Gaby Hinsliff’s article on NHS pay (Sunak is the ‘too little, too late’ PM. That is why he is failing in the NHS and this wave of strikes, December 22) makes some excellent points about the need to call for “reform”. I work as an NHS Inpatient Physiotherapist and we have also recently voted for industrial action. The main reason that is put forward for this and for supporting our nursing colleagues is that we are voting for the future of our professions. Pay freezes in the name of austerity have inevitably created an almost unbridgeable inflation gap, hence the Royal College of Nursing’s request for a 19% pay increase.
Pay freezes weren’t the only problem. The readjusted safe staff numbers created ratios of one nurse to eight patients in intensive care and one to 12 in rehabilitation. These levels are designed to be the minimum, but they have become the goal. These levels are not guaranteed by law in England. Add in staff vacancies and illnesses, and you start to get very low numbers. The sad fact is that while senior nurses filled the gaps on strike days, we saw better staffing levels than on previous days. Evidence shows that low staff numbers make patients less mobile, increasing impairment. These pressures reduce the likelihood of proper communication and increase tension between staff, patients, and families.
To provide much-needed reform from passive “care” entitlement to a more active engagement in prevention and recovery, we first need numbers and future recruits. This is only possible through fair recognition: a salary increase.
Recently, a fellow nurse and I posted a bill in the International Journal of Nursing Studies of the nursing care failures we received while in the hospital. Senior nurses chastised us online for our disloyalty and ostracized us for our recklessness in describing these lived experiences. Gaby Hinsliff is right: she praises the founding principles of the NHS, but challenges the archaic administrative, professional and clinical vested interests that prevent real reform.
Emeritus Professor of Mental Health Services Research, University of Exeter
One of the big problems in the UK is the old slogan ‘free at point of delivery’. Here in Italy, or at least in Umbria, we are not afraid of charges for health services. First, low-risk, high-cost treatments, such as a major operation or an extended hospital stay, are totally free. This is a great form of security for people.
Routine tests (blood work, ECG, etc.) and prescriptions are charged, but this is based on income, with three tiers. The lowest is free. It sounds complicated, but it’s all in a barcode on your health card, which you swipe, and bingo, your payment is calculated in a split second.