We need a radical rethink about NHS and social care workers beyond their pay

Since the beginning of the coronavirus pandemic, we’ve seen a change in the way the British public views our public services, particularly our NHS and social care system. We’ve seen, in the response to Covid-19, the vital importance of work that some would have previously classified as “low-skilled”, and many have been forced into a radical rethink about the value placed on certain jobs.

We’ve witnessed the phenomenon of people gathering together every Thursday evening in a show of appreciation for key workers. People clapped to show their solidarity with NHS and care staff in a public display of support on a scale that surpasses anything that has come before. And the clapping wasn’t just for doctors and nurses – it was for cleaners, porters, cooks, healthcare assistants, care workers, laboratory staff, reception staff, estates workers, midwives, ambulance staff, physiotherapists, radiographers and the myriad of other roles that make up our NHS and our social care system.

The coronavirus pandemic is not over – far from it – but the question must now be asked: how can we channel this new-found appreciation of the hard and dedicated work done day after day by NHS and care workers? Our answer to this question, as Labour Tribune members standing for the party’s national executive committee, is that we must build upon this new awareness and take action to ensure that these workers continue to be valued and appreciated. The lessons of the pandemic must not be forgotten and we cannot just go back to “business as usual”.

All three of us standing for the NEC have either worked in the NHS or have represented those who do, and we have seen for ourselves the way in which the NHS and social care operate against a background of constant change, continuing to provide vital services whilst undergoing reorganisation after reorganisation. We all saw David Cameron promise in 2010 that there would be no more top-down, disruptive reorganisations of the NHS. We all saw his Coalition government bring in the most disruptive, top-down reorganisation in the history of the NHS with Andrew Lansley’s 2012 Health and Social Care Act.

The Health and Social Care Act sowed the seeds for the fragmentation of NHS and care systems. Well-functioning public health systems were fractured and passed to local authority control. Yet over the last decade, local authorities have had 60% of their funding cut from central government according to the LGA. Spending on public health has declined, and many authorities have had to cut the services they are able to provide.

All of this has created the perfect storm for our health and care systems and now this pandemic has tested those systems and found them sorely wanting. We’ve seen the government bring in private companies like Serco and Deloitte to run huge out-of-town testing systems, and we’ve read the reports of test results going astray and never finding their way back into patients’ medical records. We’ve seen the government exaggerate the number of tests done, double counting samples taken and, unbelievably, counting a test kit put in the post as a test completed. There really is no end to the astonishing steps that this Tory government has taken to try to conceal the crisis in healthcare that this pandemic has so cruelly exposed.

We’ve witnessed in England and Scotland patients being discharged from hospitals back into care homes without being tested for Covid-19. We’ve seen the shocking outbreaks of the disease in care homes as a result, and a huge increase in the numbers of deaths. 25% of all Covid-19 deaths across the UK have been in care homes. As Shadow Scottish Secretary and Tribune MP Ian Murray points out, in Scotland that figure is an appalling 45%.

In Wales, health minister Vaughan Gething stresses that their protocol is to test all residents returning from hospital and only those with negative results are transferred back to their care homes. The Welsh government also publishes regular summaries of the scientific advice upon which it make decisions, and ministers are ensuring a stronger lockdown for longer than in England.

We mustn’t forget another vital piece of the healthcare jigsaw here: palliative care, generally provided by hospices. Adult hospices only receive 30% of their funding from the government and statutory funding (children’s hospices receive even less, around 20%) and the rest of it is raised by by fundraising and charity events. The lockdown has put a stop to many of these activities – charity shops are closed and the fetes, fun runs and sponsored events that are the lifeblood of the palliative care sector are forbidden during lockdown, threatening the whole future of hospice care. We have to take hospices off this insecure footing.

We need to take a serious look at central government funding of palliative care. We should work with experts in the field and with trade unions to bring this vital part of healthcare back into the NHS, and end the inequality of pay for qualified medical and nursing staff working in the hospice sector.

We also need to work with the trade unions in taking a long look at the years of austerity under which health service staff, despite having their salaries reviewed by the NHS Pay Review Body (NHSPRB), were subjected to either frozen wages or a pay cap of 1%. We need to reinstate respect for the independence of NHSPRB in the same way as the independence of IPSA is respected in their annual determination of MPs’ pay rises. We need to look at ways in which to compensate the shortfall in NHS pay, which was allowed to develop over the years of the failed Tory austerity experiment. Labour’s 2019 manifesto promise to give all public sector workers a 5% pay rise was an attempt to address this and should be worked on.

Showing workers that they are valued isn’t just about pay, although that is an important factor. We need to restore equality to the entire health and social care sector – bringing an end to minimum wage jobs, and ensuring proper training and career progression. We also need root and branch reform of the social care sector, and an end to privatisation and outsourcing. Local authorities must be properly funded and resourced to provide this vital service.

We need to restore the NHS nursing and allied health professional bursary, which was scrapped by the Tory government. With many people wishing to to train for these roles as mature students, and working in the NHS whilst they train, the student loan system just does not work and has demonstrably led to a fall in applications for these training places. Bursaries must be reinstated to rebuild and replenish our healthcare staff and to show them that they are valued.

We will fight to support our health and social care workers. When the next pandemic comes, we need to have the infrastructure in place to ensure that this time, we are ready. We must return to the values of the NHS, free at the point of delivery based on need, founded by Labour MPs under Labour Tribune MP and health and housing minister Nye Bevan in 1948. We can only achieve this under a Labour government.

Theresa Griffin, Liz McInnes and Paula Sherriff are standing for Labour’s national executive committee.

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