NHS nursing on the brink

It's generally quite reserved about attacking government policies, preferring to adopt a cautious and measured tone in its comments.

Which makes its current bitter criticisms of the spending policies of the coalition government all the sharper and more cutting.

In the run-up to its conference this week, the RCN has said that 61,000 posts are at risk of being slashed across the health service, including nursing and other jobs, with 26,000 already lost in the two years to April.

It also pointed out that community nurses were among those facing cuts, which meant that government plans to move care from acute hospitals to community sites were simply a "facade."

RCN general secretary Dr Peter Carter warned that, "Yet again... NHS organisations are making short-sighted cuts across the UK.

"Nurses are being stretched too thin and many are approaching breaking point. Inevitably, patient care is going to suffer.

"We are now seeing a clear and worrying picture of a health service which is struggling.

"It is struggling to keep people out of hospital because of pressures on the community and it is struggling to discharge them with support when they leave."

The college doesn't disagree with the government policy of keeping patients out of hospital by emphasising community care.

But is points out that this requires resources and those resources have not been forthcoming.

It highlights specific cuts as well as more general figures, so there can be little rational argument with its conclusions.

But that doesn't appear to be a problem for coalition Health Minister Simon Burns, who simply denies it all, saying that he "doesn't recognise these figures" and continues to claim that the cuts have only affected 450 nurses.

Talk about flying in the face of the facts. Nurses are not stupid and they are not generally blind.

They can see the effects of cutbacks - they work with them every day.

What the minister doesn't say is that nursing work patterns are widely variable and while the head count may be constant, the number of shifts that they work is not and many more nurses than ever before are working less than a full-time equivalent.

Also, the reliance on agency staff limits the training potential, so many nurses working across the NHS are less qualified than they might be, while the reliance on nursing assistants is growing apace.

Mr Burns quotes elevated numbers in training as having doubled, but to what level will this intake be trained?

And he doesn't point out that the rise in training numbers is necessary to counteract the flood of nursing staff leaving an overstressed and underfunded service.

Not surprising when you note that unpaid overtime is normal and only 17 per cent of nurses told the college that their wards were properly staffed.

They also reported that they felt unable to give the level of individual care and contact they felt appropriate because they were to overloaded and overstretched.

It's a sad comment on a service that was admired and emulated the world over.

When telling us all that we are going to have to face cuts because people are living longer and as a result needing more services, government diminishes pensions and extends the working life.

It's no use saying and doing all that damage while at the same time cutting back on those services.

Maybe, just maybe, the minister is spending more money on the NHS.

But the evidence says that it's not going on nursing staff.

Perhaps payments for increasingly privatised segments of the service and the institutionalised use of agency staff might explain it, Mr Burns?