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Can you count Jeremy?

Dave MundayMy son Will has just had his second birthday. We’re currently on the one and two word sentences, and alongside this, he’s started to show a real interest in counting. He gets “one, two, three” every time now and can mostly get to ten. At first he did have a bit of an obsession with eight. No matter what number I said he would keep saying “eight” was the next number. I mention this because he’s two, counting should be difficult. I was wondering what excuse Jeremy Hunt MP had? I ask that because I’ve picked up at least two examples this week where I think Hunt’s understanding of numbers isn’t up to scratch.

The first example I want to highlight came from an article in The Guardian, ‘Number of mental health nurses drops by 15% under Tories’. First off, this has a big impact on the 1 in 4 adults who experience a mental health problem in any given year and the 1 in 10 children who have a mental health problem. But how does it affect the mental health nurses themselves?

In the summer Unite in Health carried out a survey of all members and 135 of the responses came from mental health nurses. Those responses showed:
•    56% of respondents said they sometimes & frequently had to work more than their contracted hours with   39% ‘always’ working more.
•    64% of MHNs reporting their workload had ‘increased a lot’ over the last year.
•    40% reporting their morale ‘worse’ and 47% ‘a lot worse’.
•    84% reporting morale had worsened due to workplace stress and 70% reported it had worsened due to ‘dissatisfaction with the quality of care you feel able to provide’.
•    41% would ‘probably not’ and 33% would ‘definitely not’ recommend their profession as a career in the NHS.
•    81% reporting experiencing work related stress in the past year.
•    47% ‘very seriously’ and 30% fairly seriously considered leaving their current position in the NHS.
•    80% reported ‘frequently’ and 14% reported ‘sometimes’ when asked have staff shortages occurred in your working area.

As the Unite/MHNA chair, George Coxon  responded to the new figures, “It is extremely troubling to see such a huge loss of skill and expertise in the rank and file of mental health nursing. This is impossible to justify even amidst this extended period of austerity and attrition with indefensible cost pressures across health and social care.”

You would hope that Hunt would see that in his stated quest to achieve parity of esteem, these numbers are ensuring we head in the opposite direction.

The second example I want to highlight came from a letter written by MPs from the Commons Health Select Committee. In the letter, the chair, Dr Sarah Wollaston MP, takes apart the governments claim that the NHS will have £10 billion in additional health spending up to 2020-21. She highlights that the figure is “not only incorrect but risks giving a false impression that the NHS is awash with cash”. And unlike my son, Wollaston’s comments aren’t ‘learning by rote’. She gives a very comprehensive analysis as to how she has got to this figure.

On the day of the autumn statement last year, George Osborne spoke about this wonderful investment that the NHS would get. However the sting in the tail was the increase in spending was partly ‘robbing Peter to pay Paul’. So the NHS protection was only in the NHS England budget and areas such as public health and health education faced big cuts. In a political sense, a clever move, in a healthcare sense a real disaster. What I found most irritating at the time, and still do, is Osborne’s argument that he was delivering on what the NHS needed to achieve the ‘Five Year Forward View’. I’m assuming he didn’t bother to read it as on page 4 it states:  

“The first argument we make in this Forward View is that the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”

For anyone out there thinking, ‘but don’t we need to cut all this health spending because we spend too much and we are poor’, have a look at a blog by The King’s Fund [ (then chief economist), John Appleby, ‘How does NHS spending compare with health spending internationally?’. It clearly highlights that this is a political choice, and with the ‘Slash, Trash and Privatise’  Sustainability Transformation Plans, expect this to get worse. This has led Unite national officer, Sarah Carpenter to call for; “the government to stop burying their heads in the sand and to give the NHS the substantial capital funding it requires without undermining this funding by making cuts elsewhere in the health budget. We need action — not this perpetual false economy that’s making health workers’ jobs all but impossible and posing very real risks to patients’ lives.”