What lies behind Hunt's message? 5 December 2013

By James Lazou, Unite researcher

Jeremy Hunt's claim that cruelty by NHS staff has become 'normal' is a politically motivated insult to the nurses trying to look after patients and hampered by destructive government 'reforms'.

“Cruelty became the norm in our NHS and no one noticed” health secretary Jeremy Hunt told parliament last week. A headline-hitting soundbite that was duly splashed across paper after paper.

Hunt's implication - in his formal response to the mid-Staffs enquiry by Sir Robert Francis - is that criticisms of the terrible Mid Staffs scandal are universally true for the 1.3 million people who work in the NHS all across the country.

Hunt’s message is not about spreading hope or building a culture change in the NHS. These comments come from a minister who is only too willing to run down the NHS and its staff, 'liberated' as he now is of any legal duty to secure a comprehensive health service. Hunt's message on cruelty is yet another drip of the poison that we are fed every day about our public health service.

Using the Robert Francis QC investigation as cover to denigrate the NHS, Hunt’s is a cynical strategy to soften us up for the changes he really wants - privatisation and charging.

Hunt himself co-authored a pamphlet that called for just that. In Direct Democracy, written in 2005, he stated that "Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain" and that the NHS was “no longer relevant in the Twenty-First Century.”

And his colleague Dr Paul Charlson, vice chair of conservative health, said of NHS charges:

‘I think it’s a good idea in principle…It would be political suicide for a party to introduce this. They could only really do it if there was a feeling in the country that health services were falling apart.”

Every day NHS staff contact Unite. The message we hear is not one of heartless indifference, but of dedication, diligence and worry about their services and ability to do their jobs in the face of cuts and reorganisations that Hunt's government has introduced.

Last week I heard paramedics and ambulance technicians from Yorkshire talk about how the cuts to their service, and an increasing reliance on private ambulance firms to ‘plug the gaps’, were leading to daily cases of dangerous under-staffing and in some cases unnecessary deaths. Members of Unite working for Yorkshire ambulance trust told management their worries that patient safety would be affected by the trust’s plans to slash £46 million over five years and replace highly qualified ambulance crew members with emergency care assistants with only six weeks training. The response of the Trust? It de-recognised Unite so it no longer had to listen to their patient safety concerns.

The story is similar across the country - service cuts and costly waste as private contractors are brought in to replace NHS staff. From pathology, pharmacy, to hip operations and ambulances, the NHS is going through an intensifying process of salami-slicing cuts and mini-privatisations - in most cases without the public having any idea.

Morale in the NHS is now rock bottom, our latest annual staff survey shows.

Staff are being forced to work long hours, often working unpaid to cover for staff shortages, service cuts and rapidly increased workloads. In particular members reported vacancy freezes, lack of cover for sickness and absence as well as the toxic effect of reorganisation.

Over two thirds of respondents reported that their morale and motivation was worse or a lot worse since last year. Nearly three quarters of respondents blamed increased workload - with 70% of nurses and health scientists reporting frequent staff shortages.

Nearly half of staff reported increased stress levels. Staff shortages, restructuring and reorganisation, falling pay and attacks on terms and conditions were all having a significant impact, they said over half of respondents said that they would probably not or definitely not recommend their own occupation or profession as a career in the NHS, and three fifths of members had fairly seriously or very seriously considered leaving the NHS in the last year.

Other healthcare unions are finding the same story, too. The Chartered Society of Physiotherapists (CSP) membership survey found that almost two thirds (66%) of respondents stated that morale and motivation in their workplace was worsening, as did 75% of Unison respondents. 70% of physiotherapists staff felt dissatisfied with the quality of care they were able to provide to patients, and 66% with the level of restructuring and reorganisation.  

The Royal College of Nursing (RCN) also surveyed members and found that while many continue to believe nursing to be a rewarding career, there was a growing pessimism about nursing. Just under two-thirds (62%) of RCN members working in the NHS have considered leaving their job in the last year.

Actions speak louder than words and this government's actions are devastating for our NHS.

If they were serious about changing the NHS “into the most open and safest service anywhere in the world” then here are some better suggestions as a start:

1. Implement the recommendations of Francis in full – as it stands the government has cherry picked the parts of the report they want to get the headlines. Without implementing the full report these changes are unlikely to be more than hot air.

2. Listen to staff and their unions - Unite has put forward a 5 point plan with additional suggestions that take Francis' recommendations on patient safety still further.

3. Fully resource the NHS - the NHS is already understaffed before the cold & flu season even starts. This under-staffing is a deliberately mandated policy - the NHS is in surplus, and has returned more than £3.5 billion underspend to the Treasury since the coalition took over, even as staff cuts bite. The government needs to staff wards and services adequately so that the service doesn’t collapse in winter.

4. Hire more staff - and stop running existing staff ragged. Staff working without breaks and putting in hours of unpaid overtime to fill shortages, are far more likely to act unsafely or be unable to do their job to the level they wish.

5. Stop the attacks on NHS staff - stop the endless demoralising denigration of ‘cruel’ nurses and ‘lazy’ doctors.

6. Stop cutting their pay – further demoralisation is caused as many NHS staff are working harder for less - having lost up to 30% of pay since Hunt’s government took office, with cuts to pensions terms and pay freezes.

7. Stop the privatisation - Fewer than 1 in 10 NHS workers thinks the NHS is safe in this government’s hands, according to a poll carried out by 38 degrees. More than two thirds say the ‘reforms’ have damaged patient care. 83% of NHS staff think the main motivation for the ‘reforms’ is to increase privatisation. Putting profit ahead of patient safety is adding to staff stress as they strive to hold together the NHS in the face of this assault.