Review by Steve Fouch
CMF Head of Nursing.
In May, the Government announced a move towards a fully seven days a week service in hospital and primary care. (1) This proposal sounds good in theory. Running GP surgeries seven days a week would increase equity of access and reduce pressure on overstretched A&E departments. Meanwhile mortality rates for patients admitted to hospital at the weekends can be up to 16% higher than those admitted on weekdays, (2) so running the same standards of staffing and services at weekends also sounds sensible. The major problem is cost. It will require more staff, paid at higher rates for working unsocial hours, the running and maintenance of complicated medical equipment, heating and lighting. However, with the NHS needing another £30 billion a year by 2020 just to maintain services, (3) where is the extra money going to come from?
The second issue is staff. Initially we could recruit nurses from overseas, but we are not going so readily to recruit more consultants and GPs. The current intake of GP trainees is running at 70% of capacity – and the gap widens year on year. Newly qualified doctors are put off becoming GPs as they see all the non-medical work and stress it now entails. (4) Yet to reach the Government's target of 5,000 new GPs, half of all medical graduates would have to train in family medicine. (5)
Many nurses, living with long term wage freezes and possible cuts to overtime pay, are getting weary and angry enough to consider industrial action. (6) Others are leaving the profession; projections suggest a decline in the nursing workforce of 0.6 to 11% between 2011 and 2016. (7)
The general election campaign showed that none of the parties were addressing the critical challenges facing the NHS. Staffing and funding are just two of many issues, including an ageing population with growing expectations, increasingly costly medical technologies, and a rise in chronic diseases often brought on by poor lifestyle choices. The NHS was founded in the forties to address very different needs. We need a major rethink of what kind of health service we now need, and how we fill the gaps left behind.
The church could be a key part of addressing some of these gaps. Much of the psychosocial support now given by GPs is what local minsters undertook in the past. Churches already promote health through clubs for the elderly, parent and toddler groups and Parish Nurses. (8) Can the church reengage in other areas of primary healthcare, as it has done so successfully with debt counselling, food banks and street pastors over the last few years? Maybe it's time for church and state to rethink our roles?