Another porky – or should I say “falsehood” – by Jeremy Hunt

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In his Telegraph article attacking Stephen Hawking’s 19 August speech on the NHS at the Royal Society of Medicine Jeremy Hunt made a series of statements that exhibited his trademark use of weasel words, distortions and omissions. But there was one outright lie that really bothered me as it exemplified the very thing he was being accused of by Hawking – shameless abuse of statistics. In the Telegraph article Hunt produced the following bar chart of the different parties’ manifesto promises on NHS spend by 2022-23.

Hunt's claim on parties' extra funding (Telegraph 20 Aug 17)

I knew immediately there was something wrong with that graph because I had read the Nuffield Trust’s report on the different parties’ manifesto pledges on NHS funding and recalled that Labour had promised to increase funding by more than the Conservatives. I looked at the Nuffield report again and discovered that what Hunt had done was truly sneaky. He had used two different baselines from which to measure the different parties’   funding pledges, thus artificially deflating the Labour and Lib Dem NHS funding pledges by several £billion relative to the Conservatives.

For the Conservatives his baseline was current 2017/18 NHS spend (£123.7bn a year), and for Labour and the Lib Dems his baseline was the projected NHS spend in 2022/23 if existing government spending plans continued (£128.4bn a year).

To make a true comparison Hunt should have used the same baseline for all parties – either current or projected spending levels.  That’s what the Nuffield report did.

It analysed the different parties’  manifesto spending pledges and estimated the promised NHS funding increase of each party by 2022/23 compared with spending this year.

The graph below from the Nuffield Trust shows the true picture. It also shows that all three parties’ spending pledges will mean a reduction in NHS spend as a percentage of GDP and will fall well short of various reliable predictions of NHS funding requirements.

Conservatives spending proposals would bring total health spending in England to £131.7 billion by 2022/23, an increase of £8 billion over spending this year.

Labour’s spending commitments would bring total health spending in England to £135.3 billion in 2022/23; an increase of £11.6 billion over spending this year.

The Lib Dems promised to increase NHS spending to around £132.2 billion in 2022/23; an increase of £8.5 billion over spending this year. 

Jeremy Hunt’s bar chart should have looked like this:

Actual NHS funding pledges of three main parties

Labour promised to spend nearly £4 billion more on the NHS than the Tories.  The Lib Dems also promised to spend more than the Tories.

Hunt’s trick of using two different baselines tells the opposite of the truth. This isn’t “cherry picking”. It is a deliberately deceptive use of statistics. The real data was there, already analysed and easy to find. Hunt has a team of people working for him. He can’t pretend he didn’t know.

 

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NHS staffing in crisis – and government response still totally inadequate.

Recent figures show that NHS staff shortages have got worse but statistics don’t convey the dreadful reality of how this affects NHS staff and patient care. To understand the real impact we have to read the accounts of brave doctors, nurses and other health care staff describing the daily stresses of their work – stresses that are leading many to breaking point and to leave the NHS.

There are now more nurses leaving the profession than joining.

Nurses leaving

Those that remain struggle to provide safe effective care. In the recent NHS staff survey, 47% said current staffing levels were insufficient to allow them to do their job properly and 59% reported working unpaid overtime each week.

Staffing levels in some places are so poor that not only can quality care not be guaranteed, but safe and humane care is also at grave risk. Doctors and nurses are warning that this is creating another “Mid Staffs” across the country.

Recruitment from overseas to fill the gaps is now at risk too. Since the Brexit referendum applications from EU nurses have dropped 96%. This is having a serious impact on nursing numbers.

But the shortage of 30,000 nurses is not caused by the Brexit threat alone. The chronic shortage of nurses is the result of years of short-term planning, cuts to training places, underfunding of the NHS workforce and pay restraint – amounting to a real terms pay cut of 14% since 2010.

The government’s response is to try to minimise the scale of the staff shortages while announcing new initiatives that are inadequate to the problem.

For example Jeremy Hunt recently tweeted there were now 12,000 more nurses than in  2010.

Jeremy Hunt tweet on nurse and doc numbers

But this is untrue. In May 2010 there were 280,950 nurses in England and in March 2017 (the most up to date stats we have from NHS Digital) there were 285,893. This is an increase of 4,943 or 1.6%.   Yet over that period the population rose by 5% which means that there are now fewer nurses per person than in 2010. Key areas of nursing have suffered actual reductions in numbers: mental health being a prime example. See this excellent blog by David Munday for detailed analysis.

