Theresa May's Torrid Week Must Not Drown Out Dire NHS Warnings

For there can be no doubt: our health service is in crisis. Waiting lists for treatments have surpassed four million for the first time in a decade, thousands are waiting too long for cancer check-ups and millions are waiting too long in A&E.
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Never in the recent history of the health service have so many dire warnings about the state of our health service come so thick and so fast.

In just the past 24 hours, NHS Improvement Chief Executive Jim Mackey has warned the NHS could "pop" without emergency cash; Simon Stevens has admitted waiting lists will climb to a record 5 million by 2021, leaving cancer care and mental health improvements in jeopardy, unless a major injection of funds is provided; and Andrew Foster, former director general of workforce at the Department of Health, has warned of excess patient deaths because of unsafe staffing levels.

This follows the Royal College of Nursing's Chief Executive Janet Davies' conclusion earlier this week that the NHS is "teetering on a financial cliff edge", and Sir Robert Francis' warning that the health service is in "crisis". Back in February he said that current NHS pressures made another Mid Staffordshire scandal "inevitable".

These conclusions are not to be taken lightly. One can only hope alarm bells are ringing loud and clear inside Number 10.

For there can be no doubt: our health service is in crisis. Waiting lists for treatments have surpassed four million for the first time in a decade, thousands are waiting too long for cancer check-ups and millions are waiting too long in A&E.

We are 40,000 nurses, 3,500 midwives and 10,000 GPs short of safe staffing levels, with little sign of any improvement. Certainly the Government's hope of recruiting 2,000 extra foreign GPs by 2020 looks thoroughly unlikely. Indeed, just 38 were recruited in the first six months of 2017.

On Tuesday, NHS Providers warned there were no domestic "quick fixes" to the severe workforce shortages in the NHS which amount to a "fundamental failure at national level." In a damning report it revealed that two-thirds of NHS Trust Chairs and Chief Executives consider workforce concerns to be the most pressing challenge they face in delivering high quality care.

One Acute Trust Chief Executive, with 45 years of experience working in the NHS, said: "I have never seen so many staff work under so much pressure for such long periods of time." Another added: "I have no real sense that the scale of the challenge is truly understood nationally."

Evidently, seven years of Tory underinvestment has left services teetering on the brink of collapse.

The one per cent pay cap has become an intolerable burden on our already overstretched and overworked NHS workforce. The salaries of NHS nurses have fallen 14% below inflation since 2010. In real terms, the pay of a Band 5 nurse is £3,214 lower today than in 2010/11.

Predictably, this decline has led to a 10% fall in satisfaction with pay and contributed significantly to the escalating workforce crisis. Recruitment and retention remains a major issue, with the number of nursing vacancies doubling in three years, and the number of NHS nurses in England falling for the first time in four years.

In the Budget later this month, it seems Theresa May will finally review this disastrous pay cap. The decision is long overdue. During the General Election not even a tearful nurse could persuade the Prime Minister of her damaging pay cap: it seems the "magic money tree" only provides fruit for the DUP but not the health service.

And yet, as the IPPR's recent analysis has found, lifting the pay cap makes good economic sense and would save on the enormous £3billion annual bill the Government pays on agency staff to plug the workforce gap.

However, this pay increase cannot be funded from existing budgets and the Chancellor must find new money. NHS Trusts ended 2016/17 with a reported collective deficit of £791million and requiring them to fund the increase themselves would merely escalate the financial crisis in the health service, with damaging implications for patient care.

Outside the Budget, Brexit remains the leading issue of the day and of critical importance to the health service.

The million-strong NHS workforce contains 62,000 EU nationals. They are the lifeblood of our health service and we greatly rely on their care and commitment in our time of need.

It's a testament to this Government's failed Brexit strategy that Theresa May has refused to safeguard the future of these staff. The consequence for the health service has been dire: the number of European nurses registering to work in the UK has plummeted by 96% since the EU referendum last winter.

Just 46 nurses from EU countries registered with the Nursing and Midwifery Council (NMC) in April 2017, compared with 1,304 in July 2016.

Perhaps we shouldn't be surprised. Critical questions remain unanswered and the uncertainty has merely exacerbated the crisis. Will health professionals from other EU countries be able to work in our NHS after Brexit? Will there be a cap on their numbers?

In the words of Chris Hopson, Chief Executive of NHS Providers: "the outlook for international recruitment is uncertain."

Patients and NHS staff should not be bargaining chips in May's hard Brexit negotiations. This Government must provide the clarity and certainty which the public expects and which is absolutely crucial in ending the exodus of EU workers from our health service.

Government is about choices and the one facing Theresa May in the upcoming Budget is clear.

Lift the pay cap and place our NHS on a sustainable financial footing.

Or escalate the workforce crisis, increase patient and staff dissatisfaction, and continue the downward spiral of care which has become the watchword of the Tory NHS.

After all, even Jeremy Hunt now thinks it is "impossible" to argue the NHS doesn't need more funding.

Jon Ashworth is the shadow secretary of state for health and Labour MP for Leicester South

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