The ongoing junior doctors strike has unfortunately focused the attention of the public and the media away from the plight of nurses and midwives. I believe this group deserves much more sympathy.
Nurses and midwives, while not required to study for as long as doctors, nevertheless have to complete a degree course. Nurses’ standard hours are usually 37.5 to 40 hours per week and many work extra nights, weekends and evenings to earn enough to provide for themselves and their families. A Royal College of Nursing report from 2015 found that 35% of nurses have to work 12 hour shifts.
Unlike junior doctors they are more likely to have to go home on public transport than jump into a car after a night shift. Even those nurses and midwives who can afford a car are often required to pay for parking in hospitals, at a cost of up to £600 a year, while the Chief Executive has their nominated free parking space.
When it comes to accommodation, nurses in London, even if in training, no longer have nursing accommodation provided, as my mother did when she trained in the 1960s.
Nurses and midwives will not be getting more than a 1% annual pay raise, unlike Junior Doctors who will be getting a 13% increase if they accept the new contract. Yet they are not talking of strike action. Nurses are soon to have to pay tuition fees even though it could take them 20 years to pay these back; and new nursing and midwifery students will no longer have access to maintenance grants while studying. It’s no wonder that there is a shortage of 10,000 nurses in London alone, and trusts are paying through the nose for agency workers and enriching private agencies at the expense of the tax payer.
It is more likely that a nurse rather than a junior doctor will clean up the bodies of the dead, have to deal with drunken or abusive patients and provide comfort to the bereaved.
So the next time you see the junior doctors picketing spare a thought for the nurses and midwives who are getting a much worse deal and write in support of them to your MP as I have done.
* Chris Key is dad of two girls, multilingual and internationalist. He is a Lib Dem member in Twickenham who likes holding the local council and MPs to account.
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29 Comments
I don’t understand why the public backs the strikes. Just because someone disagrees with a policy doesn’t mean they should launch an all out strike on it and the Lib Dems position seems to be; ‘It’s a shame, but it’s the Tories’ fault’.
Not trying to rein in strike fervour is a mistake. There’s talk of indefinite strikes and imagine the chaos and anger that will cause.
It’s also illogical for the doctors to say “the strikes don’t affect patient safety” then say overwork affects patient safety because what about the senior doctors who have go cover for them.
It is worth watching Liam Fox on the Daily Politics last week when he admits that the “7-day NHS” was essentially a manifesto phrase with no real detail or substance behind it (4 minutes in) and isn’t actually about delivering elective services at the weekend:
http://www.bbc.co.uk/iplayer/episode/b0794y38/daily-politics-27042016
Given that it was reported back in February that Hunt vetoed a deal that all parties (apart from himself) could agree on, it comes across to me that it is his unwillingness to lose political face over Saturday pay rates that has led the situation to where it is now:
http://www.independent.co.uk/life-style/health-and-families/health-news/jeremy-hunt-vetoed-deal-to-end-junior-doctor-dispute-which-was-supported-by-the-nhss-own-negotiators-a6861606.html
Coming back to the original article, if Hunt succeeds in imposing his changes to unsocial hours on the doctors, will nurses, midwives and other NHS workers be next in his firing line? Are the junior doctor contracts the thin end of the wedge?
@Peter – I think it is actually the other way around; the nurses already work a seven day shift system…
“Nurses are soon to have to pay tuition fees even though it could take them 20 years to pay these back”
I thought that the Lib Dem line was that repaying maintenance costs and increased tuition fees under worse borrowing terms was a good thing, that it does not discourage students and that it increases social mobility? For the last few years I’ve been suggesting that those claims are flattered by large numbers of student nurses receiving grants and having their fees paid by the NHS. Unfortunately this government’s changes are a chance to see if I was correct, but this particular aspect of the problems facing nurses does look like a Lib Dem chicken coming home to roost.
@Roland, they absolutely do (as do junior doctors currently), and have out hours unsocial payments as part of that deal:
http://www.nhsemployers.org/your-workforce/pay-and-reward/nhs-terms-and-conditions/nhs-terms-and-conditions-of-service-handbook/unsocial-hours-payments
My concern is that if the hours classed as unsocial for junior doctors is reduced (as is Hunt’s goal), will nurses, midwives and others suffer the same fate?
@Eddie – the public backs the strikes because they understand that once the new contract was imposed, strike action was the only option left to them other than either accepting it, or leaving their job.
But Nick, that mainly explains why the doctors support the strikes. What’s so wrong with accepting the contract?
Doctors have a duty of care to patients once the patients enter the hospital. If something goes wrong during an operation or someone catches an infection in hospital then lots of the doctors walk out it will be deeply unfair.
Infections in old people can be a matter of life and death. I don’t see how doctors can walk out over this. It seems to be it would be more productive to campaign to get the Conservatives out of government.
Peter Watson – It was the Tories who wanted to remove maintenance grants for all students not us. Ditto the decision to put in tuition fees for nursing. Surely in an essential profession where there is a shortage of people (and we have to rely on nurses from India and the Phillipines) it is critical to continue to ensure that they do not end up in huge debt. Theresa May wants to deport nurses from overseas earning under 35k but then wants to make it more expensive for British nurses to train – explain that logic?
