This Marginal Seat Is a Litmus Test For the Struggling NHS

Southampton's hospitals have come under intense strain thanks to austerity. Will cuts to public services define the election result here?
December 9, 2019, 12:39pm
Junior doctors protesting outside Southampton General Hospital in 2016. Photo by PBWPIX/Alamy Live News

“I am so passionate about my career, but I do not think that I will be able to continue practicing if the cuts continue,” Emma*, a student nurse, tells me candidly. I’m in Southampton, a city that’s divided between the Conservatives and Labour more than most. Tory MP Royston Smith holds onto the constituency of Southampton Itchen with just 31 votes – it’s the tightest Tory-held marginal in the country, and one Labour will feel they need to win if they’re to come out of this election successful.


Southampton is a rare spot of urban sprawl in rural Hampshire – as Jeremy Corbyn noted in his visit in November – and, like the majority of the UK, it’s been hit hard by austerity. Southampton City Council has been hit with £136.4 million in cuts over the past seven years, and this year urged government for a “significant injection of funding” from the government this year. Among the sea of Tory blue in the county, this is somewhere that Labour have a real shot – and Southampton Itchen is one of the party’s key targets.

Despite the upcoming vote being framed as a ‘Brexit election’, the NHS recently overtook the EU as the issue most important to voters. It’s something that has been in the news almost constantly this election, with Jeremy Corbyn obtaining 451 pages of documents reportedly proving that the NHS is on the table in trade talks between Boris Johnson and US president Donald Trump – a claim strongly denied by the PM.

The NHS has a visible presence in Southampton, with Southampton General Hospital and the Royal South Hants Hospital providing the majority of services in the area. Although they’re both in the neighbouring constituency of Southampton Test, most of the 70,000 residents of Itchen rely on them for their healthcare. With a number of GP surgeries also dotted around the city, there should be more than enough provision for the people of Southampton, including the sizeable student cohort. But not everyone here is happy with the cuts we’ve seen to public services over the last decade.

Southampton General Hospital

Royal South Hants Hospital. Photo by George Bendall

Southampton’s two universities – the University of Southampton and Solent University – were recently identified by VICE UK as among those whose students could help to swing the election, and the vast majority are reliant on the local NHS services. With almost 35,000 students combined, they could really have a real impact on the vote here.

Students from both universities say that healthcare is one of the biggest issues among young voters here. I’m told that the sexual health services are “useless”, and the local surgeries are described as “patronising” and “awful”. Young people speak of hospital appointments cancelled at the last minute and rearranged at awkward times, with the lack of personalised care within the mental health services repeatedly coming up.

Rosie Chalk graduated from Solent in 2019, and described the effect that local cuts have had on her personally. “I have to wait over six months and travel to Basingstoke [over 30 miles away] for an autism referral because my GP said there is only one in the area,” she explains. “I’ve not been coping with day to day functioning and been fobbed off with ‘you’re just anxious’ and invalidated by the GP because it costs them to refer me.”

According to statistics from the Mental Health Foundation, one in six adults in England had a common mental health issue in 2016, with poorer and more economically disadvantaged people disproportionately affected.


John* has worked for the NHS in mental health care for over 30 years. “The Tories have promised more money for mental health but nothing has materialised, to my knowledge,“ he says. “The cuts have impacted on me and my colleagues drastically on many levels.”

Both the public and staff are feeling the strain. Royal South Hants Hospital, just north-west of the city centre, is the quieter of the two hospitals in the city, but the car park looks pretty full as I arrive and there is a near-constant stream of ambulances. Wherever you look, there are staff on their feet tending to patients, doing their absolute best to provide care.

This is despite the difficulties they’re facing; I’m told that they have to deal with higher caseloads in the community, less resources and fewer colleagues on shift. John says the situation is stark: “On occasion, there will be literally no beds in the country for a specific case, such as adolescents or specialist needs such as secure female. Even getting detained under the Mental Health Act does not guarantee a bed will be available. Very ill people remain in the community as a result, despite it being unsafe.”

Statistics show that thousands of patients at Southampton General Hospital had to wait over four hours in A&E in October – 82 percent of patients were discharged within the four hour target, far below the target of 95 percent. Across the country it’s a similar situation – austerity has seen the NHS chronically underfunded. As of 2019, there were over 4.5 million people on waiting lists for treatment and over 15,000 fewer beds available overnight when compared to 2010.

Royal South Hants Hospital ambulance

An ambulance at Royal South Hants Hospital. Photo by George Bendall

Unsurprisingly, people are leaving the NHS for alternative employment, and it’s hard to see a reverse in this trend unless something changes. Emma isn’t alone in questioning her future. According to John, it’s not just a struggle for the NHS to fill roles in Southampton – it’s happening across rest of the UK as the pool of prospective employees continues to shrink. “This is a nationwide issue,” he emphasises.

With employees under intense workloads and dealing with budget constraints on a daily basis, is it really any surprise that there’s a high turnover of employees? Applications to study nursing have plummeted by a third in England since the Tories abolished the nursing bursary, and many experienced nurses retire at 55 without being replaced. It’s difficult to see where new staff are going to come from, particularly as there’s so much uncertainty over immigration as Brexit drags on.

Emma, who has worked in over 15 different wards at a number of hospitals, knows that something needs to change. Although a relative novice, she’s already been stretched to her limit: “I work 12-hour shifts up to five times a week with an hour of break, which is often missed as we put our patients’ needs above our own.

“I often have to look after over 10 patients with one other member of staff, with many of these patients requiring round the clock care. Our workloads are increasing but we don’t have the staff or resources to meet these needs – we’re stretched beyond capacity.”

Leaving the hospital, cars are still coming in and out of the car park. I see Southampton residents from all walks of life here, going about their day and getting the medical care they rely on. Staff bustle up and down the corridors, friendly and approachable – yet clearly working hard to deliver it.

The city has become one of the key battlegrounds of this election, and the NHS is just one issue that’s been highlighted by Labour in this campaign. Huge numbers of workers, both in Southampton and across the country, are overworked and underpaid while doing a job that’s so crucially important to us all. Many eyes will be on Southampton Itchen next Thursday, but none more so than those of the staff who work in its hospitals and clinics.

* Name has been changed