Last week Boris and his band of overpaid children announced they were using the NHS as a scapegoat for increasing National Insurance contributions. Whilst he was gaslighting a nation, I was working my last shift as a Clinical Sister.
Those who know or worked with me are I’m sure aware of my passion for the NHS and how massive this decision has been. Whilst the gravity of it continues to tug at me, I’ve never felt so weightless. Although it seems sudden, even to me, I have been planning for this moment for over a year. My trust in the NHS and the various leaders who allege to work in our best interests, was crushed years ago, and despite desperately hoping and actively working for change – it clearly isn’t coming.
There is a myriad of reasons behind my departure, my partner Dan asked the other day if I thought all the campaigning around fair pay and becoming involved in the politics surrounding the NHS had tainted my view and was perhaps influencing my negative feelings towards work. I would say the last year spent being an activist has been the most empowering experience of my whole career, and the confidence I have now to advocate for patients and staff has grown incredibly. However, Dan was likely right in some ways, I now have a much wider understanding of the powers at play that directly influence the NHS and it’s workforce, and that insight has left me even more disillusioned.
It is absolutely unbelievable to me that the NHS is in such a dangerous position currently, and there is nobody advocating for us. Not only that but we’re so demoralised, disillusioned and completely drained of energy that we don’t even advocate for ourselves. Engagement with unions is poor and that in my experience is a two way street. You have leaders of unions saying that strength only comes from members being involved and active, yet there is no effort from the union to effectively communicate with members. There has been an ongoing consultation on pay from almost every healthcare union this summer – hardly anyone knows about it. RCN reported the results of theirs today – over 90% voted to reject the 3% pay award - but only 25% of those eligible to vote managed to do so. The concern here is that if this goes to a ballot asking whether to call for a strike or any other industrial action - we would need at least a 50% response rate. So where is everyone?
Where was the publicity for this campaign? Why weren’t there sponsored adverts on social media etc. Why weren’t there billboards everywhere?? In some cases the links to the surveys were imbedded in blogs making them difficult to find, people weren’t receiving the emails, there was little push to ensure contact details for members were up to date. There was an expectation for reps on the ground to carry this message, when we are volunteers having to organise these actions around working on the frontline. This is whilst you’ve got union leaders on a salary that outstrips the Prime Minister, millions being spent on their payouts who seem far more interested in their egos than they do about workers rights. When you’ve got some members of staff who literally can’t afford to pay their subscription fees it is an absolute disgrace and puts reps like myself in a difficult ethical position when trying to recruit.
Next on my hit list of people with misguided loyalties is the NHS Trusts and their leaders. They are enablers for this government and rather than willingly inflicting another below inflation payrise on their staff, they should be demanding the government fund one that reflects their skills and experience. Why aren’t they all standing together and saying to Boris, Sajid and whoever else – our duty of care is to our patients and staff, not to you and your mission to decimate the NHS. These integrated care systems could give us a clue though, with £9 million estimated to be spent on just 42 new CEO roles. When each will be on up to £270,000, which again massively outstrips the PMs salary, it isn’t surprising they keep quiet about their staff using food banks. We have also heard reports that whilst all other NHS workers in England received a hefty bonus of claps, and a St George’s cross split between 1.3 million of us – in a move not dissimilar to MPs receiving £10k for changes to working during COVID, some NHS bosses were awarding themselves financial bonuses.
What I find most concerning is there still doesn’t seem to be any recognition of how critical the situation is with staffing nationally, and no adequate plan for recruitment and retention. If anyone thinks that a 3% payrise will have any kind of impact when outgoings are increasing in every possible direction – you need to go and talk to some NHS workers. Do you think £12.50 an hour for a qualified nurse who could find themselves the only nurse on a ward of 20 patients is enough? Having trained to degree level and working under the most intense pressure I’ve ever personally faced, risking our lives and that of our families - to care for others. Then getting a call off a bed managers saying they need to pinch a Care Support Worker for another area that is in a more dire position. The doctors are just as thin on the ground, if not worse. I don’t think there is any area of the NHS that has been left unscathed.