@chris key “explain that logic?”
Far be it for me to defend the Tories, but their approach seems a pretty logical and consistent extension of what they started – and what Lib Dems in Coalition actively supported. Perhaps Lib Dems should explain the logic of why the new regime of fees and loans is bad for nurses but good for everybody else.
In the few years before the 2015 election, in discussions about tuition fees and student loans on this site I don’t recall anybody apart from me even mentioning nursing students. We were told (often in quite a triumphalist tone) that students had not been discouraged and that social mobility was improving. If nurses are a special case, then surely it is beholding on Lib Dems to explain why arguments about shortage of supply and a need to support applicants from poorer backgrounds should not apply equally to medicine, teaching, engineering, etc.
I’ve been on this site for long enough to realise that not all Lib Dems supported increased fees and worse loans, but the party cannot ignore what it did so publicly and enthusiastically when complaining about the situation now.
Peter I have only been a member for less than a year so. I personally have never been in favour of tuition fees for either nurses or teachers which are key professions where there is a shortage and salaries are relatively low (not sure the same can be said of engineering). As for maintenance grants we as a party as condition of allowing tuition fees to rise wanted these to be protected so the Tories are out on their own on that one.
What about the balance factors, pretty good job security, okay redendancy arrangements, excellent final salary pension, decent pay, not exceptional but decent, life in the public sector including the NHS not that bad. Speak as someone still working in the public sector albeit part time, who used to work up to 15 hours a day and then on call!.
@Peter Watson
I consider the tuition fees vote one of the darkest chapters in this party’s recent history – for a variety of reasons. Tim Farron voted against it and it is one of the reasons I voted for him in the leadership election. A recent BBC article: http://www.bbc.co.uk/news/education-36150276. I agree with the Sutton Trust.
@Nom de Plume “I consider the tuition fees vote one of the darkest chapters in this party’s recent history – for a variety of reasons.”
I completely agree. It casts a long shadow over everything that Lib Dems say now.
Even on unrelated topics it is used to challenge the trustworthiness of Lib Dems. And once conversation shifts towards further and higher education, the issue is even more of an impediment to being heard, lurking like an elephant in the room waiting to jump out and shout “Hypocrisy!”.
I have been involved in enough discussions on this site (not the first time today I’ve written something like and felt old!) to have seen plenty of Lib Dems defending the principles of the Coalition’s approach to student funding. The party still seems torn between owning and disowning the policy, with some simply appearing to prefer to forget about it.
For STEM students (which would include nurses), Ukip policy is to cancel their student tuition fees, if after qualification those STEM graduates work in the UK for a minimum of 5 years.
But I also feel that the UK should produce a list similar to the Australian skills needs list, but updated every year, and that list of needed skills [in the UK], should be circulated to all schools with prospective A level students. The purpose of that info circulation, would be to ‘jog’,…or tempt students into the direction of those needed skills with the incentive that if they pursue careers on that list then their studies will be tuition free?
What I find odd with the present system is that we might ‘import’ a newly trained doctor or nurse who graduated in (say) Poland, who can work here with no [Polish], tuition fees hanging over their head. But conversely, a new doctor or nurse trained here in the UK, is crippled with thousands in student debt even before they think about a house or having a life.?
@J Dunn “What I find odd with the present system is that we might ‘import’ a newly trained doctor or nurse who graduated in (say) Poland, who can work here with no [Polish], tuition fees hanging over their head.”
Potentially that foreign doctor/nurse/engineer/etc. could compete in the job market by working for a lower gross salary and receive the same nett income if they are not repaying their tuition fees through PAYE.
Thanks to dear Jeremy Hunt, up here in Scotland we’re having to deal with queues of junior doctors at Gretna and Berwick…. they also say they’re not that keen on some bloke called Eddie.
@Peter – Thanks for the link to the NHS site over unsocial hours and would tend to concur with your concerns.
My point however was poorly phrased. From conversations and my reading of media reports, it would seem that nurses etc. (ie. NHS medical staff not on doctor’s contracts) view their job as being 7-days a week, with additional payments for certain days, whereas the doctors view their job as being 5-days a week with (optional) overtime. Hence why we’ve so far seen little support from nurses etc. for the junior doctors…
@Peter – “Potentially that foreign doctor/nurse/engineer/etc. could compete in the job market by working for a lower gross salary and receive the same nett income if they are not repaying their tuition fees through PAYE.”
Potentially, but this is the NHS…
There is evidence from the USA that the H-1B skilled guest worker visa programme has resulted in companies (particularly those employing STEM graduates) employing foreigners at circa 20% lower pay than resident workers. However, with the USA we are talking about private companies and not state enterprises. I therefore suspect that with the NHS, the foreign medical practitioners would get the same gross salary and benefits as the UK graduate, but have a much higher disposable income because of the lack of tuition fee repayments.
