19 Jan 2012

A check-up on the NHS

Nurses and midwives have withdrawn all support for the Government’s health bill. But as the row over future reforms rumbles on, what’s the impact of all this uncertainty on the NHS today?

The Royal College of Nursing and the Royal College of Midwives withdraw their support for the Government's health bill (Getty.)

Health Secretary Andrew Lansley has stepped out to defend the Government’s controversial health bill, after the main medical unions representing nurses and midwives on Thursday called for it to be scrapped completely.

The Royal College of Nursing and the Royal College of Midwives had previously said that opposing the Health and Social Care bill would cause too much turmoil. However, the RCN said “serious concerns” have not been addressed during the parliamentary process.

The union also said the recent change in the bill to raise the cap on the number of private patients being treated in NHS hospitals to 49 per cent, is a “serious threat” to the NHS. Chief Executive Dr Peter Carter said: “It is now clear that these reforms are forging ahead on the ground without the concerns of nurses and other clinicians being heeded.

“We have sought a range of assurances, but now feel that the reforms as they stand could have the opposite effect from that which was intended.”

The Royal College of Midwives labelled the bill a “massively expensive distraction” from the challenges the NHS faces. Chief Executive Cathy Warwick said: “The Royal College of Midwives supports many of the Government’s aspirations for the NHS, such as clinically led commissioning, greater engagement of service users in their care and more integrated services, but the fact of the matter is that these can all be achieved without the need for this divisive and costly bill.”

Meanwhile, Labour renewed its calls today for Health Secretary Andrew Lansley to drop the bill. Shadow Health Minister Baroness Thornton said: “This upheaval is costly in terms of money and costly to patient care. As well as the cost at a time when the NHS has to find £20 billion of efficiencies, today the nurses and midwives have asked for the bill to be dropped, arguing that their concerns have not been answered.”

“These reforms are forging ahead… without the concerns of nurses and other clinicians being heeded.” RCN Chief Executive, Dr Peter Carey

However, the Health Secretary Andrew Lansley today claimed the opposition to the bill was more about the issues of pay and pensions. He said the bill is “essential in order to give nurses and doctors clinical leadership”.

He added: “The bill actually enables the NHS to deliver efficiency savings and improve performance – not least because actually the Bill is part of the process of cutting administration in the NHS.”

‘Stress will bulge out’

But while politicians and medical unions wrangle over the future changes to the health system, what is the true situation for the patients themselves within the NHS?

At the end of last year, the Government abandoned its opposition to the waiting time targets that were set by Labour in 2008, despite the Health Secretary Andrew Lansley previously calling them “arbitrary”. However, there is evidence that patients are now waiting longer than they should for treatment than during Labour’s time in power.

Waiting times have increased since the Coalition came to power (Department of Health.)

Figures released today by the Department of Health from November 2011, show 91 per cent of people were treated within the target 18-week period from the point of referral by a doctor. The average wait time was 8.1 weeks. In December 2009, when Labour was still in power, 93 per cent of people were treated within 18 weeks, and the average time to wait for treatment was 7.7 weeks.

Chief Economist at the King’s Fund, John Appleby, told Channel 4 News that despite this rise, waiting times are still much shorter now than they were before 2008, when the 18-week target was introduced. However, he said that with NHS money being frozen over the coming years “the stress will bulge out somewhere, and it could affect waiting times more dramatically in the long-run”.

The latest data shows there has been a 1.2 per cent fall in full-time employees within the NHS since September 2009. But that doesn’t tell the whole story. While the number of midwives and nurses dropped by 0.6 per cent over that same period, there was a 3.4 per cent jump in the number of doctors. There was also a 4.2 per cent rise in qualified ambulance staff.

John Appleby from the King’s Fund analysed these figures for Channel 4 News, saying that although overall staff numbers have come down slightly in the last two years, the number of people employed by the NHS is still much higher now than it was ten years ago. He explained that the majority of NHS job cuts have been focused on managerial positions: “They are trying to make job cuts as far away from the patients as possible”, he said.

On the face of it, figures from the NHS information Centre paint a rather bleak picture when it comes to complaints about the health service. During the period 2008 to 2009, 137,736 written complaints were made, but the following year, that figure jumped to 152,832. The latest data from 2010 to 2011 shows complaints fell slightly to 148,171, but that is still a 7.7 per cent increase compared to two years previous. Nevertheless, John Appleby from the King’s Fund told us the rise could simply be because the media is encouraging more people to complain, rather than directly because of poorer standards within the health service.

‘It’s getting worse’

Channel 4 News asked viewers to get in touch with their own experiences of the NHS. Ian McKinley told us about his mother who was treated for a broken collar bone at Furness General Hospital in Cumbria. He said she has already had her initial treatment, but she is struggling to book a follow-up appointment because there is backlog.

“She desperately needs to have a follow-up appointment because it doesn’t seem to be healing properly”, he told Channel 4 News.

“It felt like under Labour, things were getting better in the NHS but under the Tories it seems to be getting worse. Cameron said he would protect the NHS but he’s done the opposite”, he said.

But not all of the tales are ones of woe. Jane Owen lives in Stroud and she has nothing but positive things to say about her recent experiences with the NHS. She was diagnosed with pleurisy last summer and had blood tests at her local hospital. When her tests came back as abnormal, she received a call from her GP late at night telling her to go straight to hospital because it was feared she might have a blood clot on her lung. She said she was supposed to have CT scan within two weeks, but this was brought forward so that she had it within five days.

“I’ve got nothing but praise for the NHS. My rheumatologist always stays in touch to see how I’m doing, so the support is really good”, she said.