That sinking feelingBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3251 (Published 12 August 2009) Cite this as: BMJ 2009;339:b3251
All rapid responses
Inititally with interest, then more and more with horror, I read
"That sinking feeling". Is it really that bad? Both Tories and Labour
promised no cuts in the NHS budget, but in an era of unpredictable
inflation this means that no growth will be possible. Factually, the
budget will decrease in real value.
Our Trust as probably the majority of English Trusts is forced to save at
least 5% of the budget, or increase the income side accordingly. As Nigel
Hawkes pointed out, the latter has to be achieved with the current
facilities and staff. But lots of jobsin the NHS, especially the patient
centred ones, are strenous: Nurses working 12 hour shifts, doctors taking
their time for the patients (and the EWTD may be introduced on paper, but
there are still quite a few of us with the ideal to put the patient
first...) and relatives, managers trying to avoid major financial
catastrophies... No wonder that the newest numbers show more than 40000
calling in sick per day!
Nigel Hawkes shows the standard answer to financial strains: Cut the
staff, or freeze recruitment. Does anybody really think that this will
help? The remainig jobs will be under more pressure, and more people will
be off sick, leaving even more work for the other staff. This spiral needs
to be stopped.
Industry has the knowledge that any successful product needs investment
first: You cannot build a 21st century car (computer, television...)
without new ideas and facilities. The NHS wants to deliver the highest
quality care for the peanuts- but that cannot work. If we want the highest
level of care, we need to invest first- and not facilities but staff is
still the most important factor in the NHS.
Competing interests: No competing interests