Nursing has taken a bad beating. It’s only now, with the arrival of a pandemic, that we’re seeing evidence of this first-hand.
As Boris Johnson so Churchillianly expressed, we are fighting a war against an invisible enemy. But what he didn’t mention, is that we don’t have the foot soldiers to front it.
Time after time throughout this pandemic, the Great British Public has taken to their doorsteps with pots and pans, their TikToks for their dances, their Instagram for their runs and their gardens to complete fundraisers to show support for our brave NHS workers. Such support is humbling and heart-warming. But, in the week that the government promises a £60,000 cushion to bereaved families, does it feel a little like a gross oversight into what Tory HQ has done to our sacred NHS over the past decade?
A little over four months ago, my girlfriend was admitted to hospital with border-line sepsis, she had to spend four nights in Stoke Royal, one of the largest hospitals in the UK. During her time their, she was told she needed to remain on a drip with essential antibiotics for the entire duration of her stay. Upon changing wards, she was left off her medication for seven hours while only three nurses covered five wards — approximately 25 beds. The nurses were overwhelmed, unable to keep up and unable to offer the incredible service that Nay Bevan envisioned some 75 years ago. This was before the pandemic, but certainly not the first experience of an utterly underfunded National Health System.
Fast forward to today, a world away from the freedom of January. Every evening at 5 o’clock, the Health Secretary or whichever Johnson stand-in can face the media, addresses the nation to deflect questions about the approach to this pandemic. The truth is, the warnings of underfunding have been there for years, we just didn’t listen quite as well until it was completely and totally forced into the forefront of daily conversation, as has been the case these past six weeks. Austerity felt, to some, like an over-politicised campaign term from the left to bring down the Tories, but now we can all see first-hand, a National Health Service on the brink.
In 2017, the Royal College of Nursing (RCN) surveyed 30,000 nurses across the UK about job satisfaction and quality of patient care during shifts. The results were, as they put it ‘Shocking’ and revealed ‘nursing staff in every setting across the UK in crisis’. The report published on the back of this survey, entitled ‘Nursing Against the Odds’ detailed over 50 per cent of nurses reporting their shift not-staffed to the level planned, over a third leaving care undone due to lack of time, and two-thirds working unpaid overtime regularly.
The report was frank, it warned drastically that lives were at risk if untrained support staff were on call as well as unregistered nurses — with the number of registered ones on duty down 4 per cent since 2009. To further emphasize the point, the survey was conducted in May, well outside of the typical winter boom in hospital admissions. It concluded: ‘Short-sighted cost-saving measures and lack of funding have been demonstrated to be significant factors in the issues described’.
The Nursing Against the Odds Survey was conducted one year after ‘Exercise Cygnus’, the then little-known study into how our country would cope with a pandemic. The result showed the country’s health service would collapse. The report was kicked into the grass until it was brought back into the public’s attention this year, showing clearly that the government willingly ignored a decisive study about the state of our health service.
The RCN pleaded again for funding in 2018, with acting Chief Executive Dame Donna Kinnair saying:
‘The answer to the problems [facing nurses] is a comprehensive workforce plan focused on recruitment and retention that links population need to staff numbers’.
Kinnairs evaluation still rings true today. In the ten years of conservative power, we’ve seen a 1 per cent increase in nurses, contrasted with a 6.9 per cent increase in population. We now have approximately 7.8 nurses per 1,000 people. For comparison, Germany has 12.85, USA 11.61 and France, 10.46. The United Kingdom has a similar rate to Lithuania and the Czech Republic, yet our GDP is 53 times the size of Lithuania.
Prior to all of this (in 2016) the government took one of the most drastic decisions in the nursing-shortage saga. They opted to remove the Student Bursary to supposedly increase the number of nursing places available. The then-existing NHS Bursary scheme limited the number of student nurses to 20,000, which couldn’t be increased because of the government’s policy of austerity, thus, as Tories do best, they lumped the burden of student fees onto the student, in theory increasing the available intake. The following year, applications to nursing-related subjects were down 23 per cent. The overall intake now is 8 per cent down on the 2016 number.
In the December 2019 election, Labour reported we’d lost 200,000 nurses in the decade of Tory austerity. As is uniform with all party ‘facts’ this must be taken with a pinch of salt, (figures include deaths and retirements) but it does bear some truths. It highlights that not only are we not attracting new nurses, but the nurses we’ve got are quitting in record numbers. An eye-watering 97,000 nurses left their positions voluntarily in the time period given, citing things such as poor work-life balance (up 163 per cent to 18,013 in 2018) and health reasons (up 99 per cent to 4,234 in 2018). In 2018 alone, 27 per cent more nurses quit the NHS than in 2010. The bottom line: more nurses were and are leaving the NHS than joining it.
Since 2010, the Conservative government has strangled spending in the NHS, resulting in a reduction in nursing numbers, student nurses, quality of care and quality of life for the nurses themselves. Over the past five years, The Royal College of Nursing has pleaded with the government to pour resources into the NHS to stop potentially catastrophic long-term issues. Those calls fell on deaf ears. Today, we face the largest health crisis in a generation. One which we are woefully underprepared for.