Nursing in crisis

This piece appeared in PRN Magazine in July 2015 Nursing in crisis: The disappearing numbers   A pay-freeze, a row over safe staffing and new rules to kick thousands of nurses out of the country: it’s been a stormy summer in medical politics. Benedict Cooper reports. You’d be forgiven for thinking that the government has it in for the nursing profession. In the last two months alone, a string of policies have put pressure on a workforce already in strife, and laid some shaky stones to step over next.First NHS England asks NICE to halt an investigation into safe staffing – to the approval of the Department of Health but the dismay of safe staffing campaigners. Then the Home Office chips in with tough new rules to deport non-EU migrants earning less than £35,000 a year, which the RCN says could lead to the loss of 7,000 nurses. And, finally, to round off a torrid month, in his budget the Chancellor delivers the news that the pay freeze on all public sector workers is to continue – for four more years. “Getting tough on migrants might play out well with the public, but anyone who has worked in an NHS hospital knows how crucial these workers are for the service.” Take any one of these decisions in isolation, and you will find nurses reeling as a result. Take them all together, and it begins to feel like a concerted effort. Getting tough on migrants might play out well with the […]

The quiet exodus of GPs

This article appeared in the New Statesman in July 2015 George Osborne quietly slipped into his budget some news that the medical staff perhaps dreaded, perhaps didn’t even imagine was possible: the public sector pay freeze will continue. For another four years. I’ll just let that sink in. For months, doctors and nurses have been begging the public and the government to take notice: pressure on the wards is building to dangerous levels. Medical staff are overworked, under-appreciated and underpaid, and now there’s this insult to injury – a further slap in the face from a Chancellor unwilling to reward their graft with a share of the recovery, for which they have already sacrificed so much. It’s so far from justice, such a total misdirection of priorities, it’s taken this long to process. The Conservatives are on such a high at the moment that judgement seems to be on hold. Back in April at the health election debate, Jeremy Hunt barely managed to defend the Health and Social Care Act, on which the Conservative government’s entire health record will be judged. But last week he unveiled a policy that could only have made it into the X-rated version of the Health and Social Care Act. And his explanation for why printing the cost of a prescription, with the words ‘Funded by the taxpayer’ on the box would help patients and not just leave them guilt-ridden as well as sick, was so unconvincingly delivered on Question Time that I doubt it would […]

Greece: a word from the wise

From Will Hutton’s Them and Us (2010); Chapter 6 ‘Blind Capital’ “The new credit default swap (CDS) was meant to insure the holder of a security against default, but in fact it did little more than provide the means to speculate on the price of bonds, rather as currency options could be used to speculate on currencies. Again, there was no insurable interest: the CDS was not an insurable premium but a gambling chip. Buy a CDS in a bank or country debt, and as soon as there was concern about the credit-worthiness of the loan the price of the CDS would rise. Hedge funds buying CDSs in incredible volume would be key destabalisers during the banking crisis – the trigger for both Bear Stearns’ and Lehman’s demise – and later triggers of the sovereign debt crisis in Europe. It was massive buying of CDSs on Greek government debt in April 2010 that forced the massive EU and IMF bail-out.”  

The time bomb at the heart of the NHS

This article appeared in the New Statesman on July 1st 2015 Staffing: the time bomb at the heart of the NHS There’s an unnerving continuity at the Department of Health: a maddeningly consistent split between two realities. First there’s what’s going on in the wards, in the hearts and minds of the profession. Then there is what ministers like Jeremy Hunt and Ben Gummer say at the despatch box. The DoH must be aware, for example, that on Tuesday the Royal College of Nurses (RCN) voted 99.4 per cent in favour of a motion to lobby to reinstate the investigation by the National Institute for Clinical Excellence (NICE) into staffing levels, scrapped by Simon Stevens earlier this month. It was one of the urgent recommendations of the Francis Report after Mid-Staffordshire: someone needs to look into safe staffing levels, now. Not long later, NICE got on the case. Results had started to come in, guidance was being formulated. Jeremy Hunt, Ben Gummer and others must know that the RCN, safe staffing campaigners and other experts were incensed by the decision to halt this investigation, announced by Stevens without warning in a speech to the NHS Confederation in Liverpool. But in case they missed it, the full wording of the RCN motion was pretty unequivocal: “That this meeting of RCN Congress deplores the decision to halt the current work by NICE on safe staffing and calls for RCN Council to lobby for the reversal of this decision that puts patients at […]

