We Talked to UK Healthcare Employees Who Are Worried About More Cuts to the National Health Service
"It's all about profit and not about compassion or about care."
This article originally appeared on VICE UK.
Today's Conservative victory has sent tremors through so many avenues of society, it's almost impossible to quantify at this point. But other than "cuts," the word on many people's lips today is "NHS."
More precisely: what is going to happen to a public health service that has already been dismantled, sold off, and privatized under David Cameron's government to a point that many don't recognize it? How are our A&E doctors, nurses, social workers, care assistants, surgeons, radiographers, GPs, psychiatrists, acute caregivers, physiotherapists, and midwives' lives going to change? How will patient care be affected?
How could our national mental health crisis possibly get any worse?
I spoke to several NHS workers to get a sense of what they're thinking and feeling today.
SARAH MATTHEWS*, 25, COMMUNITY HEALTH NURSE IN LONDON
"The sense of pessimism this morning among the people I work with is suffocating. I'm absolutely gutted. I work in a team of people who work with individuals in the community who need rehabilitation after being sectioned, help getting back on their feet. I also work in the process of sectioning, too, when people become a danger to themselves or other people. I've already done two visits this morning, and can do up to six a day. That is a lot of people's wellbeing to manage, and it's a direct result of two local acute mental healthcare wards closing in the last five years.
We've seen a 40 percent increase in people requiring risk management, but the facilities just don't match the demand for this kind of care. It's basic, GCSE-level maths. I previously worked on one of these wards and, often, up to 16 patients would be being cared for by two members of staff. It's not enough. At one point last November, in my borough alone there were 16 people requiring urgent psychiatric admission in the space of 24 hours, and many had to be sent back to a crisis center or their own homes. One man, approaching 80-years-old, ended up trying to take his own life as we tried to find him a bed. This is only going to get worse under further Conservative reign. People are already being outsourced to wards far away from their homes, because of the lack of local authority funding to keep their local acute care wards open, and with increased privatization we'll see this happening more and more.
Young people like me coming into the NHS have the energy and sense of responsibility to fight. We'll see this election as something to make us do our jobs better, despite any challenges. This isn't the case for those who have worked in the NHS for a long time. Eight people in my team left last week—social workers, care coordinators, psychologists—because they just couldn't see things getting any better. We've also had warnings from the very top asking us not to talk to the press about any of this, which is pretty telling."
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IZZY WILSON, 25, JUNIOR DOCTOR, NORTH-WEST ENGLAND
"I have a dawning sense of serious concern following the results this morning. Privatization of the NHS under the Conservatives has been growing steadily but until today I don't think we realized the amount of danger we could be in. Emails have gone out this morning from the medical director in the hospital I work in addressing people's immediate worries, and he, like the rest of us, feel like a dark cloud is gathering. I have exchanged more than a few ominous looks with colleagues this morning in the hospital corridors.
What shape the NHS will be in after five more years of ground-level cuts is anyone's guess. Poor Ed—he wasn't perfect, but he seemed to be be providing the only realistic, hopeful plan for the NHS and anyone who worked in it. What we as doctors are reminded of every single day is that it's individual people who matter—this is something that David Cameron doesn't get. The day-to-day reality of what the inevitability of further cuts will bring can't be predicted at this point, really, but while there are sick people in need of doctors and other healthcare professionals, I hope patient care won't be compromised. What will change is staff morale. Over-worked, under-paid staff make mistakes and are profoundly stressed. The NHS should be a happy institution."
MICHELLE COPELIN, 55, STAFF NURSE, CORNWALL
"I work in a community hospital that was on the brink of closing, but then it was put off until after the election. It's a community hospital that once had 28 beds. There are now 16. The hospital will be closed now—we're all quite sure about that.
It's all about profit and not about compassion or about care. We have a lot of patients who come into the hospital before they go home, but because of the cut backs, the trusts are keen to close these community hospitals. They've brought this thing called 'care closer to home,' which aims to make a lot of nurses work in peoples homes and cut out the middle man—which is the hospital. People will be very vulnerable, including lots of elderly people in rural areas. They won't have people looking after them and there aren't going to be enough carers who want to work for minimum wage in people's homes, rather than a hospital setting.
This is just one cog in the wheel of the NHS that will be affected, though. All the hospitals throughout the country will be feeling the same. When I saw the results of the election this morning, I cried. I was so shocked. I assumed people would think about the NHS more, about what would happen to it, and it's especially shocking when you consider that a lot of Conservative voters are older—the people who will probably need the NHS quicker than the rest of us."
