New figures reveal an alarming rate of nurses departing from NHS England, resulting in a concerning downward trajectory in retention rates. The already strained National Health Service (NHS) is seeing an exodus of nurses on an unprecedented scale, at a time when the strain on the service has already reached breaking point.
Last year, 33,000 nurses left the NHS, meaning that 10 percent of the nursing workforce have left NHS employment in each of the past three years.
The data is from an annual report published by the Royal College of Nursing (RCN). In the introduction, it states that “previous labour market review reports have warned of impending crises in the future supply of nursing staff, due to a lack of adequate workforce planning and workforce strategies. This year’s report shows that these warnings have inevitably been realised.” Such is the crisis that the RCN estimates there are now 40,000 vacant nursing positions in the health service.
The report goes on to qualify that this has been driven by a “perfect storm” of inter-related issues affecting recruitment and retention, which include the Brexit vote to leave the European Union (EU), workload, pay pressures and the impact on new nursing staff due to the restrictive changes for prospective nursing students.
The 33,000 nurses who left the NHS could staff 20 hospitals and is a 20 percent rise on that of 2012-13. These figures were provided by NHS Digital. As part of an analysis of their data, the BBC noted that the gulf between those leaving and joining the profession was much narrower in the earlier period. It explained, “Leavers outnumbered joiners by 3,000 last year, the biggest gap over the five-year period examined by the BBC.”
These figures confirm earlier reports delivered by the Nursing and Midwifery Council and the King’s Fund think tank last autumn. They both issued stark warnings of the decline in nursing staff, which the Department for Health and Social Care dismissively rebutted as a “mere 0.2 percent decrease” from the previous year.
The Department for Health declared that since the start of the Conservative government in 2010—in a coalition with the Liberal Democrats—the number of nurses has risen. However, figures show that it is a minute increase of just over 1 percent, whereas comparatively the population has grown by 5 percent. According to the BBC, the demands on NHS services as a whole have increased by somewhere between 10 and 20 percent in the same period.
The report highlights that staff across the board saw their real term median annual earnings fall by 14.3 percent between 2011 and 2017.
Applicants to study nursing in the UK have fallen steeply, with a 22.7 percent decline since 2016 as well as a 23.7 percent decline for those from the EU. Brexit has been chalked up as the obvious reason for such a decline for EU applicants. The changes in funding from bursaries to loans have had an adverse effect on UK applicants. Given 5 percent of nurses and midwives and 4 percent of auxiliary staff come from an EU country, the current post-Brexit situation—which has seen no specific guarantees afforded to EU migrants to the UK—the figure is hardly surprising.
Various sources cite that NHS Improvement—the regulating body of the NHS—already has various measures in place to try to halt the exodus of nursing staff. These include transfer systems for those looking for new jobs, master classes in retention for Human Resources teams and nursing directors, and “Awards schemes” in recognition of achievement.
The government points to its “historic” increase of nursing training places by 25 percent. But Siva Anandaciva, chief analyst at the King’s Fund think tank, responded that “training nurses takes many years and will not meet the short term needs of the NHS or its patients.”
Any claimed increases are set to fall from August as postgraduate nurses, midwives and allied health professional students are being forced to take out student loans to cover their costs.
Undergraduate nurses had their bursaries abolished last year, which immediately led to a 23 percent slump in the number of applications by students in England to universities nursing and midwifery courses.
Some 1,000 trainees, who are postgraduate students, come into the profession every year and receive a bursary for tuition and maintenance, worth up to £8,000 a year. This bursary is also being ended, with the postgraduates forced to take out loans from the Student Loans Company.
The lack of resources, both material and human, continues to undermine the world’s largest national health service, which is 70 years old this year. The systematic assault on the NHS by successive governments has taken its toll and the cracks are ever more evident. The scenes over the Christmas period—with thousands of people unable to access basis health care and scores of people dying whilst waiting for ambulances and on trolleys in hospital corridors—demonstrate the terrible impact of the slashing of the NHS funding.
In an unprecedented letter, dated January 10, doctors representing 68 A&E (accident and emergency) departments wrote to Prime Minister Theresa May that “the NHS is chronically underfunded. We have insufficient hospital and community beds and staff of all disciplines especially at the front door to cope with our ageing population’s health needs.”
The letter notes that “[t]housands of patients are waiting in ambulances for hours as the hospitals lack adequate space,” citing scientific publications and the length of time patients are expected to stay in Emergency Departments (ED), impacting negatively on mortality rates. The letter concluded by quoting the NHS constitution of 1948: “The NHS belongs to the people … it touches our lives at times of basic human need when care and compassion are what matter most.” For the ruling elite, these sentiments are a dead letter.
The growing privatisation of the NHS is the unstated goal of the Tory government and its big business backers. Recent figures revealed a further £3.1 billion out of the roughly £101 billion budget of the NHS was hived off to the private sector last year alone. This onslaught sees private companies now in control of 43 percent, an increase of 9 percent on last year’s 34 percent share.
Despite the pledges by the trade union bureaucracy to organise a “fight” in defence of the NHS, they have not lifted a finger as the government has intensified its attacks. The unions refused to mobilise their membership for a national demonstration in defence of the NHS last week.
All that is offered up are dead-end appeals to a government hell-bent on destroying the NHS. Commenting on its figures on nurses leaving the profession, head of the RCN, Janet Davies, declared “The government must lift the NHS out of this dangerous and downward spiral. We are haemorrhaging nurses at precisely the time when demand has never been higher.”
Along these lines, the RCN report notes of the Tory’s initiatives: “While it is surely welcome that attention is being paid to ensuring future supply, this must not be done at the expense of ‘hollowing out’ the nursing profession and undermining the role of the registered nurse. This will be the inevitable consequence of continued failure to invest in the workforce alongside the substitution of the registered nurse role with non-registered staff.”
Labour leader Jeremy Corbyn absented himself from the demonstration, despite stating at last year’s national NHS protest that Labour would defend the NHS as “We’ve got the faith, we’ve got the fight and we are up for it!”
The struggle to defend the NHS cannot be conducted by any of the bourgeois parties, but only on the basis of the fight to build an independent party of the working class, based on a socialist perspective. This is the programme fought for by the Socialist Equality Party and its NHS Fightback campaign initiative.
For further information visit NHS FightBack and the NHS FightBack Facebook page.
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[15 January 2018]