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NHS: It’s time for joined-up thought

By Nicola Miller

Nicola Miller
Nicola Miller

These are challenging times for the NHS. The introduction of loans for student nurses and eventually, one must assume, all Allied Health Professionals alongside the junior doctor crisis has put it at the forefront of political debate, much to the chagrin of our government who would rather we turn a blind eye.

I’m baffled by people who rhapsodise about olden-times when junior doctors worked well over a hundred hours per week, wearing a hair shirt and existing on cheese scones, snatched from the canteen at stupid o’ clock. They would see us return to a time when the chronically sleep-deprived worked on our bodies and minds whilst engaged in a gladiatorial contest to remain awake and sentient.

Those people who expect medical staff to live as paragons of virtue if they want to ‘lecture us’ are quite happy to have doctors set a hellish example when it comes to work stress and burn-out. They skate over the occupational effects of exhaustion on the basis that doctors have coped with worse in the past. Well, many did manage to ‘cope’-if you want to call it that- although exhausted doctors will make mistakes and these won’t be the same as a tired plasterer messing up your kitchen walls. Who wants a macho NHS culture where high stress levels are worn like a badge of professional honour and good staff are produced in spite of damaging conditions? If we fail to protect doctors from a regresssive 90-hour standard working week then we might be next. And what chance do workers without decent trade union representation have?

Some people, I suspect, are allowing resentment and even jealousy about the goodwill and status enjoyed by doctors to colour their judgement. Jeremy Hunt ignores the fact that it takes more than junior doctors to make the NHS work at full-tilt seven days a week. Even the best doctors are hamstrung if pathology, radiology, nuclear medicine, records, OT, admin, physiotherapy and speech therapy (to name just a few) are on-call or closed at weekends. The thinking is not joined-up.

This is a shame because Bury has an interesting and at times, progressive medical history. In 1065AD, a year before the Norman conquest, Abbott Baldwin was appointed the last Saxon abbot of Beodricsworth (now Bury St Eds) by Edward the Confessor. Baldwin enjoyed great political influence by dint of his appointment as doctor to three kings in succession: Edward the Confessor, William the Conqueror, and William Rufus, and medical skill was undoubtedly a great part of his success. History shows that Abbot Baldwin was responsible for introducing medicinal recipes derived from animals into England although his cure for eye ‘dimness’: a paste made from swallow chicks who were blinded, burned alive then mixed with the gall of a lactating dog has not enjoyed longevity for obvious reasons.

After the Norman Conquest, the records show that large numbers of medical practitioners with ‘foreign birth and education’ made their way to England from the time of the conquest and the Leges Henrici shows a total of 90 doctors working over here between 1100-1150. Moving forward to the 21st century, the NHS may cease to be an attractive proposition for foreign talent, and our local hospital, The West Suffolk, might struggle to recruit skilled foreign staff with the new immigration rules which state that non-EU workers will be deported if they earn less than £35,000 after 5 years of work in the UK- that’s quite a few NHS employees then. Although the Government temporarily exempted nurses from the new rules last autumn because of concerns about the shortages of NHS staff, the earnings threshold could include migrant nurses in the future if the Government decide to remove the profession from the Shortage Occupation List when they think our attention is diverted elsewhere.

The Royal College of Nursing has said this will cause chaos. The Conservative Party has stated that we need to train more student nurses yet decides to remove a bursary that is supportive of mature students: this WILL discourage new applicants. Suffolk mental health services are already in crisis and a reduction in the number of trained mental health nurses will not advance psychiatric care. And mental health nursing tends to attract older students and graduates, neither of whom are in a position to contemplate yet more debt, no matter how attractively packaged it is. The Tories conveniently forget that every student nurse must have a trained nurse-mentor when on clinical placement and locally, University Campus Suffolk offers 205 student nurse places each academic year alone. Where are their mentors going to be found in a depleted work-force? With the best will in the world, increasing student nurse training places will not address the problem of an existing ageing workforce approaching retirement and a health service with a siege mentality.


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