By Robert Stevens
The ongoing offensive against the National Health Service (NHS) has led to 28,500 health workers losing their jobs since the Conservative Party/Liberal Democrat coalition came to power in 2010.
This jobs massacre is set to escalate with another 32,700 jobs at risk, bringing job losses to a projected more than 61,000, up from 55,366 just six months ago. These cuts are being imposed as a result of the government’s unprecedented slashing of £20 billion (nearly 20 percent) from the NHS’s overall budget of £106 billion, to be completed by 2015.
The Royal College of Nursing (RCN) has compiled figures drawn from data supplied by existing NHS trusts. According to the RCN, the 61,276 posts equate to the loss of 30 NHS jobs every day over the past 30 months. The job losses already made include more than 6,000 nursing jobs from a total of 312,000 nursing posts nationally.
The RCN report notes that 1,000 posts are being earmarked as “at risk” by NHS trusts every month. Job losses on this scale mean the “NHS is sleepwalking into a nursing crisis in England that is drawing closer as the size of the cuts increase.”
Commenting on the devastating planned job cuts at just one hospital, Rotherham General Hospital in South Yorkshire, Dr Peter Carter, the RCN’s General Secretary said, “What the hell is going on when the hospital trust in a town like Rotherham, with all its poverty, can say they’re going to cut 750 jobs? They can’t do that and still provide the same level of care.”
Other jobs losses include 675 in Blackpool, more than 400 in Greater Glasgow and Clyde, around the same number in Sandwell and West Birmingham and 400 in the Greater Manchester primary care trust. A 23 percent cut in staffing numbers in South London is proposed up to 2015. In August and September nearly 700 jobs went in each month.
Newer figures of the size of the NHS workforce, released last week, show that were 7,134 fewer nurses working in the NHS in England in August than in 2010.
The cuts are a devastating refutation of the claims by both the previous Labour government, who initiated the £20 billion in “efficiency savings”, and the coalition who are implementing them. Both governments claimed that the cuts would not impact on front-line services, i.e., would not result in reductions in doctors and nurses jobs or the provision of health care to the population. The coalition included this pledge in its May 2010 Coalition Agreement. According to a recent Guardian article, former Labour Party Prime Minister Tony Blair is “said to have advised [Conservative Party Prime Minister David Cameron] to press ahead with the ‘reforms’ because, after the passage of the bill, opposition would die away and ‘it would be as if it was ever thus’.”
The huge levels of job cuts are already having a destructive impact on the NHS, with many hospitals unable to provide a basic level of care, let alone the required health provision. According to a recent annual report by the Care Quality Commission (CQC), one in six (16 percent) of the 250 hospital services inspected in 2011-12 did not meet the standard for having enough staff on duty to care properly for patients. The CCQ found that one in 10 patients are denied respect and dignity, 15 percent are not fed properly and 20 percent have their welfare and care neglected.
It comments that some services, “have clearly struggled to make sure they had enough qualified and experienced staff on duty at all times, and then to make sure staff were properly trained and supervised – making it more difficult for staff to understand and focus on the needs of each and every patient”.
This deliberate running down of staffing and resources is reaping a terrible human cost. Last year 43 NHS hospital patients starved to death. Eleven people died of thirst while 78 died from bedsores. A report earlier this year found that one in three nurses claimed they did not have enough time to help elderly patients eat or even go to the lavatory due to dwindling staffing levels.
While the jobs of thousands of fully qualified nurses are being shed, in 2011 the NHS in England employed more than 53,000 low paid and poorly trained “Healthcare Assistants”. This accounts for some four percent of the NHS workforce, with the numbers of healthcare assistants increasing by six percent each year.
More highly paid and better qualified nurses are being forced out, but now the jobs of these health care assistants are also threatened by the cuts being imposed. Nurses and health care assistants make up 34 percent of posts earmarked to be cut, the RCN study found.
As well as the huge numbers of nurses being forced to leave the state health sector, the number of new nurses being trained has fallen precipitously, down by 14 percent in just two years. In London, the fall in training places for adult nurses is even higher, down by 21 percent. This will lead to an even greater shortage of qualified NHS staff in the upcoming years.
Job cuts are wrecking all aspects of the provision of health care. The number of district nurses has fallen by one third since 2001 to just 8,000 today, with a report in March showing that almost 1,000 district nursing posts had gone in the previous 12 months. Ongoing cuts have led to a shortfall of 4,500 to 5,000 midwives, under conditions where half of the workforce are aged between 45 and 55.
The Health and Social Care Act, passed this year, lays the foundation for the ending of the state health care provision in the UK. Previous UK government operated on the basis of an enshrined “duty to provide” a comprehensive health service. The act now states that the government only has a “duty to arrange” health care. Under the act, private firms are able to take over vast swathes of public health provision and will further cut back services and health workers jobs in order to fulfil their central aim of turning big profits.
The exact number of job losses being carried out and proposed by NHS trusts is always an underestimation, as the government does not monitor the number centrally. However, as more and more NHS contracts are handed over to private firms such as Care UK, Circle and Virgin Health, job losses will become virtually impossible to quantify. Private firms are not required to submit such data to the NHS Information Centre. Their workforce plans are also unavailable for public scrutiny.
The loss of many more experienced, qualified nurses and other health care professionals will take place through the ending of the NHS Direct service and its re-organisation into a new “NHS 111” service. NHS Direct is a 24-hour telephone health advice and information service provided by the NHS for residents and visitors in England. According to the Unison public sector trade union, the ending of NHS Direct will result in 24 out of 30 call centres closing, with its workforce cut in by half from 1,500 to 750.