Intended for healthcare professionals

Career Focus


BMJ 1999; 318 doi: (Published 20 March 1999) Cite this as: BMJ 1999;318:S3-7186

Health service morale is at a low ebb according to a survey by Unison reported in the winter edition of the Health Service Report. The survey questioned more than 4,000 health workers from all occupational groups except doctors, and found almost two thirds had contemplated leaving the service in the past year. Almost one in five NHS staff has a second job, often within the NHS. Presumably many are filling gaps created by staff shortages - half of those surveyed reported increased use of temporary and agency staff. The findings are presented as “compelling evidence” for a fairer pay system. But will that buy morale?

In another report, the TUC's Health and Safety Unit finds that nurses are more likely to suffer violence at work than any other profession - one survey by the Health and Safety Executive found one in three nurses had been attacked or abused in the past year; a Royal College of Nursing study put the figure for physical attacks at more than half, and found that almost all had been verbally abused.

The figures for doctors seem lower: only one quarter of hospital doctors and two fifths of general practitioners had ever been attacked in the past, if a BMA telephone poll is representative - bad enough.

The pragmatic solutions are increased physical security, improving handling of violent situations through training, and policies that ensure incidents are analysed.

And yet… helping the distressed and unstable is part of the job; and the reward must be more than the money. NHS staff used to be heroes in the battle against disease, selfless holders of a vocation. Post-modernism has (rightly) killed those old certainties; but what will stand in their place?