A latest survey revealed that Scotland’s nursing staff is “at breaking point” and they are suffering “plummeting” morale, financial worries and a complete collapse in job security. The report by the Royal College of Nursing (RCN) said those working in Scotland's NHS were under “immense pressure”.
The RCN employment survey followed figures from the Scottish Government last month that showed a “rapid acceleration” in the number of nursing posts being lost across NHS Scotland, with the total now at its lowest point since 2006.
Some 700 nurses and health care support workers in Scotland took part in the RCN's employment and morale study. It found only 30 per cent of nurses felt the profession would continue to offer them a secure job in the future, compared with 82 per cent two years ago. Only 38 per cent would now recommend nursing as a career compared with 54 per cent in 2009. Also 74 per cent reported increased stress at work. The survey also found that 67 per cent of NHS nurses in Scotland were more worried about job cuts and the threat of redundancy than they were a year ago, while 68 per cent said concerns about their financial situation had increased in the past year.
To add to nurses' woes, they will have to pay more towards their pensions after the Scottish Government had to bow to Westminster demands that it imposed an increase. First Minister Alex Salmond had tried to resist the move but claimed Chief Treasury Secretary Danny Alexander had "threatened" his administration with a £102 million cut unless it imposed the increase on the 250,000 public-sector employees under its control.
Theresa Fyffe, the director of RCN Scotland, said, “Given the continuing cuts to the nursing workforce, prolonged pay freeze and planned pension increases, it is no surprise that the morale of nurses and health care support workers in our NHS is plummeting. While the impact of such pressures could be expected, it doesn't mean the situation should continue. If action is not taken and stress continues to increase, standards in patient care will begin to fall. The survey was carried out before it was confirmed in this week's Scottish budget that pay for NHS staff earning over £21,000 is to be frozen for a second year, so it is likely that the financial pressure on our members will increase even further.”
Ms Fyffe added, “The survey's findings should fire a warning shot across the bows for the Scottish Government and NHS managers alike. Our nursing workforce is at breaking point and the tactic of cutting posts in an uncoordinated manner is simply not working. We need a vision for our NHS which sets out how services can be delivered more efficiently without placing an unacceptable burden on nursing staff, the very backbone of health services in Scotland.”
Rachael Maskell, head of health at the Unite trade union, has warned that NHS workers are facing “unprecedented challenges to their pay, in the midst of mass re-organisation and cuts, in some cases losing 25 per cent in pay as a result.”
Margaret Watt, chairman of the Scottish Patients Association, said, “We know the nurses are stressed because there is a shortage out there. People do not realize it. We have known for a while and we are always saying when we get an opportunity that we could do with more nurses and doctors, but it never seems to happen. Morale has plummeted and it's not surprising it is no longer the golden job today that it was years ago. When people went into the job years ago, they did so because they were committed, but they do not have the same commitment as the older nurses. They knew it was the career they wanted. Now the stuffing has been knocked out of them because of shortage of staff and changes. They know there is a shortage, we know there is a shortage - the government obviously does not see it the same way. We need more nurses.”
Health secretary Nicola Sturgeon defended the Scottish Government and praised the nation's nurses saying, “Our nurses do a fantastic job. I know how tough a job it is, and they have my thanks and appreciation at all times. The current financial and economic climate is having an impact on all sections of society. However, the Scottish Government is doing - and will continue to do - everything in its power to support the NHS, and those who work in it, through difficult times. Firstly, we have fulfilled our commitment to pass on the health Barnett consequentials to the NHS in Scotland in full. Over the next three years, health board budgets will rise in real terms, reflecting our commitment to front-line services.”
She added, “Secondly, I have made it clear that, as the size and shape of the NHS workforce changes to reflect changing patterns of care, we must work in partnership with staff to ensure that quality of care remains the top priority. The RCN knows that my door is always open to them to discuss these issues.”
“And thirdly, we have made clear that a key objective of our pay policy is to preserve jobs as much as possible. We have now committed to maintaining our policy of no compulsory redundancies for a further year, precisely to give workers like nurses, who do difficult and stressful jobs, the job security that they deserve,” she said.
Dr Peter Carter, general secretary of the RCN, responded to criticism that nurses had left elderly patients dehydrated, malnourished and in soiled bedclothes by saying relatives should share the responsibility for looking after them in hospital. “If you have a 24-bed ward and have got five nurses and everybody is having lunch at the same time and half the patients need feeding, it becomes difficult to get it all done,” he said. “If someone is coming in and sitting with their loved one, they are going to have the focused, dedicated time. You get this business of wards, very, very busy people, [patients] dying to go to the loo, elderly people wetting themselves, then they lie there feeling embarrassed - and it is about helping gran get out of bed and go to the loo,” he said.
He was backed by Dr Clare Gerada, chairwoman of the Royal College of General Practitioners, who said the NHS could not afford to have nurses feeding elderly patients when their children could do it. “Families should be more involved,” she said. “I am not criticizing anyone; that is how it is. Can we afford to have someone sitting by an elderly patient … in hospital and feeding them, which might take two to three hours? Do we as relatives have responsibilities?”
However, Katherine Murphy, chief executive of the Patients Association, was unimpressed by this argument and said, “Not every patient is going to have a relative close by…The vast majority of these people are elderly people and we are now asking the elderly relatives to provide that care. We have got a government who is singing about Big Society, and I think it's an appalling indictment on society if we are now asking relatives of sick patients to provide the essential care that they are entitled to, very often at the end of life.”
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