By Duncan MacLean, Operations Manager at the Runnymede Trust.
The initiating image of the NHS portrayed in Ken Loach’s The Spirit Of ’45 as a bastion of socialism has been crumbling since May 4 1979 — the day Thatcher came to power. New Labour in fact expedited this by covertly outsourcing parts of the NHS to private companies, a process that has enabled today’s Government to push through its appalling privatisation of huge parts of the NHS.
George Osborne insists the Department of Health (DoH) is ring-fenced. It sounds good and, as part of their manifesto, it undoubtedly helped the Conservatives in the General Election. But, as we know, his statements are hollow.
It is true that the amount of money spent by the DoH has increased (figure 1). However this does not equate to an increase in real terms; inflation bites. Indeed, the DoH’s total expenditure in real terms decreased by 1.2% (£1.26bn) between May 2010 and April 2012. Expenditure in the NHS decreased by 0.9% (£788.4m) — equivalent to 22,000 specialist nurses ). In addition, NHS Trusts across England (one of which I worked for at management level) have set up taskforces to reduce spend (under the guise of the drab acronym QIPP: Quality, Innovation, Productivity and Prevention). Add to this the impact of potentially using the DoH’s budget to pay for social care, and the real funding situation looks in fact quite grim.
Thanks to data obtained by the Runnymede Trust, a think tank that focuses on equality, we know there have been job losses in the NHS. Freedom of Information requests were sent to 399 Trusts in England asking for figures pertaining to their workforce at April 2010 and April 2012. It must be acknowledged that there has been a net increase in the NHS’s workforce (types of job not specified) between 2010 and 2012 (20,682, or 3.8%). However, this only relates to the first two financial years since the General Election; the financial squeeze on the NHS is likely to impact relentlessly over the next three years as further real-term decreases ensue.
In spite of this net increase, the wider picture is troubling. Preliminary analysis shows that 88 Trusts (50% of those Trusts which have returned their questionnaires so far) reduced the size of their workforce between 2010 and 2012, 56 (32%) of which contracted by over 100 employees, with nine (5%) dropping by more than 1,000. Geographical analysis (figure 2) shows the North West has been hit hardest with an incredible 7% net reduction of 5,488. The South East has fallen by 862 (1.4%).
More disturbing is the impact of cuts on young NHS staff. In the North West, the number of employees aged 16-24 fell by 17.2%. It is similarly bleak elsewhere (South West, 11%; West Midlands, 3.4%; and East Midlands, 3.3%).
The reduction in ethnic minorities staff in the NHS is also striking. Caribbean staff have dropped nationwide by 0.6%, those hardest hit are in the North West (40.2%), the South West (10.9%) and London (2.8%). The number of Africans has reduced by 20.9% in the North West and by 10.3% in the South West. The picture is similar for Pakistani, Bangladeshi and Indian staff in the North West (14.6%, 28.2% and 9.9% respectively).
There is more to be done with the data, and it will be telling to repeat the exercise in April 2015, but it is clear from preliminary analysis that the Government’s cuts have significantly impacted on the NHS’s workforce, something that is concerning for a Department that is supposedly ring-fenced, and a situation that is likely to get worse as further budget reductions hit the NHS.
These are cuts brought in by two Conservative Secretaries of State for Health, and were made by politicians who, between them, accepted £21,000 donations from private healthcare providers, avoided tax, and were accused of wanting to remove reference to the NHS from the opening ceremony of the London 2012 Olympics. Contrary to what Messrs Lansley and Hunt say, these cuts in real terms are not necessary and have already, as the figures show, resulted in thousands of people losing their livelihoods as public servants in the NHS. The future looks even bleaker too as a government fuelled by right wing ideology makes further real term cuts and introduces legislation that will enable hospitals to outsource up to 49% of its beds to private patients. Nye Bevan would be ashamed. We now desperately need frontbench politicians of the Labour Party to take a lead to step in and resuscitate Bevan’s and Attlee’s ailing creation.
Views expressed are my own and not necessarily shared by my employer.