Tory donor runs agency fund

‘Chief executive of firm accused of ‘ripping off’ NHS on staffing is a Tory donor’ The chief executive of a private equity firm that owns one of the staffing agencies accused by the government of “ripping off” the NHS is a major donor to the Conservative Party, The Independent can reveal. Ramez Sousou, founder and co-chief executive of transatlantic private equity firm TowerBrook Capital Partners, which owns Independent Clinical Services (ICS), has donated just under half a million pounds to the party since 2010, including more than £75,000 since his company bought ICS last year. Mr Sousou founded TowerBrook in 2005 and retains a stake in the company. His wife, Tiziana Cantoni, who is not connected to TowerBrook, has also donated personal funds to the party. On Tuesday the Government announced a drive to crack down on agencies providing nurses to NHS trusts, which Health Secretary Jeremy Hunt said are ripping off hospitals with “extortionate” fees. Writing in The Daily Telegraph, Mr Hunt said: “We will wrestle the initiative away from expensive staffing agencies that have been ripping off our hospitals with their exorbitant rates, and insist nationally negotiated frameworks are used instead, which make use of the NHS’s collective bargaining power.” The move came after it emerged that a number of companies have experienced a surge in their revenue from supply staff to the NHS over the past four years. Of these, ICS was identified as a major beneficiary, enjoying a 60 per cent increase in revenue between 2011 […]

The market is reaping as Hunt sows

This article appeared on Open Democracy: Our NHS on Tuesday June 2 The market is reaping as  Jeremy Hunt sows Tough talk by the Health Secretary on NHS agency costs belies the fact that the problem occured on his watch – and as a result of his government’s market policies. Today’s announcement on reducing the costs of agency nursing staff sounds like good old Tory get tough stuff. The NHS “needs to deliver its side of the bargain, which is to make efficiency savings”, Health Secretary Jeremy Hunt said today. He continued: “Can we really afford the kind of care we all want? With a strong economy, the answer is yes – but only if we care as much about every pound the NHS spends as every patient it treats. Because money wasted is money that can’t be spent on those needing care.” But Hunt’s greatest efficiency here is with the truth behind the wastage. The Public Accounts Committee repeatedly warned him that Trusts’ finances are being squeezed as they are forced to rely on agency staff. But under Hunt’s watch, the money spent on agency fees soared to record highs. “Hunt ignored agency issue and [is] guilty of neglect”, Alan Maynard, Emeritus Professor of Health Economics at York University commented today. The Royal College of Nursing (RCN) revealed in February how spending on agency nurses leapt from £327m in 2012/3, to £486m in 2013/4 – and is predicted to be just shy of £1 billion in the last financial year. And […]

The blind faith of the right (+what’s left for the left)

‘Sanctioned’ by Dani Lafez. Dani’s artwork is for sale here – proceeds go to arthritis research.  The blind faith of the right  (and what’s left for the Left)   Dani is a very poorly lady. Severe rheumatoid arthritis is attacking her spine, she has a snapped lumbar ligament, and last week after a gruelling eight needles were injected into her vertebra, an x-ray revealed that a hoped operation to fuse two of the disks in her back wouldn’t be possible because the surrounding disks have disintegrated too much. At the age of 26 she is facing the rest of her life taking morphine, by 40 she is likely to be in a wheelchair, and she has been told that the prospects of her body being able to bear a child are almost non-existent. But these aren’t her only troubles. A month ago she was sanctioned by the DWP. It’s been a tough month. Dani’s been handed around from person to person, with vague explanations given, such as her partner being in ‘full time work’ now (it’s an apprenticeship and he’s on £3.25/hour) and a so-called administrative error in which a ‘change of circumstance’ application Dani had to fill out didn’t have a due date on it. By the time she had gathered the masses of personal medical information the DWP required, only five days later, it was too late. No benefits for a month. At the next ‘infringement’ the sanction will be for 13 weeks. – Dani is one of […]

