With the general election impending, it is crucial that we take time to consider the way in which politics shapes healthcare.
The National Health Service (NHS) was established in 1948 with an aim to make health services accessible for all. The core values outlined that it must meet the needs of everyone, be free, and based on demands of the population, not their ability to pay (Department of Health 2015).
As medicine has advanced, the average life span has increased which has intensified the demands on the system. This has resulted in inequality, debt, and strain. Although these impacts may not have been predicted initially, the cost of leaving them unaddressed is taking its toll.
While the NHS aims to meet the needs of the population, the improving diagnostic methods and survival rates for conditions, like cancer, have highlighted the need for early intervention in improving outcomes.
In addressing nationwide inequalities, it has been recognised that, based on geographical location, inequalities exist. Through analysing the discrepancies, Macmillan (2014) proposed that it may be related to the delay in referral times from GPs to specialists, and consequently the wait for treatment.
In a country where healthcare is so advanced, it seems absurd that such a vast difference in survival rates should exist. Geographical location should not dictate the time elapsed between referral to treatment.
Staff pay has been a continuous source of anguish in the NHS for the past seven years.
Pay rates are not increasing at a rate that correlates with the cost of living and inflation. Since the current coalition has been in power (2010), staff pay has decreased by six percent (Campbell 2017). This makes it increasingly more difficult for nurses to remain in the NHS if they can find better sources of income elsewhere.
I recently read an article about NHS staff quitting to work in supermarkets due to pay (Campbell 2017). With current plans to cap pay increases at one percent for another three years, staffing shortages can only worsen.
In another article discussing wages, it was revealed by the Royal College of Nursing that some nurses are accessing food banks and hardship grants to survive (Campbell 2017).
In reading this article, I am reminded of my own experiences and lack of desire to return to work in the NHS. After leaving a year and a half ago, I now feel that I am now unable to return as I would be taking a pay cut to do so.
Although the training and experience is invaluable, it often takes at least two years of employment for trusts to be willing to fund any major courses (due to financial restrictions). Sometimes, it is a case of subsidising your own training.
In considering this, I cannot help but weigh up experience against the ability to build savings while maintaining a life outside work. To meet these requirements in previous jobs, I worked agency or bank shifts, frequently exceeding full-time hours. The thought of returning to that point in my life feels less than desirable.
In line with staff recruitment and retention issues, due to ‘Brexit’, the NHS faces losing a significant number of employees recruited from the European Union. From exposure to working with these professionals, it is evident that the NHS cannot afford to lose such highly skilled workers.
Post-Brexit, registration of EU nurses has decreased by 92% (Boffey 2017). Many who are already on the register no longer feel welcome and some have returned home (Boffey 2017). It is our duty to acknowledge their contribution to our services and fight for their right to remain in Britain.
In considering the merits of the NHS, it’s vital that we remind ourselves of exactly what we possess. From experiencing and observing systems in other countries, I have consistently concluded that we are privileged.
In the United States, for example, if you are not insured, accessing services is costly and can result in debt. Entitlement to insurance is dependent on employment and benefits. Low income insurance offers very poor coverage and still requires high payments. With minimal restrictions to healthcare access, the NHS is one of the most highly regarded systems in the world, ranked at number eighteen by the World Health Organisation (2000).
At a time when the destruction of the NHS is a realistic threat, we must consider the premises on which it was founded upon.
Throughout these past sixty-eight years, research has given way to more complex treatments and an increase in the average lifespan. Despite these modifications to healthcare, the three initial guiding principles are still applicable.
In the upcoming election, the outcome could drastically impact the population and the driving forces behind the healthcare system. It is down to us to continue to highlight the sources of the problems and ways in which they may be resolved or means in which the system can be strengthened.
The presence of nationwide inequalities must be decreased, staffing issues must be addressed by resolving pay discrepancies, and retention of staff from the European Union must be prioritised.
Although these are not the sole concerns of the NHS (debt and privatisation are also noteworthy threats) the outcome of each of these carry a strong enough significance to impact the future of healthcare. In acknowledging this, the necessity to vote and to do so in a way to preserve what we have worked so hard to construct has never been so important.
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- Boffey, D 2017, ‘Record number of EU nurses quit NHS’, The Guardian [Online], 19 March, viewed 23 May 2017, https://www.theguardian.com/society/2017/mar/18/nhs-eu-nurses-quit-record-numbers
- Campbell, D 2017, ‘NHS staff ‘quitting to work in supermarkets because of poor pay’’, The Guardian [Online], 8 May, viewed 23 May 2017, https://www.theguardian.com/society/2017/may/08/nhs-staff-quitting-to-work-in-supermarkets-because-of-poor-pay
- Campbell, D 2017, ‘Nurses will see their pay ‘cut by 12% over a decade’’, The Guardian [Online], 30 April, viewed 23 May 2017, https://www.theguardian.com/society/2017/apr/29/nhs-nurses-pay-cut-12-per-cent-over-decade
- Department of Health 2015, The NHS Constitution for England, viewed 23 May 2017, https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england
- Macmillan Cancer Support 2014, ‘6000 cancer patients dying needlessly under a year due to postcode lottery’, Macmillan Cancer Support, 15 August, viewed 23 May 2017, http://www.macmillan.org.uk/aboutus/news/latest_news/6,000cancerpatientsdyingneedlesslyunderayearduetopostcodelottery.aspx
- World Health Organisation 2000, Health Systems: Improving Performance, WHO, viewed 23 May 2017, http://www.who.int/whr/2000/en/whr00_en.pdf
Florence Bull BSc (Hons) is a registered adult nurse. She has a background in neurosciences and emergency medicine. Currently she is working as a nurse practitioner in sexual and reproductive health and is an accredited sonographer in early pregnancy. Her work has been published by the Guardian and she writes her own blog, Subcutaneous. Florence has an interest in global health which was sparked by an elective placement in Tanzania during her studies. She aims to pursue a Master’s degree in this field in upcoming years.