FOR the first time since its inception, I foresee the demise of the NHS. Recent revelations, coupled with the junior doctors’ strike, dispel any doubts.
Hospitals, we are told, have been banned from declaring a “major incident” even if they are so overcrowded that patient safety is at risk. In addition, trusts can no longer go on “black alert” to indicate trouble ahead.
Meanwhile, millions of pounds in interest at rates up to 3.5 per cent are demanded as payback under a new scheme of emergency government loans to hospitals which are able to borrow to cover wages, electricity or phone bills.
Last year, thirty hospitals made interest payments totalling£75million. Next year these payments are expected to reach more than £150 million with the NHS deficit doubling at £2.2 billion. If they are so cash-strapped that they have to borrow how will charging them interest help?
Worse still, the pay of NHS administrators is still rising, despite the financial crisis which engulfs the system. Hospital chief executives have been handed rises of up to £35,000 per year with the highest earner getting £340,000. What financially troubled business, other than one funded by the taxpayer, would pay its executives even more? Shareholders wouldn’t stand for it, and we are all shareholders in the NHS. So why aren’t we demanding that someone gets a grip before it’s too late?
The number of NHS managers being paid around £300,000 per year reportedly doubled in 12 months; 44 ‘interim’ executives were employed in 2013-14 on rates of £1,000 per day. One received the equivalent of £620,000 p.a. for ten months work while frontline staff suffered a pay freeze.
No political party can escape blame for the present situation. Private Finance Initiatives, the system which sees hospitals built by private investors who take huge interest on repayment and service contracts, was condemned by Labour when implemented by John Major’s Conservative government. But that didn’t stop the Blair government enthusiastically expanding it.
Now, NHS hospitals owe a reported £80billion in PFI loan unitary charges, the ongoing costs of maintaining hospitals and paying back loans. This year, trusts will make a reported £2bn in repayments, wiping out extra money promised to fund improvements. I would need an acre of space to list the areas which need improvement.
One example: the NHS reportedly spends £80 million each year handing out paracetamol, the average prescription costing TWENTY TIMES the price of a packet in the supermarket.
Why?
EACH year 80,000 British students fail to win places on nursing courses even though the NHS is hiring thousands of nurses from abroad.
Meanwhile, British nurses in their forties who left to start families and now want to come back complain about the shortage of affordable refresher courses to update their skills. And even if they could retrain are unable to find jobs, apparently because they are going to younger European candidates.
Hospitals recruited almost 6,000 overseas nurses last year while there are 100,000 domestic applicants for 20,000 training places. Four out of five new NHS nurses are foreign: NHS managers fly to Spain and Portugal to hire as many as fifty per trip.
The economics are interesting: the NHS spends £70,000 training a nurse for three years while for the same amount it can hire three qualified foreigners on average salaries of £23,000. But is it right that we plunder nurses from other countries (which have also spent money on training) to serve our own needs?
The Royal College of Nursing accuses the Government of “lamentable workforce planning. . . we have a crisis and we’ve got NHS trusts recruiting from all points of the compass.”
In the past, training nurses was far cheaper. They learned their skills on the wards in hospitals which had the use of their labour throughout their apprenticeship, until a reform during the 1990s required that all nurses should have a degree. I worked in the NHS under the old system and the training was excellent.
Now we are chronically short of GPs. At the moment we pay locum doctors £2,000 to plug gaps. Why isn’t there a scheme to allow nurse practitioners to by-pass the first year of medical training and complete medical degrees?
In addition, the number of hospital beds available has been steadily falling. The UK’s 2.8 beds per thousand population compares with Germany’s 8.3 beds and France’s 6.3.
In my contacts with medical charities, I see miracles performed daily but the NHS has tottered for decades under the weight of debt, top-heavy management and inept political control. To an extent, it is being eaten from within.
Political parties should stop the mud-slinging, roll up their sleeves and sort out the mess they jointly created.
