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When politics and care collide

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Roy Lilley Roy Lilley

We need ‘strong and stable nursing’, ‘for the many not the few’.

Sorry about that; I think I have contracted a nasty bout of election-itis.

The bad news is, no matter who wins the NHS faces more years of austerity, as none of the main political parties is promising to spend enough to close the gap between the amount of work the NHS is obliged to do—and the amount of work it is paid to carry out.

Just to cheer you up: health spending as a percentage of GDP is set to fall. Things are going to get tighter. So, who should nurses vote for?

There is an acid test. A test that takes us to a place none of us want to remember. It takes us to a time and events that were painful, beyond belief and that NHS still struggles to live down. Events where nurses where were at the very centre.

The place I am talking about is very different now. It is a very fine, well run hospital, staffed with skilled and enthusiastic nurses. I know, I’ve been there. I’m talking about Mid-Staffs.

The hospital wrote its name in the history books, but not because people were uncaring or stupid. It was because they were driven, by political imperatives, to abandon their purpose—targets instead
of tenderness. Counting the bottom line meant it was no longer possible to count on compassion.

The politicians of the day wanted all hospitals to segue from NHS Trusts to Foundation Trusts. That required a financial rigour they are unable to deliver without cuts, and a focus on the demands of the regulators and not the needs of the patients, relatives and carers. Staffing—the biggest cost—was cut, shortcuts taken.
The front line’s voice could not be heard above the din of the management bugle. So morale plummeted, standards dropped and everyone became inured to suffering.

What turned good, honest, educated, well-trained people into an army of job-fillers?

Politics was at the heart of it. The pursuit of a policy, and the bullying that comes with trying to deliver the impossible.

People come to nursing for a career because they know it is the work they are intended for. When something is a vocation you don’t really make a decision. It takes more than talent to be a nurse, and much more than ambition. I have seen nothing that measures the love of the drudgery that nursing involves; the grinding hard work.

So, which of the political parties is least likely to put us
on the road back to Mid-Staffs? The danger is a government with a huge majority will think they can overlook the injustices in the system.

Politicians distracted by historic changes to the machinery of our nation will forget the cogs that make it all work, make it tick. But politicians who make promises that become undeliverable, then coerce the NHS into doing it anyway, are just as dangerous.

In either case nursing absorbs the pressures, and struggles—elegantly—on.

Use your vote wisely; there is a lot depending on it.

Roy Lilley is a writer and broadcaster on health topics and a former trust chair

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Comments

I do agree with Roy Lilley's article - We have not only abandon the purpose for which the NHS was formed but now use it as a political football. What is needed in my opinion is a complete transformation of the Service which includes being transparent and honest with the electorate. The truth hurts and we ourselves believe that all concerns within it can be fixed with pumping more and more money into a system with much wastage and poor health outcomes. All other countries do have part personal contribution dependant on individual use and part government funding from taxation. Free services are often very slow to improve and sustain high levels of outcomes. Services that are abused need radical overhall. From my many years of working in the NHS I have observe over the last decade a lack of care being delivered in both primary and secondary care. Until we change the health culture which now exists within the service and become more responsible for the service which we ourselves create I see no bright future in my own lifetime to look forward to
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