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Monday 30 November 2015

The less evidence there is that homeopathy works, the more effective it is.



It has been an interesting November for the health service in England.  This post is to deal with the Junior Doctors strike that has just been averted, the deficit and also nursing issues all of which are important.  If you get bored and do not want to read this, just scroll down to the pictures.

Jeremy Hunt has managed to convince Junior Doctors that they need to go on strike over the NHS contract in England that they are convinced is not safe for patients and not fair for doctors.  This is both with the issue of the removal of protection to stop doctors working too hard and payments for antisocial hours being cut (in addition to a redefinition of what antisocial hours are).  In addition to this, he had refused the offer of arbitration on these issues (though he did finally agree to this, as well as suspending his threat of imposition of the contract).

In addition to this, hospitals in England are running up huge deficits.  Part of this is due to the reduction in payments that they get for seeing patients, and part is due to the huge pressures that austerity is causing.  When councils have to cut social services, patients suffer, and if those patients are in hospital, they can not be discharged to an environment that is felt to be too unsafe (before anyone takes offence at this, the only place where someone is not at risk is in the afterlife).  Some have argued that this just shows how inefficient the NHS is, but they forget one big thing.  Circle, a private company had the contract to run Hinchingrooke hospital, and gave it back.  Although may may site the CQC reviews, other point out that it just was not profitable due to the huge pressures in A&E.

Now the government have stated that they want this to change, and in order to do this, more care is to be provided in the community, but a big problem in providing this is that GP surgeries are understaffed.  Loads have vacancies for partners to join them, much more than was the case in 2010.  Although the government has stated that they are going to change this, no sign of this has been noted.  More doctors are leaving salaried jobs in general practice as many are leaving partnership, basically as they are able to earn more money for less work elsewhere.

This issue with a shortage of doctors is not just seen in General Practice, but also in hospital specialities such as psychiatry and also in Emergency Medicine, the speciality that is thought to be the most affected by changes in the NHS contract in England.

And the NHS is not just facing a shortage of doctors.  Many hospitals do not have the nurses available that they need to provide a good standard of care.  So the government, in their wisdom, are to remove the bursaries that nursing students get.  The argument is that the courses are in huge demand and lots of people are turned down.  However this does not look at the issue that people are leaving nursing.  And why should they stay?  They have had pay rises frozen before and loads have left to become agency nurses rather than work harder for less pay in the NHS.   Worse, restrictions on pay both those that have been in place in the past for nurses within the NHS, but also the planned ones for agency staff run the risk of reducing the numbers from abroad that we need to fill the vacancies that are present.

Jeremy Hunt himself, in addition to telling everyone that Everything is Awesome, has endeared himself to NHS staff by taking his children to A&E as his GP was closed rather than contacting the out of hours service and lately, stating that mortality (i.e. death) rates are greater on weekends.  It is not.  (While you are more likely to die if admitted on a weekend, the day you are most likely to die on is a Wednesday.)

So, NHS staff have been leaving before 2010, but more have left since then, and while the Conservatives have said that they are going to give the NHS more money, they have stated that they have done so before, and yet the cuts, sorry, efficiency savings, continue...