Since the general election, I have been waiting for the penny to finally drop with the government and NHS England. I hoped that many of the manifesto promises made in the run up to 7 May would be shown to be hot air electioneering, and that when the reality hit home, plans for the NHS would suddenly become more realistic.
But every time I see the news, there has been another announcement about the NHS that seems entirely ungrounded in reality. It has been gratifying to see more coverage of the potential pitfalls from the media - the grand announcement of a 7/7 NHS (that already exists), and the extra 5000 GPs has been met with an increasing realisation that it is totally unfeasible by much of the public. But the government and Simon Stevens, Chief Executive of NHS England, plough on.
I listened with incredulity as they announced that the way to control the NHS staffing budget was to cap agency rates. Oh Mr Hunt, are we back to me having to highlight the error of your ways again? You cannot cap the rates and number of agency shifts without first addressing the reason why they are being used in the first place. There are not enough nurses. There are not enough doctors in a number of key specialities such as emergency medicine. You have created a high pressure, poorly remunerated, target-driven environment. You have misunderstood the basic tenets of staff retention. Until you address this and have staffing across the board back to safe levels, the only thing you will achieve by targeting agency staff is to put NHS employees working alongside them under even more pressure.
Following the logic of market forces, let's assume you cap the rates. So the agency staff decide it's not worth working for the NHS anymore. The mechanism propping up an already very wobbly service vanishes. More pressure on NHS hospitals and staff. More patient safety being compromised. Fail.
Let's say that the agency staff do stay, but not the ones you want. A lot of NHS nurses and midwives use agency work to make up shortfalls in their pay. To provide support for their colleagues without underselling themselves by doing the hours as overtime, when doing them as an agency shift is potentially better paid. So you reduce the pay to agencies. But the good, experienced, local nurses no longer do those shifts. You leave the less well qualified agency workers to support an already struggling key staff. Fail again.
You need to go back to the drawing board and concentrate on making sure all staff feel valued; that their pay is fair; that they are supported by their senior colleagues. At the minute many NHS staff are compromising their own health so they can provide basic patient care. Your workforce is exhausted and demoralised, and being told to make £22billion of efficiency savings in a setting already pared to the bone. I see these staff as my patients. When the stress gets too much, they come to me. Usually exhausted, often in tears. Devastated to be letting their colleagues down. Many are depressed, not sleeping. Their own physical and mental health is suffering from working for an employer that has different priorities from their own.
The healthcare assistant with a bad back, who is lifting patients on her own because there aren't enough colleagues to help her. The nurse staying late for back to back shifts because there is no capacity in the rota, and the patients need care. These consultations inevitably involve the phrase "if you were treating a patient who was in the same situation as you, what would you advise them?" These are committed individuals who do not take time off lightly. Who hate ringing in sick. The only way I can get them to accept help is to frame it in the language they know. And reluctantly, it usually works. They realise they are not fit to do their job, and they need to look after themselves for a while.
As NHS staff drag themselves into work, waiting for the next bright idea from above, they see the news. They see how the prime minister disagrees with the 10% pay rise being awarded to MPs, but feels he has to respect the recommendations of the independent body IPSA.
I feel like shaking you Mr Cameron. You absolute hypocrite. How dare you? Please, please justify to me and all the other NHS staff, how you feel bound to honour the recommendation of the independent pay review body for MPs pay, but you and Mr Hunt didn't feel that same honour when the independent pay review body for NHS staff made their recommendations? Oh no, you didn't, did you? You ignored them. You over-ruled them as the monopoly employer of almost 1.4million NHS workers.
You argue that bankers bonuses shouldn't be capped, as they are needed to ensure the best and brightest stay and work in the UK. An argument being given to bring MPs pay into line with other roles in the public sector. Clearly you don't think this applies to those staff working in our National Health Service.
The House of Commons sat for 142 days in 2014. Assuming a similar number of days this year, due to the 14 weeks of parliamentary recesses, MPs will earn £74,000 for working less than five months of the year. I'm sorry if all this talk about pay is vulgar, but given the press and government have spent so long talking about GP pay, I feel it's only fair. I can earn more, and work less as an MP than as a doctor. Maybe it's time for a career change.