Live blog: new mood of militancy among nurses

CMF’s Head of Allied Professions, Steve Fouch (pictured below), is at the RCN Congress in Liverpool. He’s giving us live text, tweet and blog updates as events unfold. Keep following this blog post for further updates.

Monday 11 April 2011

13.01

The Royal College of Nursing Congress in Liverpool got off to a heated start this morning. The opening debates and key-note addresses have tackled the impact that cuts in staffing, pay and hours in NHS trusts are having on patient care and staff morale, while waste in procurement, prescribing and in private financing initiatives is wasting resources that could be put into front-line health services.

Motions early in the conference revealed nurses are getting militant about the impact of cuts on their patients and colleagues. In the key note address before lunch today Peter Carter, the RCN General Secretary, said that he had never heard so much talk of industrial action from nurses around the country.

This comes on the back of a year-long campaign by the RCN to document where cuts are being made, and where efficiencies could be made without impacting front-line services in the NHS. As trusts in England seek to save £20 billion over the next four years, some 10,000 posts are due to be lost, 54% of which are clinical staff, mostly nurses and doctors. Comparable cuts are being seen in the NHS in Wales and Scotland.  See this link.

At the same time the RCN says that inefficiencies in procurement, over prescribing of medicines, waste on management consultants, PFI initiatives on new hospital building (sometimes costing the NHS ten times what the new builds actually cost) and an estimated £2.5 billion surplus squirreled away by NHS trusts, means that, without hitting clinical services some £4.7 billion could be saved this year alone.

The government disputes these figures http://www.bbc.co.uk/news/health-13029534, but there is an agreement on both sides that there is a need for efficiencies, and as NHS costs increase at a faster rate than new funding, there is shared agreement that something has to be done. The real problem is what, and, as the RCN points out, patients won’t recover without nursing and medical staff, so why are trusts making the cuts here rather than these ‘back office’ savings?

Christians are called to be good stewards of God’s creation http://www.biblegateway.com/passage/?search=genesis%201:26&version=NIV, and this extends to our health services. We are also called to uphold the cause of the weak and the vulnerable http://www.biblegateway.com/passage/?search=isaiah%201:17&version=NIV, and it is often those patient groups with the least voice (particularly the elderly, those with long-term mental health problems, immigrant communities and the terminally ill, to name but a few) who tend to lose out when cuts are made. Standing up and giving a voice to the voiceless is surely a calling that all Christians in the health service should take up.

13:25

We have just heard (via the Guardian) that Health Secretary Andrew Lansley is to attend the RCN Congress after all. He had initially not been expected to attend, although he is not slated to make any speeches. Given the current mood here that may be wise.

14:22

#Congress2011 Lansley is apparently only meeting with a small number of nurses representing regions (@SteveFouch)

14:46

#Congress2011 Paul Ekwuruke – partnership breaks down if one partner breaks faith, promises or commitments (@SteveFouch)

14:54

#Congress2011“we are all married to the #NHS, for richer, for poorer, in sickness & in health” (@SteveFouch)

15:15

Andrew Lansley is now only meeting a limited number of invited representatives in a closed session – which drew an annoyed gasp from the floor when announced by the Chair of the RCN Council! There will be a public Q&A with one of his junior ministers tomorrow or Wednesday. Be interesting to see if he makes a more public appearance at the BMA ARM. The mood in the BMA sounds, if anything, even more unhappy than the RCN

15:21

debates continue – the first one this afternoon raising the question of whether the RCN should be continuing to work in partnership with Government and local authorities in light of current cuts – the upshot of which was several memorable quotes, the most memorable was that, like it or not, the NHS is like a marriage, and all parties are wedded to it, for richer or poorer, in sickness and health – we have to keep talking, even when relationships become strained for the sake of our patients.

Another resolution called for more transparency when NHS services are being redesigned on the impact on patient safety and well being, and currently being debated is one on the huge impact that welfare reform is having on the health of vulnerable communities (such as the elderly, drug users, the mentally ill, and young families in socially deprived communities). The focus of today has, undoubtedly been on a critical engagement with government and NHS leadership about the impact of austerity measure on patients, vulnerable communities and NHS staff, and we have only just skirted over the issue of the NHS reform bill. This is in marked contrast to the somewhat more cozy atmosphere at last year’s Congress, before any of the cuts and reforms were being proposed and all party leaders were making warm and cuddly comments and fuzzy promises about what they would do for nurses and the NHS if they were elected.

16:00

so – what a first day at Congress! The membership of the RCN are articulating a real sense of anger and frustration at how nurses are being demonised in the media – the accusations of a lack of caring and compassion in modern nurses (the “too posh to care” accusation about graduate nurses, the various scandals in the press about falling care standards in the NHS and for the elderly in particular), and the accusation that they have gold plated public sector pensions. Then there is a real sense of outrage and impact of cuts in services and staffing by NHS trusts seeking to cost save, and the RCN’s own finding that nursing staff are working longer hours, unpaid and without resources or back up to deliver adequate care.  As jobs are on the line (4-5,000 nursing posts this year, maybe as many as 20,000 over the next four years, let alone losses of doctors and allied health professionals on top of this), welfare cuts impacting the well being of the most vulnerable and disenfranchised, it is no surprise that there is an air of militancy and what feels like reforms that seem to be disproportionately affecting the sick, disabled and vulnerable.

And there are well researched alternatives – efficiency savings that may take more effort, but that will ultimately benefit front-line services rather than cutting back. If we are to be good stewards, we need to be looking at coalface efficiencies we can make in every area of the NHS, as well as at how we can champion the health needs and services of vulnerable groups in society.

Posted by Steve Fouch
CMF Head of Allied Professions Ministries
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