Socialist Worker

Voices from the NHS: a system on the verge of breakdown

As the Tories launch a major assault on the health service, frontline healthworkers speak out on the state of the NHS

Issue No. 2236

 (Pic: http://www.timonline.infoTim Sanders )

(Pic: Tim Sanders)

‘The Tories want to poison the NHS.’

Karen Reissmann, community psychiatric nurse and Unison health executive member

The Tory plans, announced last week, prescribe a toxic mix of cuts and privatisation to a service already weakened by years of this deadly cocktail.

New Labour drove the market deep into the NHS—and the Tories want to enshrine in the very soul of the service.

Thousands of jobs will be slashed and waiting lists will grow.

Once again, we’ll be faced with the grim roll call of those whose suffering cannot be eased because the government claims there aren’t the resources or people to treat them.

Meanwhile, multinational health firms will circle the ailing service, looking for ways to extract its lifeblood.

Despite their claims to have reinvented themselves, the Tories hate the NHS and always have. Their leader Winston Churchill opposed its birth in 1945.

But the service is a dilemma for the government. It can’t stand that the NHS is a system of universal healthcare that treats people irrespective of wealth—but this is the very reason for its enduring popularity.

Mass protests and strikes in defence of the NHS threatened the government of Margaret Thatcher several times during the 1980s.

Instead of the invincible “Iron Lady”, she was revealed as a mortal who could be beaten.

As a student nurse in 1982, I helped lead some of those movements. Then, as a staff nurse in 1988, we struck over pay and won major concessions.

During that fight, and every other battle, we found we had mass support.

That is because millions of people’s lives are affected by attacks on the NHS.

It’s the reason why so many people rally to defend their local hospital when it faces cuts—and why so many will support health workers who are prepared to take action.

The doctors, nurses and therapists who speak out on these pages paint a picture of a system stretched to the limit.

The overburdened and stressed out staff who hold the system together are like a tinderbox—and a spark of action anywhere could ignite the whole thing.

Every demonstration and meeting in defence of the NHS is part of a movement that helps the workers’ confidence. The pressure on our health unions for a fight back is growing.

The health service may be on the critical list, but the Tories and their crazed therapies are despised everywhere.

It’s time to begin the battle.

‘People’s lives are being put at risk by the lack of investment in maternity services.’

Sarah Davies, midwife and lecturer in midwifery in Salford for 28 years

Midwifery is in crisis. Birth rates have risen sharply and there are not enough midwives to cope.

We have the crazy situation where people who have trained for three years are told there are no jobs to go to—because there isn’t the money to fund their posts.

Mothers and babies are having their lives and wellbeing put at risk.

Short-staffing is a major factor in “near misses”—situations where mother and baby narrowly avoid serious complications.

If you go into labour and you don’t have a midwife to stay with you because they are all busy running between women, it is likely that you will be frightened.

Fear and stress are factors in the increasing caesarean rate—currently almost a quarter of women in Britain give birth by caesarean.

The lack of staff is also causing the emergency closure of many maternity units. In Greater Manchester, temporary closures of maternity units are happening on a regular basis.

A woman in labour will ring up her local unit to find it is closed so she will have to travel to another one. You can imagine the uncertainty and anxiety this causes. Also, post-natal care has been massively reduced.

Midwives have had enough of this.

Our union recently rejected the employers’ attempts to trade limited job security for a two-year pay freeze. That reflects our mood.

I think we’ll be on the TUC demonstration in March against the cuts in large numbers.

And if our union asked us to take action in defence of the service, I think midwives would rally to the call.

‘Patients are regularly being admitted and assessed on trolley beds in the corridors’

London Ambulance Service worker

On a frontline ambulance you see the pressure the NHS is under. We are always busy—at all times of the day and night.

We go into a lot of different hospitals and they are always overstretched.

There are often several ambulance crews queuing in A&E. There are not enough beds on the wards, so the A&E staff often have nowhere to send patients and a backlog develops.

We hear the A&E nurses phoning round desperately trying to find free beds on the wards to free up space.

All the time we are waiting, we could be out dealing with another call.

In some hospitals, patients are regularly being admitted and assessed on trolley beds in the corridors because there just aren’t enough cubicles.

One of the reasons that the ambulance service and A&E departments are always so busy is that we swallow up a lot of cuts to other services.

