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Spending cuts: are nurses' jobs at risk?

Rhona Aikman wonders how the health service will cope when thousands of nurses face unemployment as a result of the proposed spending cuts ...

I hadn't realised how few nursing jobs were available until recently, when I had a final year student for a few days. I had been asking where she would like to work after qualifying, and she said she was not hopeful of finding work as only a few from the group ahead of hers had managed to find permanent jobs.

I decided to go the NHS Scotland website where vacancies are advertised just to see for myself - and was quite shocked at what I found.

After looking at all the health board areas, I found two mental health and 12 general nurse posts suitable for newly qualified nurses in the whole of Scotland. With the proposed 1,523 nursing and midwifery posts to be axed over the next 18 months the outlook for newly qualified nurses is bleak.

My area, Glasgow and Clyde, is the largest health board in Scotland and although they propose that the reason for job losses will be natural wastage, the end result will still be 553 fewer nurses in post. The SNP government has pledged to protect frontline services; but I wonder how this is possible given the scale of cuts. Meanwhile, several hundred more student nurses will qualify over the next 12 months and how many will have jobs?

Although more time has passed than I care to admit since I qualified, I do remember how much I learned in my first post. On reflection it gave me such a solid foundation. While over the last few years we have been hearing about similar problems with newly qualified teachers, they do at least have a guaranteed years work as a probationary teacher.

The public may be reading that the health service is protected from budget cuts, but in reality millions of pounds of efficiency savings were already planned. The nurses I have spoken to are not really worried about their jobs, but they are concerned about how they will cope when the staff reductions begin.

Investment in the health service over the last few years has improved waiting times for both inpatient and outpatient appointments considerably. We could argue around target driven care versus quality and patient outcomes, but there is no doubt waiting times are very important to patients. Can these improvements be maintained with the proposed cuts?

It is likely there will be a knock-on effect from local authority budgets being under strain. With the ageing population rising how will they manage to maintain services for the elderly and vulnerable? I am concerned about the shift of more services from hospitals into the community; I understand that it has the potential to save money and patients may prefer to receive care in their own home if possible, but I am concerned because I do not feel at present that primary care has the capacity and resources to cope with much more.

The next few years are no doubt going to be a challenge not just for the health service. Nurses need to keep abreast of changes and be prepared to speak up if they feel local services are being adversely affected. Often reports are circulated seeking comments and never has it been more important to respond.