Monday, 28 September 2015

The Conservative Party is now a threat to our National Health, our doctors’ health, and your family’s health.

My bad picture of last night's super-Moon
With all of the spin (and that’s putting it generously) the media have put on Jeremy Corbyn’s leadership, including a false claim The Times apologised for in the 80s that he gave £45 to a man he thought was an IRA bomber, you’d be forgiven for thinking that, as David Cameron put it, “The Labour Party is now a threat to our national security, our economic security and your family's security.” Now, I could spend all day refuting these claims but that’s not what this post is about. This post is about, as the title suggests, The Conservative Party being a threat to our National Health, our doctors’ health, and your family’s health.

So why are the Conservatives a threat to our National Health (Service)? I am not going to talk about the pseudo-privatisation of the NHS, because to most people (i.e. not political wonks like me) it could seem rather abstract; this topic deserves its own post with a fuller explanation. Setting that aside, our most obvious point of call is the rather large funding gap between what we should be putting into our National Health Service and what is actually being put into our National Health Service. According to a document published on (I shall be referring to this document several times because it is choc-full of information) that since 2010 a funding gap of £20 billion has grown. This monstrosity of black hole didn’t just appear out of nowhere

Chart showing the NHS funding settlement during the last Parliament was the most austere in its historyWhenever someone criticises the Conservatives: “The Government has cut the NHS,” you always get the same response: “Well actually, we increased the budget by X billion pounds from last year.” This is a sly political trick because… it’s true; under David Cameron’s Tory (and Lib Dem) government NHS expenditure has increased every year, even in real terms. However, this fact is ultimately an irrelevance as NHS expenditure has risen every year - in real terms - since its inception, what really matters is how much the budget rises each year to cope with things such as population rises and price rises for drugs & treatments.

As you can see from this graph (right), since the Tories came to power, the NHS has had the smallest yearly budget increases in its entire history, less than 1% average per year.

Most of these savings were made “by freezing staff salaries, squeezing the prices paid to hospitals for the treatment they provide, and cutting back on management costs.” I would like to point out that a pay freeze is politician speak for pay cut, as inflation means your pay is worth less. According to Unite the Union, “NHS workers have had real term pay cuts of between 13%-19% since 2010,” compared to that of the general populous of about an 8.5% pay cut (although this data is admittedly out of date). In any meaningful terms, the NHS has been cut.

Even with these cuts, “Quality... held up on many measures, at least in the initial years of the funding freeze,” but you can't freeze (read: cut) NHS staff pay indefinitely; eventually our medical professionals that we trained at our universities will rightly get annoyed and move to another country or join an agency where they can get paid more (and cost the NHS a heck of a lot more). In fact this is already starting to happen: according to a study by the British Medical Association earlier this year: one third of GPs are considering retiring from general practice in the next five years, another near three in ten are considering changing their hours from full time to part time, 9% are considering moving abroad, and 7% considering quitting medicine altogether.

It’s even more concerning when you consider young doctors, the future of the health service. The same survey revealed that nearly one in five trainee GPs are considering working abroad before 2020. In fact, in April 2015 (when the article was published), 500 GPs had begun the process of leaving the UK to work abroad.

Chart showing Performance against the A&E target slipped towards the end of the last ParliamentThe effects of ever more strained medical staff working for less money is starting to show. The NHS, at current, has a target to make sure that 95% of patients are seen within four hours of arriving at an Accident & Emergency department (side-note: when this target was introduced by New Labour in 2004 it was 98%, it was then revised down by the coalition in 2010). In this graph (right), it can be seen that in 2011 the 95% target was hit fairly consistently; since then, the cuts have been catching up with outcomes. Infact it got so bad in early 2015 that one in 5 patients did not get seen within four hours. In fact, it was so out of the ordinary to hit the target this year that it was a news story when the target was achieved this May. I don’t imagine it will be many years until the target is lowered again.

ADr Clifford Mann, president of the Royal College of Emergency Medicine, said that targets have not been met because of, “a shortage of hospital beds.” Other reasons given by the BMA include not enough nurses or middle grade doctors.

This leads me neatly onto the next point about our doctors’ health, firstly, their personal fiscal health. Now I don’t think I need to explain why doctors should be highly paid, but I'll do it anyway. To qualify for a medical course, you need at least an AAB at A-Level (not to mention in the hardest subjects like chemistry and maths), so you essentially need to be in the 90th to 95th percentile in all your subjects. You then need to pass an incredibly intense five year medical degree, then onto two years of foundation training as a junior doctor, then two years of core medical training, then 4-6 years of speciality training or 3 years training to become a GP. And after all of that you still need to stay in what is called “Continuing professional development” which involves going to seminars, taking online courses, etc. They also have to pay subscriptions to various professional bodies. Not to mention their job is keeping the rest of us alive.

So now it’s established that doctors deserve to be fairly paid, why is it that Jeremy Hunt, the health secretary in the Tory government, has decided to take away overtime rates for junior doctors working “unsocial hours”, essentially giving them a 20%-30% pay cut? This does not bode well, we are already in a situation where half of trainee casualty doctors leave the A&E speciality within four years. All this pay cut will do is push more junior doctors over the edge to either move or even quit completely. At a time where we can’t meet basic A&E targets this will do the opposite of help.

Of course, this will do nothing for their physical and mental health either. Having 90 hour weeks with only 30 minute breaks every six hours will do that to you. What doctors that are left in the country will be even more overworked, underpaid, and stressed than they normally are, and stress leads to mistakes.

I’m sure by now you’ve cottoned on to the idea that this will all be seriously detrimental to yours and your family’s health. Chronic underfunding by the Tories and pay cuts has lead to the NHS bursting at the seams, unable to meet basic A&E targets that any social society should. On top of this, the Tories have had the fantastic idea of alienating our only salvation for the future by drastically cutting their pay. Of course this will exacerbate the funding problem because the NHS will have to waste a lot more money on locum (agency) staff rather than their own.

Everyone’s health is at risk if we allow the Conservatives to continue with their plan of ideological NHS cuts. Think of your friends, your family, yourself, and if you really want to see anyone suffer ill health because we entrusted the NHS with a party that frankly doesn't care about its, and by extension your, health.

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