I stopped to chat with some of the strikers outside Ards hospital yesterday evening (Friday 6 December). After talking to Barry and Gillian (pictured left and right above) I am firmly convinced that they are absolutely right to raise urgent concerns over the state of our health service.
The media tend to focus on the issue of equal pay – and to be sure that is important; but it is only the start of a whole sequence of problems that tend to feed back and amplify each other.
So let’s start with pay. A qualified nurse in Northern Ireland starts on £22,795, whereas in Scotland they start on £24,670. Could that be one reason we are struggling to fill nursing vacancies?
And if you struggle to fill vacancies, then you end up turning more and more to agencies to supply temporary contractors. Now, the bill for contractors in the NHS in Northern Ireland was £76m in 2014-15. That rose to £134m by 2016-17, then £156m in 2017-18, then £200m. And this year the total is expected to reach £230m.
Does anyone notice a pattern?
Putting all that public money into agency staff is a bad investment. Only some of it goes to the nurses and other staff themselves – the rest goes to the agency, to cover costs and to generate profit. So as the bill rises, more and more of our public funds are going straight into subsidising somebody’s private business. That’s money that is no longer available for investing in recruiting and retaining full time, permanent NHS staff – another self-reinforcing, negative feedback loop: the more you put into external agencies the less you have for recruiting and retaining permanent staff; the fewer staff you recruit, the more vacancies you need to use agencies to fill.
To put figures on it, one nurse reckons we need an extra 3,000 nurses. How much would that cost? At the Scottish starting salary, something like £74m. In other words, the £230m we are going to spend this year would fill those posts three times over. But not a penny of it will go to nurses (or any of the other categories of staff) directly employed by the NHS.
And of course, it is not just about nurses. You need a whole team, from porters to maintenance staff, to cooks, the whole gamut of people into whose hands we entrust the health – the lives – of our children, our parents, and we ourselves.
As someone who went in for an operation (minor, thankfully) only a fortnight ago I cannot emphasise enough how courteous, professional and caring all of the staff were. What’s more, they would have given anyone the same first class treatment, from the poorest to the wealthiest, from the youngest to the oldest, regardless of gender, ethnic background, religion, sexual orientation and so on, for all of us, for all our diversity, free at the point of treatment.
That is a national treasure not to be squandered. And it is imperative that we invest urgently, to halt the wasteful spiral of outsourced spending we are currently witnessing. The longer we put this off the worse the situation will get – exponentially so.
So I urge you: remember this on Thursday, 12 December, in the privacy of the polling booth. Vote for a party that recognises the urgent situation our health services are in, and will invest in emergency treatment, before it is too late.
7 December 2019