What surprises me about NHS Trusts and their lack of action regarding pay, is the amount they spend on agency, bank and locum workers – an estimated £6.2 billion a year. This will I’m sure rise this year, we are now seeing many Trusts offering inflated bank and agency rates to entice workers to book shifts. They still aren’t being filled, resulting in substantive staff being moved from their areas to those that are struggling. To have the risk of being moved every shift hanging over you causes anxiety, and in turn leads to staff going off sick or leaving. Robbing Peter to pay Paul seems to be the long term plan, but it’s so detrimental to staffing levels it causes more problems than it solves. We have relied on goodwill for far too long, there is very little left.
I was one of the lucky ones, who received my training for free and with a small bursary, nursing students now leave with around £70k worth of debt. Their course is nothing like that of their peers doing other degrees, these nursing students are working 40 hour weeks and paying for the privilege. Their supernumerary status on wards is in constant jeopardy because we don’t have the staff to fill the rota, so they are forced to pick up the slack at the detriment to their learning. To me it’s exploitation, much like Internships in the private sector it’s just free labour we mislabel as education or training – and it’s wrong.
Standards of care are at the worst levels I have ever seen, and I refuse to be complicit in delivery of it. I’ve spoken before about moral injury and the impact to mental health of workers, we are humans not machines. There seems to be an acceptance that this is the best we can do at the moment, relentlessly struggling on doing what we can with what we’ve got. As a Sister trying to manage this it was so incredibly difficult, having to firefight in every direction whilst unprepared, unprotected and under resourced - with the government fanning the flames at every opportunity.
The National Insurance hike is the latest attempt to undermine a workforce, using us at the excuse for robbing a nation. It’s a dangerous rhetoric that risks further enflaming ill will towards the NHS, something I had firsthand experience of whilst delivering a petition to parliament. We were buoyed with the hope of 800,000 signatures in support of a 15% payrise, and we were so proud of our achievements with the campaign. We were then descended upon by anti-vaccine protesters who aggressively gatecrashed the event and screamed that we were murderers and likened us to Doctors in Nazi Concentration camps. We were followed to Number 10 by these people and their screaming, until the petition was delivered. A day or two later the petition was introduced to the members of Parliament, and as Jon Trickett tried to deliver the introduction we had written – he was interrupted by the Deputy Speaker and stopped from continuing. To me that was a clear message from Parliament that whilst more than happy to make decisions on our behalf, they aren’t willing to hear the consequences.
Leaving my career of a decade is obviously bittersweet, part of me feels like I’ve let them win and assisted in their campaign to destroy the NHS. I’ve jumped a sinking ship, leaving my colleagues behind to be dragged down with it or swim to less harmful shores. Alongside battling through the pandemic I’ve spent the last 18 months building a lifeboat, which is how I am now able to escape.
When I was suicidal, it was in part because I felt trapped – nursing had become claustrophobic. I could not see any other options for myself, my future and ultimately my happiness. There’s two elements to this, the career aspect and the identity aspect. So you’ve trained for years, got a degree specifically in nursing, you don’t feel like there are other jobs are available to you. Even other professions within the other NHS aren’t all that easy to transfer into, and you feel as though the issues we face are so widespread they are unlikely to change in a different specialism. The identity element I guess links into the whole vocation vibe, nursing really does take over your life if you let it, and you almost feel guilty to admit that it doesn’t. It’s the second descriptor I give to myself after my name, before I even say “I’m a mum” it’s “ Hi I’m Kirsty, I’m a Nurse”, and it’s been that way for nearly ten years. That is something that will be difficult to shed, almost like we wear the uniform on the inside, and I’m not sure the nurse in me will ever leave.
I still feel that sense of duty and responsibility, I won’t be able to walk away from campaigning for better. Partly because of the colleagues I leave behind, but also because I truly believe the NHS is worth saving. Without the workforce, there is no NHS, and it’s time the government, NHS bosses AND the workers themselves realise it.