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Philip Hammond’s budget had some strange moments, but perhaps the most bizarre were his comments about public sector pay.

In the case of the NHS, Hammond confirmed that nurses and other staff may have to wait even longer for the seven-year public sector pay cap to be lifted, and went on to connect any future pay increases in the NHS to improvements in productivity, under a so-called agenda for change agreement, something that Jeremy Hunt had previously outlined.

Preposterous Expectations

Quite how nurses in particular demonstrate an increase in productivity is beyond me.  Will this be based on the number of bedpans they provide?  Will they have to measure the quantities of bodily fluids they clean up?  Provide spreadsheets for all the hands they’ve held or the brows they’ve mopped?  The notion is truly preposterous.

Essentially it’s just another way of avoiding decent pay increases for staff that he and Jeremy Hunt know they can take for granted.  But maybe not for much longer as more and more NHS staff at all levels are now choosing to leave the service and either go into private medicine, or abandon the profession altogether.

As a result of Brexit and the continued confusion from the government over the status of EU migrants, we’re seeing NHS staff abandoning the service in their droves.  This has left many hospitals increasingly short-staffed, especially when better paid jobs are now on offer elsewhere.

John Lewis

A radio interview on budget day included a shocking revelation from a specialist nurse working in Oxfordshire’s John Radcliffe Hospital, probably one of the best NHS facilities in the country.  Rachael Marsden and her husband Bob, a clinician himself, were interviewed as part of Radio 4’s Moneybox programme and were asked for their reaction to the announcements in the budget.

Rachael expressed disappointment that there was no pay rise for nurses and explained that any so-called productivity increase would be difficult given that they were so chronically short of trained staff.  

Asked if she could work any harder she said it was an ‘interesting concept’, commenting that:

When you have fewer nurses because they are leaving because the salaries are so poor, they’re retiring and they’re not being replaced, so we’re under-resourced and have too few staff.  Then we’re expected to work harder.  That’s an interesting concept.  I don’t know how they can make that work.

When asked for her reactions to Hammond’s comments about pay deals being justified only in terms of recruitment and retention of staff, she acknowledged that retention was an important issue but then went on to reveal one scandalous reason for a more recent rash of staff vacancies in her ward:

Many of the nurses on our ward have recently left to work in a new shopping centre.  They get paid more at John Lewis.

She was referring to the new £460m Westgate shopping centre opened in the city centre a few weeks ago, where they are also reportedly struggling to fill vacancies.

Waste

The staggering waste resources that represents is hard to fathom.  Desperately needed and highly trained nurses leaving an already struggling and under-staffed hospital to do retail work.

I don’t denigrate the idea of working in a shop, but the idea that skilled health professionals should be pushed into such a drastic change in career has to be one of the most damning indictments of this government’s stewardship of our health service.  The only advantage I can think of is that if you do literally shop till you drop, there’s now likely to be someone with the proper training there to help pick you up.

As the NHS loses more and more key staff, it places even more intolerable strain on those remaining.  Human resources challenges are set to become even greater, but instead of addressing these the Chancellor witters on about such nebulous concepts as productivity as if he was talking about widget production in a outdated factory.

Patients are not products, hospitals are not factories and health care cannot be measured in those terms.  NHS staff deserve more than being fobbed off with this kind of inappropriate expectation.

Given the fact that our chancellor also downgraded economic forecasts as part of his budget, perhaps he needs to question his own productivity and suitability for his position.  I’m sure there’s a nice shelf stacking job in ASDA waiting for him any time he’s ready to move on.

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