Christmas is a time when families come together to care for each other: this year, with waves of strikes in the public sector paralysing the UK, millions of people are struggling even to care for themselves, writes Philip Bushill-Matthews.
Public support for the various strikes is variable: but support for healthcare strikers is both positive and growing. There is clearly a major problem with pay where nurses in particular have felt left behind, but that is by no means the only issue: 40% of nurses leaving said they felt burnt out because of pressures at work. For the NHS is to survive this has to be addressed. Then there are so many other interlocking problems: the Government has failed to show it understands any of them, and also seems not to care.
A recent World Healthcare Organisation (WHO) Report observes that some 115,000 foreign trained nurses were on the UK register in 2022, an increase of 66% since 2017. Those coming from the EU have declined while recruits from Nigeria and the Philippines have increased. The most significant change has been in the nature and number of those leaving the profession entirely. The Kings Fund recently reported that from June 2021-June 2022 there was a 25% jump in the number of nurses exiting the NHS, a new high of at least 34,000 in the 12-month period. Of particular concern is that two-thirds of this total were under 45 years of age.
There are some 50,000 nursing vacancies in the UK and over 10,000 medical posts also currently unfilled. According to the Economist, EU countries in the OECD have an average of 3.7 doctors per 1000 population: the UK has 2.9. The UK also has a £9 billion backlog of building repairs, and the NHS overall has some 7 million people on waiting lists.
Meanwhile the number of beds available in NHS hospitals has halved in the last thirty years. Latest comparative data from 2019 shows the UK with 2.5 beds per 1000 people compared with France at 5.9 and Germany 8.0. To compound the problem one-sixth of UK beds are filled by patients well enough to be discharged but with nowhere to discharge them to, given the lack of sufficient social care facilities within communities.
Although not on strike the voluntary sector is not immune to problems, with hospices facing extra costs of £100m a year. Generally reliant on donations to cover 80% of their normal running costs, some hospices have claimed they will have to reduce services.
Care homes are also struggling. There are at present some 17,000 care homes in the UK housing around 400,000 residents – 70% of them suffering from some form of dementia. Although there are around 700,000 care home staff, there is still a massive shortfall of some 170,000: in 2021 there was a turnover of nearly 30% of care-workers – in part because many have discovered they can earn 30% more money working in supermarkets or for Amazon. With local Councils responsible for disbursing funding, the Government is providing £850 million less than is needed now despite the number of elderly people requiring long term care projected to increase by nearly 60% over the next ten years. This is another problem which is bound to get worse. The country’s 10,000 pharmacies are also close to collapse, because of decreasing funding and increasing demands.
Having been Vice-Chair of an NHS Trust for several years I share the frustration felt at all levels. In the end there will need to be more money, but more money on its own does not address the core problems of extra bureaucracy and complete lack of joined-up thinking. The best way to find any solution is to start by recognising the nature and scale of the problems. Then to lean on the advice of the people directly involved rather than try to impose solutions from the top.
The question ‘who cares?’ has at least two answers. The first is that the population cares about their own health, the health of their loved ones and the viability of the overall healthcare sector. The second is that those who work in the sector care very much. Their mission is to protect and enhance the quality of life of those in their care: their only proviso is that it should not be at the expense of their own quality of life. All those involved in the care sector are there because they want to be there and want to see it succeed. They know better than any Government.
Ministers are not talking to unions, which is unreasonable. Ministers are also not listening, which is unhelpful. Only when they do both will solutions have the chance to emerge – and people might start to believe that the Government also cares.
The Author, Philip Bushill-Matthews, is former Leader of the British Conservatives in the European Parliament.