David Munday cites figures showing that between 2010 and 2017, the number of mental health nurses reduced by 4,942 (from 40,630 to 35,688) or 12.2%. It means a change from 1,296 people/mental health nurse to 1,549 people/mental health nurse.

This is scandalous given years of Government rhetoric about “parity of esteem” between mental and physical health.

There has also been a decline in numbers of community based nurses. One in seven district nursing posts were lost between 2014 and 2016. The government’s decision to hand over responsibility for children’s community nursing to local authorities while simultaneously cutting their funding has led to cuts in health visitor and school nurse numbers. Health visitors have declined from a peak of 10,309 in October 2015 to 9087 in March 2017.

The Government’s response to this is to say they will increase nurse training places. It has just announced some £16 million for 10,000 extra clinical placements for nurses, midwives and allied health professionals by 2020. It seems the government was only moved to act on funding because universities protested that they had been given no extra funding for the clinical placements.  This is yet another example of a reactive decision to avoid bad headlines rather than sensible pro-active planning for the future – because extra nurse training places should have been funded years ago when people began warning about the impending crisis.

Latest data shows the number of nursing degree applications has fallen by 23 per cent this year compared with 2016. This is in large part due to the abolition of the NHS student bursary.  Even though there are still more applicants than places there has been a reduction in applications from  mature students with children – a group that has always been a key demographic for nurse recruitment, and more likely to stay on in nursing once trained.

But even if there is to be an increase in nurse training places, those new students will not qualify for several years, so will not help the current staff shortage. And increasing training places won’t help if high numbers of nurses still continue to leave the profession.  The only way to ensure adequate staffing levels is to stem the flow of nurses and other health workers leaving the NHS and this means reversing the decline in pay and conditions. Pleas to the government to address this by nurses’ unions such as the Royal College of Nursing have fallen on deaf ears.

Nurses have reached their limit. In 2016 we saw unprecedented industrial action by junior doctors. Now it looks like the nurses are prepared to consider taking industrial action to defend their pay and conditions.  The main nurses’ union, the Royal College of Nursing,  recently surveyed its members to gain their views on industrial action and a majority indicated their support. As with the junior doctors this is not just about pay but about ensuring we have the necessary nursing workforce to provide safe high quality patient care.

Those of us who care about the NHS and its future can show support for our nurses and other health care professionals in their struggle for decent pay and conditions by joining them at their Scrap the Cap rally in London on 6 September. Let’s show them how much we value our nurses and make it a day to remember!

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Labour demands inquiry into privatisation of NHS-owned recruiter | Society | The Guardian

via Labour demands inquiry into privatisation of NHS-owned recruiter | Society | The Guardian

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Pay our nurses a fair wage

Today, 15 different organisations representing NHS employees (including the Royal College of Nursing and the British Medical Association) have written to the Prime Minister urging her to scrap the draconian pay cap on our NHS staff. (1)

“The public sector pay cap has forced professionals out of jobs they love…

Those who stay are overstretched and under pressure to do ever more with less…

The longstanding cap stands in the way of recruiting and retaining the best in healthcare.”

The pay cap has meant that there has been a 14% fall in real-term nursing pay since 2014 (2). This is just one of the factors that is leading us towards a crisis in staffing.

Not only is it unfair, it is incredibly short-sighted. Along with the removal of the bursary that enables people from all backgrounds to train to become a nurse (3), the ever more stressful conditions leading to 50% of nurses considering leaving the profession (4), 1 in 10 posts already vacant and Brexit threatening to stop us recruiting the additional staff we need (5), this pay cap is simply making things worse – for nurses and, ultimately for us. And remember, it is not only nurses but other health care workers too, for example physiotherapists and OTs, that are affected by the loss of the student bursary and by the pay cap.

I have been so touched by the support I have had recently for standing up for nurses and other health workers – both in the election campaign and since then when you saw how Jeremy Hunt used his victory speech to personally attack me and accuse me of spreading falsehoods (6). I know that what I wrote in response, where I provided evidence about the extent of the NHS staffing crisis, resonated with so many people because of the respect and gratitude you feel for our NHS staff and your awareness of how vital it is to have adequate and sustainable staffing levels.

It’s time to remove this pay cap, to pay our nurses a fair wage and to start to take the steps to move the NHS back from the brink of a staffing crisis.

