MORE than 2,000 senior NHS doctors have signed a letter calling on Prime Minister Theresa May to increase spending on health and social care because ‘unacceptable levels of safety concerns’ mean things ‘simply cannot continue’ the way they are.
The doctors who organised the letter – Anita Sugavanam, consultant anaesthetist, and Rob Galloway, an emergency medicine consultant at Brighton & Sussex University Hospital – said it is one that they hoped ‘we would never have to write.’
In the letter they say: ‘We are constantly failing to meet our own and our patients’ expectations. We apologise to them and we also empathise with them. We feel handcuffed and paralysed working in this current NHS.
‘We are exasperated and feel demoralised because we are not able to provide and develop the excellent care we were trained to give. We are simply fighting fires on a daily basis. There is a real risk of a brain drain at our level from the UK if this government does not listen to us.’
They urge May to act on a letter sent in January from three leading MPs who urged her to invite all political parties to discussions in a bid to reach a cross party agreement on the future of healthcare and social care funding.
They also call on May to act on the recommendations made in the Barker commission in 2014 which said that more people should have free social care paid for by tax and welfare changes and for the percentage of GDP spent on healthcare to rise to at least 10%.
The doctors argue: ‘It is impossible to provide effective efficient patient-led innovative healthcare which is free at the point of contact when we spend less on healthcare than other comparable OECD countries.’
They conclude by saying: ‘This is not a political statement. Again, we reiterate that we represent the most senior tier of healthcare workers and we are writing to you for the first time en masse. Do not ignore this letter, and provide a response as soon as possible.’
Responding on Monday to the open letter from 2,000 senior doctors published in the BMJ on NHS funding, Dr Mark Porter, BMA council chair, said: ‘The entire profession has been calling out for help over the last few weeks but these requests seem to have fallen on deaf ears.
‘The BMA has repeatedly raised concerns, both publicly and with the government, that the current NHS funding settlement is inadequate to deliver the standard of care which patients deserve and that doctors and our colleagues in health and social care want to be able to provide.
‘Instead of outlining a plan to deal with the crisis, the government has tried to play down the pressure that services are under. The government cannot continue to stick its head in the sand. Our hospitals are in the red, patients are suffering and staff are working under impossible conditions.
‘The system is at breaking point and it’s not just our hospitals that are facing these issues – GPs are conducting millions more consultations every year while also facing a recruitment crisis.
‘The government must urgently look at the long-term funding, capacity and recruitment issues facing the system as a whole if we are to get to grips with the pressures the NHS faces year in, year out, but which are compounded during the winter months.’
• The Royal College of Midwives (RCM) is calling for the NHS Pay Review Body (NHSPRB) to break the government’s policy of public sector pay restraint. MPs were due to debate the issue on Monday, after a petition against pay restraint gained over 100,000 signatures.
The RCM produced a briefing for MPs as part of its ongoing campaign to end the government’s policy of pay restraint for midwives and other public sector employees.
Jon Skewes, RCM director for policy, employment relations and communications, said: ‘The government has got to show that it values NHS staff, who are working harder and harder, with what seems less and less.
‘As in the past, the government is pressuring the NHSPRB to keep pay awards to a maximum of 1% for NHS staff. They need to stop this pressure and genuinely allow the pay body the freedom to recommend pay awards. Every day we hear from our members that they are struggling with understaffing and subsequently are working harder and longer hours for less and less pay and this simply cannot continue.’
In the last six years, the value of the average midwife’s salary has dropped by £6,000. If the pay restraint continues until 2020, that is expected to increase to £9,000. Skewes added: ‘The government cannot continue to expect maternity services to run on the sheer goodwill of midwives alone, and that is why the RCM will continue to campaign to break with the government’s policy of public sector pay restraint.’
• A landmark piece of legislation that sets out how elderly and vulnerable people receive care and support will fail unless the government announces new money for social care, warn councils.
In its submission made on Tuesday 31st January to the Treasury ahead of the Spring Budget, the Local Government Association, which represents more than 370 councils in England and Wales, says the continued underfunding of social care is making it impossible for local authorities to fulfil their legal duties under the Care Act, leaving it on the brink of failing altogether and councils facing the prospect of court challenges.
The LGA says the funding crisis in social care is threatening the very spirit of the legislation which is about supporting people’s well-being and helping them to stay well and live dignified, independent lives. Councils say that if government does not urgently announce any new money for social care, then ministers need to be ‘honest and upfront’ with the public about the limitations of the care and support they can provide.
This could mean only managing to meet basic needs such as helping people get out of bed in the morning rather than enabling our loved ones to enjoy fulfilling, independent lives at home in the community, rather than a hospital ward. In its Budget submission, the LGA is also calling on government to set out contingency plans to deal with major failure in the care provider market, with the lack of funding already causing some providers to hand contracts back to councils or cease trading altogether.
The Care Act, which passed into law in 2014, was several years in the making and represents the biggest reform of adult social care in a generation. The legislation aims to give people more control over their lives and allow them to stay well and independent for as long as possible, placing a duty on councils to promote people’s well-being.
But councils are now warning that the original intentions of the act are at risk of failing as a result of the lack of funding for adult social care services, which could see:
• Providers pulling out of the publicly-funded care market or going bust
• Growing unmet basic needs such as getting washed and dressed, or helped out of bed
• Shorter care visits
• Further strain on carers
• An overstretched workforce with an increasingly high turnover
• Greater pressure on GP surgeries and hospitals
• More and more people stranded in hospital unable to leave.
The LGA says that an inability to support people to stay well and live independent lives would constitute a failure to meet the very spirit of the Care Act as well as its statutory duties, which could result in judicial review.
Just eight per cent of directors of adult social care in councils say they are confident in their capacity to meet the full duties of the Care Act in the coming financial year, according to the latest ADASS budget survey. The LGA estimates the overall funding gap facing social care remains at least £2.6 billion by 2020, after the government failed to announce new money in the Autumn Statement and Local Government Finance Statement.
It has also urged the government to use its recently announced review of health and care to consider new long-term solutions to secure the sustainability of care and support that includes genuinely new money rather than piecemeal measures that will not alleviate the social care crisis, with councils at the heart of that discussion.
Chairman of the LGA Community Wellbeing Board, Cllr Izzi Seccombe, said: ‘The Care Act is a really important piece of legislation which the LGA fully supports. But the intentions and the spirit of the Care Act that aims to help people to live well and independently, are in grave danger of falling apart and failing, unless new funding is announced by government for adult social care.
‘It is not good enough just to be trying to help someone get washed and dressed.
‘Adult social care is about much more than this. It is about aspiring to help people live their lives to the fullest, and with dignity, not simply just get by. This is the great strength of the Care Act, which unfortunately is now at risk.
‘If no new money is urgently announced, then government needs to be honest and upfront with the public about the limitations of the care and support we can provide, and the fact that as a society we will no longer be able to meet the ambitions and objectives of the Care Act.
‘The need to inject new money into how we provide care and support for our elderly and vulnerable residents is something which councils, charities, care providers and the NHS are fully united in calling for.
‘Genuinely new government funding is now the only way to save the Care Act, and to protect the services caring for our elderly and disabled people and ensure they can enjoy dignified, healthy and independent lives, live in their own community and stay out of hospital for longer, reducing the pressures on the NHS.’
