Kevin Austerberry: Nurses will fight on to halt the turmoil of NHS reforms

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CALLING a halt to the Health and Social Care Bill is now the only way we can protect patient care and nursing standards in the NHS. The Royal College of Nursing did not take the decision to oppose this bill lightly.

Up until a fortnight ago, we had engaged with the Government at every stage of these reforms, consistently raising the very real and valid concerns of our members with the intention of ensuring patient care does not suffer.

It is important to point out that the RCN is not opposed to change across the NHS per se, nor are we opposed to the idea of competition in the NHS, but we now feel that the scale, speed and design of these reforms is fundamentally damaging to the principle of a health service which is free at the point of use.

In this region, we work on behalf of nurses and nursing at all levels and everything that we have seen and heard from our members in recent weeks has led us to conclude that the consequences of the bill may be entirely different from the principles which were originally set out.

Our Frontline First campaign has shown that whilst cuts are being made patient care is being put in jeopardy; at the last count 48,000 posts in England alone had been cut. With this is mind, the RCN proposed an amendment that would guarantee safe staffing levels, but the Government chose not to take this proposal forward.

Without these checks and balances, and a commitment to regulate the healthcare assistants who are so crucial to the delivery of care, these reforms could damage the very system they were designed to improve.

Now, as the Bill reaches report stage in the House of Lords, and even with the amendments that have recently been added, the RCN is maintaining a position of outright opposition to this new legislation.

The view is being echoed across professional bodies that represent practically every healthcare profession in the NHS. Criticism is now even coming from those who have actively supported Health Secretary Andrew Lansley in pushing for reform, such as the NHS Alliance and the National Association of Primary Care.

While some amendments have now been made, for example ensuring that the Secretary of State will maintain overall responsibility for the Health Service, these amendments do not go far enough towards addressing our members’ concerns. We believe that in their current state, the reforms will still adversely impact on patient care and nursing staff.

In particular, the amendments do not address key concerns around competition, nurse involvement, the private income cap and health inequalities.

Nurses have real fears that if the cap for private income is set at 49 per cent then the needs of the market will be put before the needs of the patient, in short this could mean that patients who cannot pay will be forced to queue behind those who can.

The RCN is committed to building a better NHS with high quality patient care at its centre. Trying to implement these reforms at a time when all Trusts are facing very real financial pressures is adding unnecessary pressure on frontline nursing staff.

As a whole, the NHS has been asked to save £20bn by 2014/15 and this is creating a monumental financial headache for those trying to make the new budgets work on the ground. In this region, there have been real difficulties faced across Mid-Yorkshire Hospitals NHS Trust, Leeds Teaching Hospitals NHS Trust and Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, with the number of posts reduced and significant reorganisation within hospitals and staffing structures.

In a recent survey by the RCN, more than half the nurses questioned said they were too busy to provide the type of care they really wanted to in the current climate.

Dealing with such significant cuts to services and staff numbers would be difficult at any time. NHS staff should not have to deal with this alongside dramatic and distracting reform which is making their jobs almost impossible.

These reforms are already creating enormous turmoil and must be halted. The RCN will continue to raise the concerns of our nurses. Our fear now is that the combination of the financial pressures faced by the NHS, the rising challenges of public health in an ageing population and the introduction of these reforms will create a very bleak future for the National Health Service.