Thank you for reading

 

Louise

Dr Louise Irvine

 

Sources:

  1. https://www.rcn.org.uk/news-and-events/news/unions-send-message-to-pm
  2. https://www.rcn.org.uk/nursingcounts/scrap-the-cap
  3. https://www.theguardian.com/society/2016/jul/21/nhs-bursaries-for-student-nurses-will-end-in-2017-government-confirms
  4. http://www.mirror.co.uk/news/uk-news/national-hell-service-landmark-nurses-10053340
  5. https://www.politicshome.com/news/uk/health-and-care/nhs/news/86626/96-drop-eu-nurses-joining-nhs-referendum-vote
  6. https://nhaswsurrey.wordpress.com/2017/06/12/the-facts-dont-lie-and-nor-do-i-an-open-letter-to-jeremy-hunt-mp/
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The facts don’t lie, and nor do I – An open letter to Jeremy Hunt MP

Dear Mr Hunt

On Thursday night, in your acceptance speech, you accused me of “falsehoods”.

In your words, you accuse me of lying about “both our record with the NHS and also our motives”. You were clearly rattled that over 12,000 people in South West Surrey showed their concern for the NHS and voted for someone who questioned your record, but that is what democracy is all about – holding the government to account.

The truth is that I haven’t lied for the simple reason that I haven’t needed to. The facts speak for themselves.

When I talked about your record, I drew out many facts:

  • The number of people lying on trolleys waiting more than 4 hours to be admitted to a hospital bed increased from 387,737 in 2015/16 to 560,108 in 2016/17 – that’s a 45% increase in one year. I’m sure I don’t need to remind you that a trolley is one of the least safe places to be in the health care system or of the three patients who died in Worcestershire hospital on trolleys during last winter’s crisis?[i] The British Red Cross described it as a “humanitarian crisis.
  • Ambulance response times, especially for the most urgent calls, are the worst since records began. The national target of reaching 75% of Category A calls within eight minutes has not been met for 32 consecutive months. [ii]
  • Mental health services are struggling. Suicide is the commonest cause of death in boys age 5-16 yet children’s mental health services can’t cope with the volume of referrals and often there is not a single mental health bed anywhere in the country due to cuts to mental health provision. [iii]
  • Performance against the 6-week cancer treatment target and the 18-week elective treatment target are deteriorating. [iv]
  • Infant mortality is rising for the first time in years, having been rising for poorer children for a decade. [v]
  • The Royal Society of Medicine attributed the 30,000 excess deaths in the winter of 2015 to cuts to health and social care. [vi]
  • The NHS has fallen further down international league tables of mortality due to treatable causes. [vii]

None of these is a lie.

I also talked about the increasing privatisation for the NHS and your quote that “I am not privatising the NHS”. Was it a lie when I pointed out that the percentage of Dept of Health budget spent on for-profit providers rose by 25% in two years? [viii]

Perhaps it was my comments about funding that you felt were untrue. I said that the NHS had been underfunded and that future plans in the manifesto were insufficient. In fact, it was your government that was rebuked by the health select committee (including two Conservative MPs) for claiming that you’d be spending an extra £10 billion a year on NHS by 2020.[ix] They pointed out that a large proportion of this was taken from public health and doctor and nurse training budgets. Moving money around within a service to appear more generous than you actually are is fundamentally dishonest. [x]

In fact, your claim that you will be spending an extra £10bn per annum by 2020 compared with 2015 turns out to be only a £4.5 bn increase. This amounts to a 1.1% annual rise each year in the decade from 2010 -2020[xi], the biggest funding squeeze in NHS history and not even half of the 2.7% per annum forecast growth in need over that period, according to the NHS chief executive.[xii] As for the future, Prof Anita Charlesworth of the Health Foundation says that the promised extra funding for the NHS in the Conservative manifesto is far less than the NHS needs.[xiii]

Maybe you are accusing me of lying when I draw attention to NHS staff shortages and the disgraceful way you treat NHS staff:

  • In 2015, Health Education England calculated that the NHS had 30,000 fewer full-time equivalent nurses than needed – equivalent to nearly one in 10 positions.[xiv]
  • You have imposed a draconian pay cap on nurses meaning their pay will have been cut by 12% by 2020[xv]
  • You have removed the bursary for student nurses, meaning many people who want to train to become a nurse can’t afford to do so[xvi]
  • You have treated nurses and junior doctors with contempt. Record numbers are taking time off with stress because they fear that patients aren’t receiving the care they need[xvii] and 50% of nurses are considering leaving the profession because of this[xviii]
  • In the recent NHS staff survey, 47% said current staffing levels were insufficient to allow them to do their job properly and 59% reported working unpaid overtime each week.[xix]
  • Since your announcement in 2015 of 5,000 more GPs by 2020 we actually have fewer GPs now than two years ago! [xx]

In the election campaign I stated that your performance as Health Secretary is destroying the NHS, demoralising staff and risking patient safety. As you can see from the above, this is absolutely true.

