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The News Line: Feature NHS 70 years on battles for funding
Nurses at the front of the march on February 3rd against NHS cuts and privatisation
ON JUNE 30th, hundreds of thousands of people will be marching to celebrate and defend our National Health Service.


The NHS is facing many problems because of under-funding, one of those being the decline in pay and working conditions for staff. Unison is told this by its members on a daily basis, but one way to quantify it is to use the government’s own published data on why NHS staff are quitting.

The latest data tracks reasons for leaving from quarter one in the financial year 2011/12 to quarter three in 2017/18. During that time the total number of leavers increased by 6%, but the data reveal that some of the more worrying reasons for staff leaving have increased dramatically.

For example, the most recent data show that almost 5,000 staff left their NHS job for ‘better work-life balance’ over October, November and December 2017. In the first quarter of 2011 that figure was 1,521, meaning it has increased by 213%. Those stating they are leaving because of a lack of opportunities has also increased by a huge amount, up 129% from 372 to 852.

Those leaving to seek a better reward package rose from 600 to 1,305, an increase of 117%. While some of these may have left for a better reward package within the NHS, the data still show that many reward packages within the health service simply aren’t good enough to retain staff.

Looking at these three reasons together, we can see that almost one in six workers who left the NHS at the end of 2017 did so for a negative reason: because of the lack of opportunity, the absence of a work-life balance or an inadequate rewards package.

Unison head of health Sara Gotron, said that the rewards package for NHS staff has been ‘simply unacceptable,’ and these data prove that it is having an impact. ‘Every person who leaves citing this reason is a person who could have been persuaded to stay,’ she said.

There are several other reasons given for leaving, the top three for the latest period being voluntary resignation for unknown reasons, voluntary resignation to relocate, and voluntary resignation for work-life balance. Others include retirement, transferral, dismissal, and death in service (which thankfully has not increased).

It’s not all bad news though. The fifth most popular reason that people give for leaving a job is promotion.

• The trust that runs Charing Cross Hospital is under pressure to make millions of pounds of savings to overcome a £20.6 million deficit. Imperial College Healthcare NHS Trust is planning to make £48 million in savings for the coming financial year in order to access a portion of an NHS improvement fund to help with its budget.

However, to be eligible for the money Imperial’s hospitals must meet four-hour A&E waiting time targets 95 per cent of the time; a requirement labelled ‘illogical’ by the British Medical Association (BMA).

The trust’s healthcare facilities include St Mary’s Hospital, in Paddington, and Charing Cross Hospital, in Hammersmith, which both have A&E departments. Charing Cross Hospital is threatened with eventual proposed partial demolition.

Imperial says the cost improvement plan would not affect its £7.2m investment in the Charing Cross A&E redevelopment, due for completion by next June. At its board meeting last week the trust unveiled a £20.6m deficit before funding from the NHS Improvement, Sustainability and Transformation Fund (STF) for the new financial year is taken into account.

The trust expects to gain access to £34.2m from the STF pool. The size of its slice from the STF is two-thirds contingent on the trust meeting its financial targets, and one-third on meeting the A&E targets.

As of this April, it was meeting the A&E target 84.6 per cent of the time. It did not achieve it in the last financial year either, meaning it missed out on a £6.2m portion of the STF. The government launched the £1.8 billion STF pool in its 2015 spending review.

A share of the cash is contingent on providers achieving financial and performance targets. Health Secretary Jeremy Hunt last March told providers they must take action to meet the A&E targets. NHS England and NHS Improvement then tagged the targets to the STF criteria. BMA council chair Dr Chaand Nagpaul said this placed a burden on ‘overstretched’ trusts.

‘It is illogical and counter-productive that funding to support and improve hospital services should come with the precondition to achieve government targets first,’ he said. The government must recognise that with pressure on NHS services increasing year-on-year and national A&E waiting times consistently falling below the 95 per cent target, the problem lies not in the financial management of individual trusts but rather in years of chronic underinvestment.’

• PCS parliamentary group chair Chris Stephens has called on ministers to release figures on how many civil servants are in receipt of tax credits as the pay freeze continues to hurt members.

Stephens put the government on the spot during a Westminster Hall debate on Tuesday (5 June), demanding to know how many civil servants are in receipt of tax credits due to low pay.

Championing the union’s campaign for a 5% pay rise this summer, Stephens used the debate to pressure the government to negotiate properly with PCS and reward undervalued staff in government departments.

Pointing to the false economy of budgeting for 1% across government departments he said: ‘STUC (Scottish Trades Union Congress) research shows that 70p of every pound in the public sector ends up in the private sector economy.

‘It would therefore follow that pay restraint in public sector not only harms public sector workers and their wages but harms the spending power to spend money in the private sector economy.

‘40% of civil servants in the DWP were in receipt of tax credits, 18 months ago.’ He then called on ministers to release figures of how many civil servants were in receipt of tax credits across all departments due to low pay.

Stephens went on to contrast civil servants who work for the Scottish government enjoying an above-inflation pay rise with UK government workers in Scotland who are in line for only one percent.

He said: ‘The Scottish government has been flooded for applications from civil servants who are employed by UK government departments – they are leaving to get a better pay rise with the Scottish government.’

He then explained how it was ‘staggering’ that there are 200 departments all with separate pay negotiations which had made progress on pay ‘slow’. It is frankly a nonsense,’ he added.

Praising the PCS pay campaign, he warned the government it would lead to industrial action if a decent pay rise wasn’t put on the table. He added: ‘In this the 150th year of the TUC there is still massive inequality around pay that needs to be addressed – pay rises should be funded and not come from cuts to jobs and services.’

Reacting to the debate, PCS general secretary Mark Serwotka said: ‘Ministers can be in no doubt, paying our members a derisory one per cent damages the economy, damages morale and PCS will not stand for it.

‘Our members are determined to win a decent pay rise and will take industrial action on a mass scale if the government refuses to be reasonable.’
 
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