"Britain's mental healthcare system is already strained. People are more uptight with their work and frustration bleeds into every conversation. I've been working in the NHS since 1997 and I've never known it like it is now" – Consultant Psychiatrist, Central London
LAURA WEEKS, 25, SENIOR NURSING ASSISTANT, CENTRAL LONDON
"The majority of us NHS workers, having grown up knowing that Labour founded it, are disappointed and anxious about the election results today. Privatization is a big concern and not something I agree with at all. I want everyone to be treated and looked after well, and feel that the Tories will increase of privatization from this point onwards in a way that will directly affect patient care. This is not what the people I work with have voted for.
I've never been able to afford to do my proper nursing training because I've got no money, but I'd love to be more beneficial than I am now. But that's probably just gone out the window. It's a shame because we need more nurses absolutely everywhere. In the last five years, staffing has decreased dramatically, which is very dangerous in a lot of areas. People just aren't being valued, so are leaving. In the hospital I work in now, we've had two of our theatre lists shut a week, too, because we just can't accommodate them.
We're being told that all the NHS changes won't affect patient waiting time, but I can't see how they won't. It's scary."
DAVID MARSHALL*, CONSULTANT PSYCHIATRIST, 40, CENTRAL LONDON
"Most people who work in mental health lean towards the left. I don't know any Tories in my field of work, which, if you know anything about the way NHS mental healthcare services have been affected over the last five years, is a no-brainer. No one thought Cameron would win today. No one. In the run up to the election we were all confident that, even if we didn't get a Labour majority, there would be some kind of progressive coalition.
What people forget is that NHS mental health services were actually pretty good by the time the Tories came in, but in the areas I work in I've seen an 8 percent decrease in our budgets, which has meant, quite simply, the closing of psychiatric wards. Entire wards. It's meant that people with serious mental health conditions haven't been able to get beds and that patients are being severely disrupted by being shunted to private hospitals. As someone who doesn't actually deal with the budgets, I don't know who is footing that bill.
A lot of the work I do is with elderly people with dementia and the cuts to social care for these people has been devastating. Lack of social care provision means that older people can't leave the hospital. They become bed-blockers, which is a horrible term, but the most accurate. If an elderly lady needs a higher level of care than someone can offer her in her home, she needs a residential facility, and if there's nowhere available, she'll stay on the NHS ward indefinitely. Hospitals are not a great place for the old and frail. They get ill. They get infections, break bones and, in some cases, die because they're there too long.
Britain's mental healthcare system is already strained. People are more uptight with their work and frustration bleeds into every conversation. I've been working in the NHS since 1997 and I've never known it like it is now. At the major hospital I work in we had to stop admitting people for routine operations for a while because there were no beds. In terms of mental health, it's going to get much worse—I just can't see how it won't. 'Worse,' in this case, means severely ill people needing a bed and not being able to get one. We'll have to rely more and more on private hospitals.
Public sector workers like me feel genuinely got-at by the Tories and all this Big State bollocks. We're hurt. I know a lot of people who are saying, "fuck this" and thinking about moving to Australia, where being a doctor is a lot more financially rewarding. I don't blame them."
WILLIAM MORGAN*, 29, JUNIOR A&E DOCTOR, NORTH ENGLAND
"I work in a busy A&E and have just had to hide in a cupboard so that I can have this rant.
Now that the Tories are back in government as a majority, they don't have to get support from the Labour or SNP MPs. This is an absolute disaster and we're going to see an acceleration of the NHS privatization. In about five or ten years time, medical insurance companies are going to go through the roof as they become more prominent.
The Tories accelerated market forces, and all trusts now will probably become independent and manage their own books. My trust failed to do that, though, because we're bankrupt. And the reason its bankrupt is because the hospital that we work in doesn't belong to the government. We're paying rent to private companies in order to work here. We're in debt, basically.
Cameron keeps promising he's going to give millions to the NHS, but what people don't know is that it's not going to the NHS—it's going to private companies via the NHS. They're hoodwinking everyone and a huge amount of burden is coming into A&E departments because there's no adequate community care. I'm very disheartened. I was hoping that the general public had a bit of fucking common sense to realize that they need to be more socialist, but people want to look after their own instead of looking after other people. I'm disgusted and I'm moving to Scotland."
*Some names have been changed.
Additional interviews by Daisy Jones.
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