Finally, you accused me of lying about your motives. I have no idea what your motives are for destroying our NHS, but I have tried to give you the benefit of the doubt.

I have assumed that you are doing it deliberately – in order to run it down and provide an excuse for privatisation.

If I were you I’d accept that interpretation, because the alternative is that this has all been caused by your sheer incompetence.

Patients and NHS staff deserve better than this. The NHS is a great organisation and provides excellent care to most people most of the time, thanks to its dedicated and hardworking staff. But it is cracking at the seams and sometimes failing, due to the many pressures it is under. I am motivated by the desire to defend the NHS and raise the alarm about the dangers it faces from a continuation of Conservative policies. And as long as you are health secretary I will continue to hold you to account for what you are doing to the NHS.

 

Dr Louise Irvine

[i] https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity

[ii] http://www.qualitywatch.org.uk/indicator/ae-waiting-times

[iii] https://www.theguardian.com/society/2016/jul/04/nhs-child-mental-health-services-anxiety-depression

[iv] http://www.qualitywatch.org.uk/latest-data/combined-performance-summary-march-2017

[v] http://www.bmj.com/content/357/bmj.j2258

[vi] https://www.rsm.ac.uk/about-us/media-information/2017-media-releases/new-analysis-links-30000-excess-deaths-in-2015-to-cuts-in-health-and-social-care.aspx

[vii] http://www.telegraph.co.uk/news/2017/05/18/nhs-care-among-worst-europe

[viii] https://www.bma.org.uk/collective-voice/influence/key-negotiations/nhs-funding/privatisation-report

[ix] https://www.theguardian.com/society/2016/oct/30/theresa-mays-claim-on-health-funding-not-true-say-mps

[x] https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget

[xi] https://www.england.nhs.uk/wp-content/uploads/2016/05/fyfv-tech-note-090516.pdf

[xii] https://www.theguardian.com/society/2017/apr/29/nhs-nurses-pay-cut-12-per-cent-over-decade

[xiii] https://www.theguardian.com/society/2016/jul/21/nhs-bursaries-for-student-nurses-will-end-in-2017-government-confirms

[xiv] http://www.mirror.co.uk/news/uk-news/national-hell-service-landmark-nurses-10053340

[xv] https://www.nursingtimes.net/news/reviews-and-reports/critical-reasons-behind-nurses-leaving-profession-laid-bare/7016295.article

[xvi] http://www.telegraph.co.uk/news/2017/05/23/number-gps-has-fallen-since-nhs-launched-5-year-rescue-plan/

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THANKS to everyone in South West Surrey and beyond who supported my election campaign

I just wanted to say a massive thank you to all of you for all your amazing hard work and commitment and your fantastic spirit during these past few weeks. Whether you displayed a board, delivered leaflets, canvassed, tweeted, shared updated, attended hustings, managed street stalls –  no matter how big or small your involvement – Thank You!

Kim, Supporting NHA in Farnham

Canvassing in Haslemere

Most importantly, thank you for your votes.

William, South West Surrey. First time voter.

You are all such wonderful people – willing to give your time, passion and energy for a cause you believe in. If there were more people like you, the world would be an infinitely better place.

Energetic meeting of progressive minds uniting to #electlouise in SW Surrey.

We did very well. We dented Jeremy Hunt’s majority, highlighted the vital issues that matter not just in SW Surrey but, it seems, across the country – NHS, education, public services, Brexit, the environment – but particularly the NHS. We forced Jeremy Hunt to address his record on the NHS and all he could do was come out with the same old sound bites and accuse us of not telling the truth! Honestly? – That is really desperate!

South West Surrey Vote Share – Largest increase NHA. Source: BBC

I’m still digesting the result and its meaning for us all but overall it’s incredibly positive. It is almost unheard of for a small party to make such gains. It shows that at least 12,093 people in SW Surrey are really concerned about the NHS and the other issues we raised. You have sent Jeremy Hunt a strong message to express that concern.

