Thursday, 14 September 2017

Metal Nurse: The Wonder of the NHS

Hopefully, it might not have escaped you, eagle-eyed readers that I am a nurse, I live in the UK and I work in the NHS. So far I have worked in in the NHS for 11 years, I started off working as a healthcare support worker in 2006, in a mental health hospital. In 2010 I got a job within the acute trust and did some extra shifts within various medical and surgical wards. 2012 I went into training as a student nurse and qualified in 2015, and since then I've worked as a registered nurse working in acute settings.

I am very proud of my job. And I am very proud of working for the NHS. Just a little background, NHS stands for National Health Service. It was founded 1949, it was launched at the behest of a man called Aneurin Bevan, with three founding principles:
  • Meets the needs of everyone
  • Free at the point of delivery
  • Based on clinical need, not ability to pay

It is the fifth largest employer in the world, with over 1.5 million people working in various roles, to break it down that includes over 300,000 nurses, health visitors and midwives, over 100,000 doctors, almost 20,000 ambulance staff and more. Operating on a budget of £116.4 billion. NHS treats over 1 million people every 36 hours, including those people who come to the UK to travel. Services range from antenatal to palliative care. From routine health screenings to cancer care. Mental health services. Learning Disabiliy services. Organ Transplants, IVF and much much more. With over 16 million hospital admissions, over 23 million attending to our Accident & Emergency departments, and so on and so forth. The statistics regarding the NHS just general boggles the mind. All funded directly from taxation. There are few services that will be charged and those include prescription charges, opticians, and dentists. Probably the biggest socialized program ever put in place. It is for everyone in the UK. As far as I am aware it is the only type of healthcare system in the world, most other ones tend to be largely government funded but some sort of payment is usually needed when people access them. I know for example in Iceland you'd have to pay a small fee to see your GP, and also foot part of the bill for any type of procedure that was not an emergency. All in all, it's an amazing system. It works extremely well, not perfect obviously.

The NHS consistently performs highly when compared to other systems. In terms of finances, it is cheaper to run than the US system, for example, the US spends 16.6% of its GDP on their system whereas the UK spends 9.9%. These were findings from the Commonwealth Fund, an American Think Tank that performs these sort of studies on a regular basis, and the NHS has regularly ranked highly.

And yet. And yet. It is in trouble from powers that be. Every successive government seems to want to use the NHS as some sort of a political football to kick around in order to gain more votes. This is especially evident with the current Conservative government that seems to be hell-bent on austerity policies even though it looks like austerity is making good on killing people off. There is this need to streamline everything and making savings on every single front, without actually taking into account that as medical science advances the population ages, and with that the average 80 year old costs the NHS 5 times more than a 30 year old. Even according to the Institute of Fiscal Studies have stated that this low level of funding from the UK will be below what is needed come the year 2020. Our population is getting top heavy with age. Essentially this government, like so many others, is only looking at the short term even though it means that we all lose in the long term. This isn't helped by the fact that the last Labour government, even though they spent considerably more on the NHS, started saddling a lot of NHS trusts with PFI agreements. Which has led to a lot of other financial issues. The number of nurses is falling, for the first time since forever.  Student nurses will not receive any bursaries, which has lead to decreased number of student nurses both due to lack or places and due to lack of interest of people actually applying to do those courses. All in all some reports indicate that there are 86000 vacancies within the NHS.

What I personally would like to see is more money being spent on public health and preventative care. Because that is one avenue that the NHS could save money on in the long term, as well as a bigger increase in social care spending. Because most people who end up with long term conditions can be managed in either their own homes or in special social care settings, but more often than not they end up in a hospital which can be disastrous for them. And this is without touching upon what has been happening to mental health services under the Conservatives, that have said all the good talk but haven't performed any of the good deeds. The number of nurses working in mental health settings has gone down dramatically and the funding has been severely reduced. Patients who are going through acute psychiatric episodes are being treated more and more in places that are not suited to their needs.

But even with all of these issues, we still strive towards providing the best care available. Because that is what we do. The NHS is the perfect example of that good healthcare is not a privilege, but a right. To be able to live a healthy life without having to worry about how much you have to pay for your health. A good healthcare system pays for itself in the long term, as will a good educational system (But I am not getting into that just yet). Thankfully, hopefully, there will be enough people in the UK who will fight to keep the NHS as it is. I am extremely proud of working for it and I will continue to do so for as long as I can. I am not a nurse to take care of those who pay the best, I am a nurse because I want to take care of people because they need it. The NHS gives me the best platform to do so. Because at the end of the day we are all just people on this same planet trying to get through lives the best we can, and we should all help each other doing so.
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