The sad thing is that this obviously unfair situation will be missed by those promoting the use of foriegn workers, because at the headline level there is no reduction in gross earnings between the two groups…
I therefore suspect tuition fees and how we fund higher education to UK nationals and tax foreign workers will need to be revisited in the coming years…
David ,If you mean Eddie above , you do him and our party a disservice. I am staunch in my view in opposition to the strike , more so than on many issues currently in the news !I think it is perhaps the very Liberalism in me that speaks on this ,for me , it is no Liberalism that accepts the loudest , and the most popular voice ,has to be heard the most ! I do support the weary doctor , the underpaid nurse ,the porter and all.But not before the sick and those for whom the service exists !Where is the Liberal voice speaking for those ?! I do not mean all year round , we always do well on that basis , but now , in the midst of this strike ?It is because we have such good people at the helm of our party , I want better from them on this .A more balanced approach .
The article by Chris is correct .We must support the least valued of professionals who are valued, by any, who know their worth . Yet I shall say who I think deserves our support and feeling of injustice .I know who deserves our understanding .The twenty five thousand plus patients whose operations have been cancelled because the junior doctors think the only way to defeat a government policy is to do it at the expense of the people they are under moral and professional oath to serve !My professional background says “the show must go on !”
We can criticise the government and should .A twenty four hour service with no extra investment, or staff ,immediately ,is a non starter anyway !But the opposite of what they are doing is not what the doctors are doing .Peas in a pod !What happened to the old Liberal and SDP middle way on industrial action ?!And why the support for minority causes, and bravely ,at times , or stances, not always in keeping with the public mood , but on this , a rather populist approach .The situation needs a Liberal voice to say, power is in the hands, on the issue ,in hand , of all but the patients suffering !
The polls reveal support for the doctors , but are the patients whose worries are greater, and their pain , waiting longer ,being asked to share their view in the polls ?!
My only relief is that our leaders were at least not out on picket lines like Jeremy Corbyn!
I suspect that if the junior doctors lose the argument, nurses, midwives and all staff such as laboratory staff required if there is a seven day normal working week, will lose all their existing extra duty payments for night and week-end working too.
Their contracts will be next in the firing line.
The most popular university course in 2014 was nursing ( by a long chalk) according to UCAS.
There were 238 applications in 2014 up from,
2007 – 58,435
2008- 103,550
2014- 237,999
Since 2007, it has been applications for nursing that have seen the largest growth. Given that previous posters have alluded to the use of foreign trained nurses, ( very good in my personal experience), the interesting political question for me , is why has this been the case? What political decisions might have led to this increase in applications?
Sorry typing error -237,999 applications in 2014
@Jayne Mansfield “What political decisions might have led to this increase in applications?”
Back in 2009 it was decided that all nurses should have degrees from 2013 (http://www.theguardian.com/society/2009/nov/12/nurses-nursing-qualifications-degrees-nmc-rcn).
I have posted a number of times on this site how I thought that this might flatter claims that student numbers and social mobility were better after increasing tuition fees, since nursing had become the most popular degree subject but nursing students were not paying fees and many were eligible for grants.
Thanks Lorenzo. I saw that comment from David but didn’t think it was worth a reply. I don’t want to comment on this website too much.
To answer a previous question of yours about why I don’t join the party: well first of all I don’t have a bank account. So even if I wanted to join I wouldn’t be able to. I don’t want to say much more on that here – just that I’ve had some difficulties over the past four years but I’m slowly solving them! 🙂
@ Peter Watson,
Thank you for the link.
It seems that the Royal College of Nursing (RCN), has been pressing for nursing courses to be upgraded to degree level for years, and that this is not a requirement that has been imposed on nurses.
Some movement it seems:
http://www.independent.co.uk/news/uk/home-news/junior-doctors-contract-jeremy-hunt-bma-nhs-strike-government-pause-introduction-a7014661.html
Hopefully it will deliver some progress.
@Roland, the RCN’s most recent press release comes across as broadly supportive:
https://www.rcn.org.uk/news-and-events/news/junior-doctors-response
I would suspect that any perception of 5 vs 7 days could well correlate with the function a given junior doctor is engaged in. It could be that an A&E doctor may well hold a different view to one working in on an elective ward.
http://www.theguardian.com/world/2016/may/10/rodrigo-duterte-declares-victory-in-philippines-election-vows-to-rewrite-constitution
ISBN: 978 1 84354 868 3 “Alpha Dogs” by James Harding chapter 5, non-fiction.
The murder of Senator Benigno Aquino was a brazen act. His widow described herself as an ordinary housewife, but challenged corrupt dictator Ferdinand Marcos.
She told political consultants Sawyer-Miller that she did not want Americans to help her. They said “We know, we have brought you a Brit” a journalist described as “Too liberal for The Economist”, Mark Malloch Brown.
Marcos refused to debate her. She said “Stand up and fight like a woman.”
Sawyer-Miller worked in The Philippines “pro bono” (for free) although they were paid for subsequent work. In the USA they mainly work for Democrats. They also worked in Chile, opposing Pinochet, in a referendum in which he wanted to extend his term. Pinochet announced the result as NO 54.5% , YES 43%.
Tim Bell is reported to have said of his opponents “It was the most brilliant proposition in the world. want to be happy? Vote NO.” (page 160).