The NHS is by its nature a highly reactive part of our public services, and is right now at risk of a bad chemical reaction between government pressure to drive down waiting lists and the financial “reset” that is being demanded of it.
What a list. What a set of choices for NHS leaders, who are having to deal with a predicted financial shortfall of nearly £7bn this year. NHS Providers pointed out that budgets have been stretched further by the pay awards for healthcare workers, but once again those raises represented an impossible choice between a demoralised workforce that goes on strike, or a better-paid one working in a denuded trust.
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Keir Starmer named the fall in waiting lists again last week when he responded to his party’s difficult set of results in the local elections. It’s not just waiting lists, but productivity targets, set at a level the previous NHS management simply did not seem to know how to reach.
The trust was pursuing foundation status at the time, and trying to meet tough financial targets to do so. One of the ways it met those targets was by shedding 150 jobs to save money, on top of 150 which were already vacant. This was not because those jobs were not needed – they were. There were now not enough staff to treat the patients.
Patients were waiting longer and longer to get their pain relief, not because the staff wanted to deny them treatment, but because they simply could not get round everyone in a timely fashion. Slowly, that became the norm, with workers forgetting or at least numbing themselves to what good care looked like.
Healthcare leaders have been warning for some time about the “moral injury” that workers have been experiencing in a stretched NHS that is unable to give people timely care. With fewer workers and services, and pressure to work as fast as possible, the risk of that moral injury leading to more staff becoming immune to the sound of pain, or making other choices that no decent person wants to make, is growing.
Labour needs to put as much effort into ensuring the quality and safety of care, as well as its speed and financial sustainability. Otherwise it is concocting a powder keg.
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