"NHS Conditions Worst Ever" -BBC

Silverdragon102, BSN · Jan 11, 2017

It really sounds like things haven't changed in the last decade that I left the NHS. When I worked in the 80's and 90'sit was normal to see 2 to 3 RN on days, 2 RN on evenings and 1 RN for nights and this was for 28 acute medical or surgical wards/units

Phil-on-a-bike · Jan 13, 2017

I joined the NHS in 1988 - and if I had to put my finger on the one thing that's remained constant it's this:

Every year - every single year, without exception - is the "worst year ever!" according to the press.

In late 1989 to early 1990 the ambulance service - at that time one, single, nationalized service - was on strike.

Seriously: six months - no ambulances. Picket lines outside the hospitals, the Army on the streets ferrying patients around in Landrovers. That was my first "NHS in Crisis" moment.

What was next?

Ward Closures - the advent of 'Superbugs' - Doctor's working hours - "Health Tourism" - Public/private finance initiatives - the end of Hospital's Crown Immunity from Prosecution - the Alder Hey Organ Scandal - the 'Postcode Lottery' - private patient queue-jumping - agency staffing.

"Weekend death rates" - that was my favourite for sheer slack-jawed idiocy. Our Right Honourable Secretary for Health drew attention to the fact that patients admitted at weekends were more likey to have poor clinical outcomes compared to those admitted through the week.

His conclusion: NHS staff were obviously all enjoying weekends off while running a second-rate skeleton service which let people die.

Actual situation: The guy brought in over the weekend has been cut out of the burning wreckage of his car and helicoptered in, coding all the way. The guy admitted 09:30 monday morning is here for scheduled revision of ingrowing toenail. Yes - one of those guys does have a significantly better outcome than the other.

(That was a diversion, but it's illustrative of the fallacious nature of the typical "NHS in Crisis" headlines.)

After a while, it all blurs into one. It's always "NHS in Crisis!" over something or other. Truth is, it says as much about the media as it is about the NHS.

Re. the current situation: The NHS has been starved of investment during the current Conservative and previous Coalition government's tenure by stealth. Keeping investment below the level of inflation and freezing pay means that while the actual on-paper amount invested has grown (enabling the government to boast of 'record investment!') yet in real terms our slice of the pie is smaller.

Also - the chickens of Public-Private Finance initiatives have come home to roost. These initiatives seemed attractive because they offerred the NHS the chance to finance large development projects they wouldn't have the capital to fund themselves.

Now they're locked into years of paying off that private investment.

It is worth noting that the latest 'NHS in Crisis' press release comes from Britain's Nursing & Midwifery Council.

There's an element of sour grapes here: the government recently abolished the bursary paid to nursing students to partly finance their training. (Pretty much guaranteeing a staffing crisis in 2-3 year's time, by the way.)

That doesn't mean an end to nurse training. It does mean a moritorium on government-subsidised nurse training. If Britain's universities thought they could fill nursing courses with private fee-paying students, they wouldn't hesitate. Those courses would be running. But they're not. With the bursary withdrawn, universities have cancelled their RN courses.

Students who have to find the cash for their education want a better return on the investment than nursing offers.

The NMC are understandably smarting over this, and have not hesitated to twist the knife with some pithy press releases.

We live in interesting times!

GrumpyRN, NP · Jan 14, 2017

Have to agree with Phil. Opinion in my department is that NHS gets starved of funds, government says it is failing, public demand something "gets done", government opens NHS up to private medicine. Voila, health care as in the American model and good bye NHS.

The rot started with Margaret Thatcher and her execrable 'internal market' and having to save money year on year since.

I live in Scotland where the government appreciates the NHS and things are a little better. Not great but a little bit better. Not gloating, this whole issue is far too important for that or for point scoring.

I have been told in the past; "It's OK, the accountant says it's all right to work short staffed". :banghead:

As you say, interesting times.