We tried

I won’t lie, I felt pretty abject on May 8th. So many hopes shattered, so many people now entering frightening unknowns, feeling insecure, threatened, battle-weary; so much disappointment, so many careers dashed and prospects ruined. This is the reality which a whole nation of healthcare workers woke up to the day after the election. Because we the Left could not persuade you the voting public what was at stake yesterday. I’m sorry. I’m sorry we could not speak over the volume of a right-wing press complicit in the dismantling of our greatest public service. We could not persuade the BBC to give you the facts, or ask the government the right questions on your behalf. Lacking all conviction, we tried. We tried to spell it out. Four years ago 400 health professionals and experts publically condemned the Health and Social Care Act, hoping to get your attention, saying the Bill would “erode the NHS’s ethical and cooperative foundations, and [would] not deliver efficiency, quality, fairness or choice”. You ignored them. Since then countless experts not driven by political ambition – the BMA, the Royal College of GPs, the Royal College of Psychiatrists, the Royal College of Nursing– have pleaded with the government to think again. They have all been dismissed by the government, which knew better. And those professionals who pleaded for mercy have since seen their budgets squeezed, pay frozen, wards shut and services fragmented. The “moral economy” which once gave NHS hospitals “almost a family atmosphere”, to quote a nurse […]

I’m voting to save the NHS

I’m embarrassed to admit, that I used to dismiss talk of the ways the NHS was changing. I’d read a few things, but never really understood what it all meant.  I never really grasped the true nature of the health service, its history and the way it is being altered today. I shrugged off talk about private companies taking over, and counter-argued with the fact that the population was growing, ageing, and as a result the way we funded its care needed to change. But for the past 18 months I’ve covered medical politics for a number of titles, including the New Statesman, Open Democracy, and others. It’s been a fascinating, often painful education. I have met with nurses, doctors, academics, politicians, campaigners, patients and concerned members of the public, who have spelled out what is happening to our NHS. The other day I had a particularly sad conversation, with a nurse I was interviewing for a feature. He described the death of what he called a “moral economy” among NHS workers. He said: “There was almost a family environment in hospitals before. That’s been taken away; the market has ripped the heart and soul out of the service”. In 2015 we face a lot of big issues as a country – low productivity, public expenditure which well outstrips our national income, environmental challenges, the need to find a fair balance on immigration and so on. They’re all important, but I’m not expert enough to make any big statements on them […]

Election special: PRN Magazine

A special election report for PRN Magazine analysing the main party manifestos and how nurses felt they were being represented in the campaigns.

Fallen angels?

My first feature in the debut edition of PRN Magazine, a new online title dedicated to the nursing profession. I was approached by the founder to cover medical politics and nursing, and this feature, ‘Fallen angels?‘, examines the link between reforms by the Coalition government and falling morale. Fallen Angels? A damning report in December revealed increasing levels of stress, anxiety, mental and physical health problems, and falling morale among the nursing profession. Benedict Cooper investigates this worrying trend. Benedict is an investigative journalist and writes regularly for the New Statesman. Illustrations by Rosie Irvine “A perfect storm is developing”, reads the brochure for the ‘Protecting the frontline against burnout’ conference, which took place in March. “Amid rising demand for services and reduced resources,” it continues, “workload is the ‘tip of the iceberg’ in terms of stressors”. It’s an uncomfortable truth which, sadly, will come as no great surprise to thousands of nurses in Britain. Studies consistently show a rising tide of work-related stress and anxiety, absenteeism both short and long term, recruitment problems, an increasing reliance on costly agency staff, and a steady decline in morale. So what’s going on? What has happened to a workforce once considered the guardian angels of Britain, and what is causing stress to rise, and morale to fall, in the new health service? “Studies consistently show a rising tide of work-related stress and anxiety…..and a steady decline in morale” Back in December, Nursing Times asked 700 nurses about their own experiences of working life […]

On the trail…

…with the March for the NHS A few shots from another wonderful gathering arranged by the People’s Vote for the NHS. It was held in Nottingham on March 28th, with a large crowd marching from the Forest Recreation Ground into the Market Square, where a host of great speakers including organiser Rehan Azam, Green Party PPC Lydia Davies-Bright, local nurse Lisa Clarke and others addressed the crowd.  

