Figures released by the Nursing and Midwifery Council (NMC) this month, highlight the deepening crisis of staff shortages in the National Health Service (NHS). They indicate that plummeting staff levels in the NHS are the result of deliberate policies pursued by successive governments.
According to the NMC, there has been an increase in the number of nurses and midwives leaving its register, while the number joining has slowed. The net result is a reduction in the numbers of nurses and midwives registered to work in the UK.
While the NMC register increased year on year from 2013 to March 2016, since then, 20 percent more registrants have left the register than joined, leading to a reduction of 5,047 nurses and midwives.
Of the nurses and midwives on the NMC register, 85 percent first registered in the UK, 10 percent first registered in non-EU countries, with only 5 percent having initially registered in EU countries.
The NMC said that between 2016 and 2017, 45 percent more UK registrants left the register than joined it for the first time. It also noted that “more nurses and midwives are leaving the register before retirement age with a noticeable increase in those aged under 40 leaving.”
Since July last year, the right-wing anti-immigrant atmosphere and uncertainty created by Brexit has drastically reduced the number of EU nurses and midwives registering to practice in the UK.
This mass exodus of nurses and midwives takes place amid a broader shortage of 40,000 nurses and 3,500 midwives in England alone, according to the Royal College of Nursing (RCN) and the Royal College of Midwives (RCM) trade unions.
Analysing the official data for the two-year period 2014-15 to 2016-17, the Health Service Journal (HSJ) exposed that 96 percent (214) of the 224 acute hospitals in England operated without an adequate level of nursing staff during the day shifts last October, and 85 percent did not have the right staff levels on night shifts.
The terrible conditions that have forced nurses and midwives to leave the register have come to light in an NMC survey conducted between June 2016 and May 2017. Of the 4,544 responses received by the NMC from nurses and midwives during that period in regard to the reasons for their leaving from the register, less than half cited retirement as the reason for leaving. In contrast:
* 44 percent cited poor working conditions, for example low staffing levels and workload.
* 28 percent cited a change in personal circumstances, such as ill-health and childcare responsibilities.
* 27 percent cited disillusionment with the quality of care provided to patients, along with poor pay and benefits.
Research by RCM last year similarly confirmed that midwives were being driven out of the profession by excessive workloads and poor staffing levels.
However, the staffing crisis is not confined to these professional categories. There are numerous media reports about the shortage of consultants, doctors, GPs and other clinical groups, thanks to the years of underfunding, the destruction of training opportunities and indifference to the health needs of working people.
GP leaders and the Royal College of Emergency Medicine say that Britain urgently needs more general practitioners and emergency doctors.
Secretary of State for health Jeremy Hunt, who capitalised on the betrayals of British Medical Association (BMA) of the junior hospital doctors’ steadfast opposition to new, inferior contract, to impose it regardless, cynically attributed the fall in the nurses and midwives numbers to “inflexible NHS contracts.”
The staffing shortage in health care—which leads to entirely preventable deaths—is, no less than the conditions leading to the Grenfell Tower inferno, social murder. It flows inexorably from deliberate policies of both Conservative and Labour governments that represent the interests of the financial and corporate elite that has nothing but contempt for the lives and well-being of working people.
After coming to power in 2010, Tory-led governments, in which Hunt held office, implemented the plans put forward by the Gordon Brown-led Labour Party in the aftermath of the 2008 global financial crash, carrying out a massive social counterrevolution to reverse the social gains of the working class.
The Tories’ indifference to staffing levels came to light when in 2015 Hunt ordered the National Institute of Health and Clinical Excellence (NICE) to stop setting safe staffing levels in order to save money. NICE had started drawing up guidelines on NHS-wide safe staffing levels in 2014 in the wake of Sir Robert Francis QC’s inquiry into the failures of Mid Staffordshire Hospital in 2013.
Since 2010, the Tory-led governments have implemented year on year pay freezes or 1 percent pay caps for public sector workers, including nurses and midwives, resulting in a real-term pay cut of up to 15 percent. Many nurses and midwives are compelled to work beyond their contracted hours, despite the heavy workloads created by poor staffing levels, in order to keep their heads above the water.
A major attack on health workers’ living standards came in 2011, when the Tories increased pension contributions and cut pension benefits. This was agreed by the health workers’ trade unions, who tacitly agreed to the government’s terms—in opposition to their own members’ who wanted to fight the measures.
In 2013, the NHS trade unions signed a rotten agreement with the Staff Council accepting a cut in health workers’ wages and conditions. The agreement included the introduction of performance-based incremental progression, an end to sickness absence enhancements, the elimination of the recruitment and retention premium and the removal of accelerated pay progression for Pay Band 5 workers, including nurses, midwives, physiotherapists and radiographers.
Last year, the Tory government announced the scrapping of student bursaries in order to reduce the funds given to Health Education England.
The RCN, RCM and other professional bodies representing Allied Health Professionals point out that the Tory government’s plan to scrap bursaries from this year will exacerbate the already dire shortage of frontline workers. The government falsely claims that replacing bursaries with student loans will attract more students for these professions—creating an extra 10,000 nurses training places by 2020.
The latest figures from UCAS, the university admission service, disprove these claims. There has already been a massive 23 percent fall in nursing applications this year in England compared to 2016, with 33,810 applying in 2017 compared to 43,800 applicants in 2016. It means that the number of nurses and midwives is set to fall even further.
It is indisputable that not only the government’s constant attacks on the NHS and workforce but the refusal of the unions to launch a unified struggle of the workers to defend the NHS and the staff’s pay terms and conditions have played a major role in the mass exodus of nurses and midwives from the register.
The willingness to oppose the attacks on NHS workers was shown in the bitter dispute of junior hospital doctors who, last year, fought the government’s imposition of an inferior contract. That is why the RCN, which allowed attacks to go ahead unhindered for seven years, has been compelled to call “a summer of protests” in order to keep its restive members under control. This follows a recent poll of RCN members finding that 91 percent would support industrial action in support of a pay claim. In an attempt to head off a possible strike, the RCN called on Prime Minister Theresa May to remove the public sector pay cap of 1 percent before a formal legal ballot on action later in the year.
May’s government are determined to go ahead with their plans to cut £26 billion from the NHS budget through its Sustainability and Transformations Plans (STPs), despite losing their majority in the election. There is no doubt that they will try to use a deliberately-provoked staffing crisis and other major problems within the NHS—resulting from years of slashing budgets—as a justification to privatise its remaining services.