In my opinion the electorate cannot afford to ignore the massive challenge of staff recruitment and retention facing the NHS, which is under unprecedented strain.
The NHS was intended to be National, providing equivalent care across the UK but inequality in health exists due to social factors and inequity of provision of healthcare, especially to the elderly, mentally ill and ethnic minorities continues.
Government cuts in social care are now impacting the sustainability of the NHS.
Access to social care increasingly depends on what people can afford and where they live rather than on needs.
Organisational cynicism (i.e. a negative attitude towards one’s employing organisation) is spreading and poor job satisfaction, emotional exhaustion and high staff turnover are becoming more common. Almost a quarter of a million patients had to move practices due to practice closures or mergers in England in 2016.
Fifteen months on from NHS England’s announcement of a target of 5,000 more GPs by 2020 we have 542 fewer whole time equivalent GPs and we are looking to European doctors to fill the gaps! “GPexit”, as the fall in GP numbers has been called, must therefore be relevant to “Brexit” negotiations because the NHS requires, as it always has, motivated and keen overseas medical staff in order to provide the service the public expects.
The initial priorities of the next Government should include genuine reassurance to overseas personnel that they are valued and welcome in health and social care, efforts to attract overseas health professionals to the UK and plans to reduce the number of young doctors who are emigrating.
The Chancellor’s announcement that there will be a GP triage system in every A&E department by Christmas demonstrates that politicians are not necessarily the best people to be running the NHS.
GPs are needed in the community to reduce the number of people seeking an A&E opinion!
There is also a pressing need for community nurses, as confirmed by the Nuffield Trust, which has stated that 21% of District Nurse posts in England remain vacant.
NHS financial savings would result from extra clinical nurse support for nursing homes, more resources for end of life care outside of hospital and more access to specialists outside of hospital.
Nationally we spend 50% of NHS resources on the last six months of life, mostly on hospital care but these costs would be reduced by strengthening community care.
Radical NHS England plans for the sustainability and transformation of the NHS are highly ambitious and the cynics would say need a good dose of realism. Limiting funding and delegating decisions to CCGs has brought in rationing of health services previously provided by the NHS.
GPs are increasingly embroiled with supporting individual patients in their attempts to obtain NHS funding for specific operations previously provided by the NHS and this has contributed to rising cynicism amongst patients and GPs. In parallel to this trend, political announcements fuel public expectation of an improving health service.
The fact is that it will be very difficult to maintain current services within budget but we do need to look at new ways of collaborating within the NHS, recognising the adverse effects of an internal market.
We need to counter an NHS culture infected by cynical attitudes (I am also speaking to myself here) by seeing the good in our NHS, by judging ourselves before others, by maintaining the hope of positive change through a valued and vocationally minded workforce and by influencing future Government policies on health and social care.