Number crunching…

100 business leaders, including Tory donors and supporters, put their name to an ‘open letter’ endorsing Tory policies – welcomed as a triumph by the party. 400 medical professionals write an open letter in 2011 urging the government not to proceed with the Health and Social Care Bill, saying it will do “irreparable harm to the NHS” – completely ignored.   Here’s the letter, and the list in full: Health Bill concerns (04.11.2011) SIR – As public health doctors and specialists, we are concerned about the Health and Social Care Bill. The Bill will do irreparable harm to the NHS, to individual patients and to society as a whole. It ushers in a degree of marketisation and commercialisation that will fragment patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the health system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively to communicable disease outbreaks and other public health emergencies. While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms will disrupt, fragment and weaken the country’s public health capabilities.

NHS: the hard questions

…If the Today programme won’t ask the difficult questions about the NHS, I will When David Cameron woke up this morning, surely he must have had a little tingle of nerves about his appearance on the Today show. On the NHS alone, his record as PM has left enough questions to fill the whole three hour show; surely a short sharp burst from Sarah Montague was going to be an excruciating experience. Today’s researchers had plenty to choose from. For years, long before that insidious document, the Health and Social Care Act was enforced on the system, alarm bells have been ringing. The BMA, the Royal College of GPs, the Royal College of Psychiatrists, the Royal College of Nursing, countless doctors, nurses, academics, public policy experts, unions, campaigners – in the interests of word count I’ll leave it there – have been warning, no pleading with the government to change course, and for the public to wake up to the ominous reality of what the Act means. But to Hell with what they think. Without even acknowledging a word of it, the only person our Prime Minister chose to quote today was Simon Stevens – a private healthcare man charged with reforming the public NHS. Of course, this is hardly a surprise. Cameron isn’t likely to quote the medical professionals who actually have to carry out the work (unlike me, see below). When you’re lead around by Oliver Letwin, the author of public-service destruction manual ‘Privatising the World‘, you’re not […]

Antibes & Juan les Pines

It’s the schizophrenic nature of my existence as a freelance journalist that I find myself one day covering the world’s largest real estate exhibition in Cannes, the next walking along the ancient stone walls of Antibes, only 12 minutes away by chugger train but in an utterly different world. I had arrived filled with a sort of neurotic momentum. That forced pace that always builds up during a week of tearing around the miles of temporarily-carpeted drags between the row upon row of neon stands of the Palais des Festivales in Cannes.   – But the further I walked through the still stones and flowered walls of Antibes, the slower I walked. My frequency changed. I could physically feel my muscles and my mind untangle with every step I took through the Old Town. With tired eyes I took in all the new colours and gentle light from the bouquets and ornaments that twinkle on the pale beige walls and wooden doors along the narrow rues and alleyways. After a little while I turned some little corner, somewhere around the Musee Picasso, and found myself face-to-face with a Spitfire-grey Mediterranean Sea. I’d allowed myself a few glances out over the previous six days, but somehow between the masts of multi-million Pound yachts dolled-up with corporate banners, and an ocean of ruddy-cheeked middle-aged men in suits braying to each other over the sound of Euro-pop, the Mediterranean doesn’t seem quite so idyllic, or natural even. This time it felt much more […]

NHS Reinstatement Bill

A new Bill plots the way back for the NHS – but it’s not Labour who are behind it First published in the New Statesman on Wednesday March 11th Later today, in the dusk of this parliament, a new Bill will get its first and perhaps only reading in the Commons. It’s unlikely to set pulses racing in any of the main party machines, but in certain circles the NHS Bill [3] represents the last ditch to save a dying public service. It is the result of three years of patient work led by two leading public health experts, Professor Allyson Pollock and Peter Roderick of the Centre for Primary Care and Public Health at Queen Mary, University of London. In the bill, they say, lies a trail of breadcrumbs to take us back to a different era. A time before the Health and Social Care Act; before the NHS was such fertile ground for profiteers. A time when money allocated for patient care wasn’t routinely squandered on futile bidding wars, failed private experiments, a contrived internal market and debilitating PFI repayments. “We’ve been working on this ever since the Health and Social Care Act came in,” says Allyson Pollock, speaking to me earlier this week. “We knew this time would come. What we’ve got in the Health and Social Care Act is a destructive reorganisation which has started the breakup of the NHS. “If we don’t bring in legislation then privatisation and the breakup of the service will continue; […]

In Pictures: Lace Market, Nottingham
In Pictures: Hockley, Nottingham