The suspension of the junior doctors’ strike has given the government a breathing space.
But the crisis of the health service will not easily go away.
Years of underfunding, rampant privatisation and the cuts in councils’ social care budgets have pushed the NHS to breaking point.
Amy is an ambulance worker in north east London. “Normally the summer brings some respite for the NHS—but not this year,” she told Socialist Worker. “All NHS workers are really under pressure at the moment.”
The Tories’ assault means that health workers face rocketing workloads, don’t take their breaks and regularly work beyond their hours. This is the experience of health workers right across the NHS.
There is a widespread sense of chaos, workers pushed beyond their limits and an inevitable crisis in the care provided.
Claire is a Unison union member at the Whittington Hospital in north London. “Everything is about saving money,” she told Socialist Worker. “But morale is low, stress is high and patient care is really suffering.
“We just don’t have the nursing staff that’s needed—if one nurse is off sick, that causes a big problem on the wards straight away.”
Amy added, “It can be very demoralising seeing the way patients struggle to get the help they need, whether that is medical or social care.
“We were called to a woman who had fallen and broken her hip. She was lying on the floor in pain for two hours waiting for an ambulance.
“Sadly this is not unusual.”
Health care isn’t just about administering drugs, it’s about addressing all aspects of patients’ needs and concerns. But Tory funding cuts and a spiralling staffing crisis, fuelled by poverty pay and rocketing workloads, are making that harder and harder.
Philippa, a junior doctor in north east England, said “I’ve just come from a general practice placement, where the service was under massive strain.
“There just weren’t enough staff to cope with the number of patients that needed to be seen.”
Philippa explained what this can means for patient care. “In general practice you only have ten minutes to see patients,” she said.
“If the time slot runs over, the next person won’t have enough time.
“That situation doesn’t help anyone—it leaves the doctor frazzled and the patient will probably feel that they haven’t talked through all their problems. It also means there’s more potential for mistakes.”
The number of unfilled nursing posts shot up by 50 percent from 12,513 to 18,714 between 2013 and 2015. In London alone there are 10,000 unfilled nursing places.
During the same period the number of unfilled doctors posts increased by 60 percent from 2,907 to 4,669.
At Chorley hospital in Lancashire health campaigners are holding weekly protests against the downgrading of the accident and emergency (A&E) department. It was “temporarily” downgraded to an “urgent care service” due to a shortage of junior doctors.
Pete Smith, a Unison member at the hospital said, “The nearby A&E departments, such as Preston, are struggling.
“We’ve seen an increase in patients but there’s not enough room for them—so that means ‘creating extra beds’. That’s why people are treated in corridors or seen queuing up in ambulances outside the hospital.”
This recruitment crisis will only get worse if Hunt imposes the new contract. St George’s Medical School in south London went through “clearing” to fill medical student places for the first time this year.
Philippa said, “There aren’t many people that I graduated with who’ve gone into speciality training—a lot took the first year out or went to work abroad. Some only went for a year but are now applying for work visas.”
She added, “When I was working in Sunderland, they were searching for nurses in Spain and the Philippines because there weren’t enough.”
We’ve had a massive increase in suicide and self-harm admissions during the last three years. That’s because local services have collapsed.Salena, mental health nurse
While the staffing crisis means services can’t cope with the number of patients, the cuts in social care make a bad situation much worse.
There aren’t enough social care packages, which are agreed between hospitals and local authorities, to discharge patients safely and at the appropriate time.
The lack of social care and primary care services, based in the community, is also pushing up the number of people going to hospital.
Salena, a mental health nurse in Bristol, told Socialist Worker, “We’ve had a massive increase in suicide and self-harm admissions during the last three years. That’s because local services have collapsed.
“There aren’t day hospitals for people to go to get help, so their condition is left to get worse and worse until it reaches crisis point.
“They’re left with no other option but to go to A&E.”
Amy added, “More desperate people with mental health issues are forced to rely on ambulance services when they are in crisis.
“We all do our best, but this is not the specialised care these patients need.”
The junior doctors’ dispute is just the thin end of the wedge.
The Tories’ real aim is to smash health workers’ pay and conditions, break apart the NHS and soften it up for further privatisation.
Claire said, “The doctors are important for us because the government will come after nurses, porters—everyone—if the junior doctors lose. The Tories will push through even more attacks on the NHS.”
New Tory plan to slash cash will bash patients
The Tories’ new “transformation and sustainability plans” (STPs) will axe hospital departments and services across England.
The STP for Barts Health NHS Trust, in north east London, gives a snapshot of the devastation that is threatened across England.
Jim Fagan from Waltham Forest Save Our NHS told Socialist Worker, “If it goes through, we’ll be facing significant cuts to hospital services that are already under pressure.
“That’s obviously going to hit patients, who live in quite a deprived area.”
He added, “A lot of the new structures the plan would put in place will make it easier for private companies to come in.”
The plan’s detail gives the lie to the Tories’ claim that it’s about improving patient care. The Transforming Services Together document projects that north east London’s population will grow by 270,000 over the next 15 years.
The Waltham Forest and Newham campaigns have said in the next ten years this would require hundreds more hospital beds and GPs.
They also anticipate a million more GP appointments and 92,000 additional A&E attendances. But the STP wants to slash the number of outpatient appointments by 180,000. The number of GPs in north east London is also projected to plummet substantially.
The Tories argue that “centralising” patient care will improve clinical outcomes. While some procedures have better outcomes in bigger hubs, the full scale plans will do serious damage to patient care.
The real aim is to slash between £104 million and £165 million over five years. Hospital departments rely on one another. So losing some specialist units at hospitals will impact on services such as A&E and maternity.
The STP itself acknowledges that the “consolidation of services” could undermine the quality of emergency and maternity care.
Patients can arrive at A&E with more life-threatening problems that require “complex surgery”.
A patient can arrive with acute stomach pain, but then be diagnosed with appendicitis.
Time is critical but the patient would have to be transferred—if their appendix ruptures in that transfer time they could die.
If a pregnant woman undergoing a caesarean suffered a bowel injury, she would have to be transferred to the Royal London to see the surgeon.
The Tories latest plans are a danger to patients—and the future of the NHS.