenges of various scales and types.

Aside from the current economic problems, it could also be that Mother Nature decides that it is high time for the UK to experience a flu pandemic to further challenge its citizens. If the pandemic arrives on our shores all routine services will cease, vaccination programmes will be immediately set up and nurses will be called upon to adapt their practice to meet new health needs.

We need to remember that the epidemic of Spanish flu in 1918 caused more deaths than there were on the battlefields of France and Flanders during World War I. Similarly, during this time of financial turmoil, Mother Nature will not necessarily be kind and leave us alone just because we have more than enough to comfortably cope with.