We did have a progressive alliance in practice, where it really mattered. That’s why we came second. The support from the Green Party, and the Labour and Lib Dem members who campaigned for me was incredibly important and is a strong foundation for future collaborative work around progressive policies in the area.

We should all be very proud.

I’ll write again so we can re-group. We may have another election sooner than we think so, let’s give ourselves more than 32 days next time….

Enjoy the weekend…

 

Warmest wishes,

Louise

Tweet from Dr Brian May. Endorsing Dr Louise Irvine as Common Decency candidate for South West Surrey

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If we VOTE TOGETHER, we can BEAT Jeremy Hunt #electdrlouise #SWSurrey #GE2017

The constituency of South West Surrey has a real progressive alliance borne out the South West Surrey Compass Group. The group is affiliated to the national organisation (www.compassonline.org.uk) which describes itself as the home for everyone who wants to be part of a much more equal, democratic and sustainable future.

For two years, members of different progressive parties and progressives with no party affiliation in SW Surrey had been meeting under the auspices of the Compass group to discuss policy ideas together and to campaign together.

We realised that there was so much common ground between those of us who belonged to the Labour Party, the Liberal Democrats and the Green Party and other “independent” progressives to put up “progressive alliance” candidates in local and national elections, where other parties would stand down in favour of a single candidate. This is because a single progressive alliance candidate would have the best chance of winning against the Tories.

A big public meeting attended by over 200 people was held on 19th April, with national speakers from Labour, LibDems and Greens, on the day the General Election was called. The atmosphere was electric and there was an overwhelming desire to unite behind a single candidate to defeat Jeremy Hunt in what has hitherto been seen as a “safe” Conservative seat because of a divided opposition.

A further open public meeting was held in Godalming on 6th May to take forward the idea of a single progressive candidate in the General Election. Labour, Liberal Democrat, Green candidates were invited, along with Dr Louise Irvine who polled extremely well with very little organisation as the National Health Health Action Party candidate in the 2015 election. Liberal Democrat and Green Party candidates accepted the invitation, as did Louise.

Prior to the meeting itself, all potential progressive alliance candidates were asked if they agreed a common platform including support for a soft Brexit, electoral reform and protecting the NHS. Each of the candidates agreed to the progressive platform, united in wanting to challenge Jeremy Hunt.

The meeting was attended by a large number of members and supporters of various political parties and overwhelmingly endorsed Dr Louise Irvine as the progressive candidate best placed to defeat Jeremy Hunt over Ollie Purkiss, the Liberal Democrat, by a 10:1 majority. At the meeting, the Green candidate, Susan Ryland, agreed not to stand to rapturous applause, but Ollie did not make such an undertaking.

The local Labour party supported Louise Irvine from the floor but nationally the party did not back the initiative as it was against their rules to stand down candidates. Because they declared their support for Louise’s candidature, three of their local members have been suspended from Labour. But local Labour Party members have continued to campaign for Louise Irvine.

Although the Liberal Democrats insisted on their candidate standing, despite his participation in the Progressive Forum, Louise Irvine is supported by local Liberal Democrats, including Penny Rivers who has recently been elected as a Liberal Democrat Surrey county councillor, herself elected as a result of Labour standing down its candidate and securing a 27% swing away from the Conservatives.

On the ground, Labour Party members, Liberal Democrats, Greens, NHA and others belonging to no party who have been energised by the campaign are working together and campaigning for Louise. This IS a real progressive alliance. So while Labour and the Liberal Democrat parties have insisted on putting forward paper candidates, there is a real coming together of all progressive political forces in the South West Surrey constituency to unseat a deeply unpopular secretary of state for health who has caused untold damage to the NHS over the past five years.

 

 

 

 

 

 

The only way to get rid of Jeremy Hunt and oppose the Tories in SW Surrey is to support the opposition candidate most likely to win. With the active campaigning support of the Green Party and numerous local Labour Party and LibDem members I am confident that Dr Louise Irvine is the best placed candidate to achieve this.

Steve Williams

Chair, South West Surrey Compass

 

 

 

 

 

 

 

Dr Louise Irvine, National Health Action Party

The candidate selected by Lib Dem, Labour and Green party members in South West Surrey to kick out Jeremy Hunt.

And if you want to help me protect your NHS from Jeremy Hunt, please vote for me.

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