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Cuts, cash freezes and privatisation put NHS safety at risk

JOHN LISTER explains how activists are launching a campaign to Make our NHS Safe For All

DESPITE the efforts and dedication of staff, the NHS is fast becoming unsafe for patients, for staff and for the wider public whose families depend on the availability of services.

Eight years of frozen real-terms funding while pressures and demands on services increase, real-terms NHS pay falling further behind inflation and rising numbers of vacancies for vital staff have all taken their toll.

Hospital budgets have been squeezed down year after year by “efficiency savings,” so hospital trusts are having to subsidise A&E and other services in which the costs now exceed the payment they receive.

NHS Improvement, the regulator, has made things even worse by attempting to bully managers and press trusts into signing up for even tighter “control totals” that would compel them to shed more staff and axe beds or services.

The fragmentation of care, and reliance on private providers for some key services is yet another risk.

And massive pressures on overstretched GPs and community-based services are creating similar problems and dangers in primary care.
Now the inevitable cracks are starting to show:

  • 65 deaths in Dudley Hospitals’ under-pressure A&E are being investigated 
  • Over 100 maternity services cases of death or severe disablement are being probed in Shropshire hospitals, while the trust plans to close one of the two A&E units
  • A Norfolk hospital facing a shortage of nurses is considering closing its only elective surgical ward, cancelling even urgent cancer operations.
  • The BBC reports that children with mental health problems are being turned away from treatment unless they are diagnosed as suicidal.

A recent BMA survey found that 95 per cent of doctors, under constant strain, were fearful of making an error in their workplace.

More such failures are certain as long as management and the media blame and pillory individuals for errors forced by lack of support, adequate systems or safe staffing levels.

The potential dire consequences of such errors were illustrated by the case of Dr Hadiza Bawa Garba, the junior doctor who had to battle for three years to win back her right to practise medicine after being scapegoated for the tragic death of Jack Adcock in a systems failure at University Hospitals of Leicester. This type of injustice must not be allowed to happen again.

Not only is it wrong to blame individuals for system failures, it’s disastrous to leave flawed systems unchanged. To do so guarantees future failures will follow.

There is a real danger that, as more services fail, the public could begin to lose their confidence in the NHS and staff could begin a full-scale exodus from the worst-managed hospitals.

A complete change of approach is required. Health Campaigns Together believes we need a campaign to make our NHS Safe For All — safe for patients and safe for staff.

It should aim to compel every NHS trust to take preventive action, with a full, open safety audit by every trust to identify potential threats to the quality and safety of patient care, with urgent action to address any problems.

We need to ensure senior NHS England managers also pledge to listen to and act on warnings of trust management and staff and crack down on any trust manager who bullies or victimises staff who speak out on safety issues.

We must demand ministers make enough funding available for safe staffing of wards and services, with a safe skill mix of staff. 

They must reverse the cuts in medical and professional training, reinstate the bursaries and act to reduce the burden of debt on newly qualified professionals and doctors.

Health Campaigns Together has repeatedly challenged inadequate budgets and bed numbers. Now we must go further and demand a safe, sound, high-quality NHS that can cope with rising demand.

The fight to make the NHS Safe For All has to be waged on the broadest possible front, to unite everyone, whatever their political views, who is ready to fight for policies that can address the staff shortages and unsafe systems that have been worsened by cuts and fragmentation of services.

Health Campaigns Together affiliates voted unanimously on September 29 to launch a safety campaign and we are delighted to have already won support from Unison’s head of health Sara Gorton, who said: “I am happy to support this important campaign for safe services.”

Expressing their support, Unite’s national health officers Sarah Carpenter and Colenzo Jarret-Thorpe said: “Staff are currently doing the best they can to hold our health service together. Health visitors have seen their numbers slashed by 22 per cent since 2015, meaning caseloads are returning to dangerous levels.

“The government should not even contemplate asking them to do the impossible, so it’s time to sort this out, for all our sakes.”

In June the BMA voted to declare the NHS unsafe for patients and staff. Now BMA leaders are also supportive of the need for a campaign.

Dr David Wrigley, vice-chair of BMA council and a Lancashire GP, said: “The BMA recognises the extreme pressure doctors work under day to day in the NHS with inadequate staffing and resources. This has a direct impact on patients with doctors now feeling they can no longer provide safe patient care.

“This is a damning indictment of failed government policy and we will continue to press hard for adequate funding and staffing of the NHS for the sake of our patients.

“The government speaks of new investment but in the same breath asks us to make £3 of efficiency savings for every £1 spent. In the name of safety and quality, austerity and savage cuts have to stop.”

We are certain there is much more support to be won if we continue to build the campaign focused firmly on the issues.

We are proposing urgent discussions on the development of a Charter for a Safe NHS, or equivalent general statement of aims, to be the basis of a larger and wider campaign to be launched at the end of November.

We can discuss whether we should be aiming for specific legislation or for amendments to strengthen the NHS Constitution — or both.

We are also proposing to work with all those who support these objectives to develop training for activists wanting to build local initiatives and pursue safety issues, and a major campaigning conference Make Our NHS Safe for All in the
spring of 2019.

We urge trade unions, professional bodies, patient groups and local campaigns to help us in this fight.

Join the campaign to Make Our NHS Safe For All.

John Lister is editor of Health Campaigns Together. This article is taken from articles on pages 1 and 2 of the latest quarterly Health Campaigns Together newspaper, available online and in print from this weekend from www.healthcampaignstogether.com

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