When Tiana Pritchard qualified as a neonatal nurse three years ago, she was delighted to be offered her “dream job” at Great Ormond Street Hospital in London. But renting a small flat in the capital with her partner left her struggling on so little at the end of each month after bills, food and transport, she had no choice but to hand in her notice.
“My partner was worse off than me and I ended up having to pay more for us to be able to survive. It started to affect our relationship, so we decided to leave London,” says the 23-year-old.
Pritchard now works in Southampton, where living costs are more reasonable, but staff shortages mean she never leaves the ward on time and often works 14-hour overtime shifts, keeping sick babies alive. Seeing Theresa May brush off suggestions that low pay is forcing 6,500 NHS nurses to turn to food banks on live television was “a joke,” she tells The Independent.
“I watched that interview and she honestly had no idea what she was talking about. The only reason why nurses are going to food banks is because the pay is not high enough and they cannot support their families.”
Jeremy Hunt has said nurses’ pay is “above the national average” as nurses around the country vote on whether to take steps towards the first nursing strike in history – because “for almost entirely all nurses, this is the worst it’s been”, according to Janet Davies, head of the Royal College of Nursing (RCN).
The threat of industrial action was announced by the RCN just five days before May appeared outside Downing Street to call a surprise election, placing the issue in the middle of what many assumed would be a clear road to a greater Conservative majority and the Brussels negotiating table.
“The snap election is supposedly to ensure Theresa May has the mandate for the Brexit negotiations, but we can’t avoid domestic issues that actually mean more to a lot of people, and the NHS is in serious trouble. There’s a real consensus now that it needs more money, otherwise it won’t survive,” says Davies.
“We’ve had some potential suicides; people ringing us and requiring urgent counselling. We do have those every now and again, but there has been an increase.”
The RCN says there has been a 14 per cent real-terms cut on nurses’ pay since 2010. Nursing manager Andy Bassett-Scott tells The Independent he had to cover the shifts of an employee who could not afford to travel to work in Doncaster as she lived far from the town and her car had broken down.
The Department of Health has said keeping pay rises below inflation helps protect jobs, but Davies warns there is a growing number of nursing vacancies as “people are so fed up they just leave”, with bosses hiring expensive agency staff to fill gaps.
Nursing is not the only vital NHS service facing enormous pressure. Paediatricians have warned of staff shortages so severe that a third of specialist children’s wards have been forced to close, while almost half of GPs have said they are planning to leave the profession amid a crisis of low morale. Chaotic scenes took place at hospitals around the country this winter as more people waited over four hours to be seen at A&E than ever before.
Labour has promised increased pay for NHS staff after years of freezes, a stop to Conservative plans for hospital closures and new laws to ensure safe levels of staffing in wards. The Liberal Democrats have said they will help fund the health service through a one per cent rise in income tax.
But following dramatic swings to the Conservatives in local elections, questions are being raised about what another five years of budget-squeezing could spell for the future of the NHS.
“The Prime Minister has made it clear on a number of occasions that there is not extra cash for the NHS. There has been the implication in her rhetoric that the NHS should see itself like other public services such as policing, which have had far larger cuts to their budgets,” says Sally Gainsbury, senior policy analyst at health think tank the Nuffield Trust.
“We would argue healthcare is not like policing. As we progress and develop as a civilised society, we tend to want to cure people of illnesses we may have lived with 50 years ago, and that desire will continue.”
Costs are also being pushed up by an ageing population, and more people living with chronic illnesses for longer, with shortfalls in social care causing more hospital visits. NHS England says the health service will face a funding gap of £22bn by 2021. The latest figures from the Institute of Fiscal Studies show annual increases in the health service budget since 2009 have been less than a third of the average yearly funding rises for the NHS over the last 60 years.
“Maybe Theresa May will stick to her current warning there’s nothing extra up until 2020-21, but if there was some clarity about what people can expect, that would be useful, because that then allows organisations to make investments,” says Gainsbury.
Others have been more scathing in their predictions of what five more years of Conservative rule would mean for the NHS. Former GP and health policy commentator Phil Hammond has said ministers are “very relaxed” about the health service in the run-up to the election as they believe there is no effective opposition, according to GP Online.
Alan Taman, of campaign groups Doctors for the NHS and Keep Our NHS Public, adds: “The NHS will become merely a logo for privatised services where a profit can be made and a shallow ghost of its former self where there is no profit if the Tories have their way.
"This election must be about public services – or what’s left of them – and how to bring them back; not about Brexit. As far as the fate of the NHS is concerned, Brexit is the great distraction, as well as putting off badly needed non-UK staff from coming here to help run the NHS”
On the BBC’s Andrew Marr show, Hunt said the Government recognises more money will be need to be put into the NHS and social care system, but emphasised the Brexit negotiations “overshadow everything” as “if we get a bad Brexit outcome, that would be a disaster for the NHS”.
Health issues hanging on Brexit range from a potentially devastating exodus of EU and non-EU staff to voters demanding to know exactly when the NHS will receive its extra £350m a week, as promised by the Leave campaign’s notorious red bus.
If there is a fall in the value of sterling after Brexit, the incentive to work in the UK will disappear for many European health workers in low-paid jobs, who have been sending cash home, says Gainsbury. “When the pound falls, the economic benefit of being in the UK disappears. The instability has reportedly already had an impact in some areas.”
May has said the NHS will not form part of a post-Brexit trade deal with the US, despite dodging the issue in a speech made to Republicans in Philadelphia. But unions and campaigners have warned the continuation of cost-cutting plans drawn up in 44 regions, involving a number of A&E and ward closures which Labour have said they will scrap, could lead to back-door privatisation of services.
All eyes will be on hospitals facing closures in key election battlegrounds, such as Ealing. Ward closures at Ealing Hospital are the focus of local campaigns in an area where the Labour MP Rupa Huq won in 2015 with a margin of just 274.
The results of the nurses’ strike poll will be announced next weekend at the RCN’s national congress. Davies says it is “frustrating” for their demands to be met with repeated soundbites from politicians. “It feels like we’re being ignored when we understand it,” she says.
“Unfortunately the only time we see a real shift is when there’s a scandal. We don’t want, the very worst thing, would be that people die or are damaged because of poor care in our NHS. Sadly, that’s the only time we get investment."
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