Many of our patients don’t really need an ambulance—they really need better home care, or a day centre, or other social care that has been cut or privatised in recent years.

‘I’ve never known things to be as bad as they are now—not even in the dark days of Thatcher.’

Diana, a community health visitor in east London for more than two decades

Services like mine are facing cuts, and it’s already having a devastating impact. Serious illnesses, like post-natal depression, are going undiagnosed because our baby clinics are so full.

Try telling someone who feels unwell but unsure of themselves that they should sit in an uncomfortable waiting room for what can seem like an eternity while their child is crying.

The immunisation of children is another area where cuts are storing up problems.

Management say if a child misses one appointment we no longer have the resources to follow them up.

That is going to put everyone at risk. Immunisation strategies for diseases like measles or TB only work if a large percentage of the population have been injected.

I’ve never known things to be as bad as they are now, not even in the dark days of Margaret Thatcher.

In child protection you often go home at night thinking about your cases. You wonder if, during your day, you missed something that might stop you from acting as a safety net for a vulnerable child—and what will happen to them, and to you, as a result.

It can stop you sleeping, but somehow you have to get up and do it all again the next day.

Many of my colleagues are so demoralised that they are taking early retirement, going off sick, or changing careers. It’s really depressing to see so much experience going to waste.

‘Our ward was so busy that at midnight we didn’t even have time to wish each other happy New Year.’

Julie Hopkins, newly qualified nurse in a respiratory ward, Birmingham

The outbreak of flu stretched us to the limit over Christmas. On New Year’s Eve, my colleagues and myself didn’t get a single break during our 12 and half hour shift.

Normally we just about cope, but that night, we had 14 patients that needed intravenous antibiotics, and only two nurses trained to administer them.

Midnight came and went, and we hadn’t had time to wish each other Happy New Year. We didn’t even get a tea break.

At 1am, I was still doing a drugs round that should have finished at 10pm. That means prioritising which patients to give medication to.

I’ve only just qualified, so I feel really uncomfortable about making that sort of decision—what if I make a mistake?

The day after New Year’s, a healthcare assistant asked me to help her with an incontinent patient who needed changing—it’s a two-person job—but I was too busy.

She asked me another two or three times, but I was still rushing around.

Six hours later and the assistant was still waiting for help, the patient still needed changing, and still no one was free.

‘We’re assumed to be an easy target for cuts—but we’re going to stand up.’

Steve Hack, speech and language therapist, who is preparing to strike against redundancies

When children who have difficulty speaking arrive at nursery, they often find it difficult to make friends and start learning to read and write.

Often, from a very early age, they become isolated. As they get older they are more likely to find themselves excluded from school and branded ‘troublemakers’.

What speech and language therapists do matters. But health Trust bosses don’t see it that way.

They think young people with special needs, and NHS professionals who support them, are easy targets for cuts. In Southwark, where I work, they plan to cut a third of our posts. They didn’t think we’d do anything.

But this time the bosses have got it wrong. We’re tired of being pushed around and now we’re getting ready to strike.

Speech and language therapists in Southwark plan to strike on Thursday 3 February. Email messages of support to the Unite union:

‘Tory plans for doctors to run 80 percent of NHS budget that are pure fantasy.’

Gerard Reissmann, GP in Newcastle for more than 20 years

By 7.45am I’m in the surgery and checking my computer for patients’ test results and any urgent business.

I see my first patient at 8.30am, and then another 35—roughly one every ten minutes after that.

With the recent flu we’ve had to schedule even more patients in, so sometimes I see 40 a day.

My surgery finishes at 10.30am, and I go out on my home visits. When I come back I move on to writing up prescriptions and following up any urgent requests.

Since I’ve been doing this job, I’ve never had time for an actual lunch break.

I see my last patient at 5.40pm, then paperwork for at least another hour, then it’s meetings all evening. Last night it was a three and half hour practice meeting, the night before it was the local medical committee, tomorrow it will be something else.

When I finally get in from work and check my email again for urgent cases, it’s not uncommon for me to find notes from colleagues written at 1am, when they are going to bed.

The idea that on top of all this, local doctors are going to replace Primary Care Trusts and allocate 80 percent of the NHS budget by commissioning services is pure fantasy.

That job is going to end up in the hands of private companies.

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Article information

Tue 25 Jan 2011, 18:35 GMT
Issue No. 2236
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