Beware Threats To Public Health

Widespread job cuts across the public sector in the UK and legal challenges to Obama’s equitable healthcare reforms in the US are a warning of what can happen when conservative forces put profit before a healthy public sector.


As NSW nurses celebrate our success in achieving mandated nurse-to-patient ratios, things are not so great elsewhere in the world.While we are getting mechanisms to improve workload issues, which will result in safer patient care, the UK faces massive job cuts across the health sector.

When the Global Financial crisis hit in 2007 and 2008, unlike the Australian Government which implemented a stimulus package to boost the economy, the then Labour Government in the UK responded by announcing plans to save costs by cutting jobs and services in the public sector, including the National health System (NHS).

The Conservative – Liberal Democrat Coalition government, which claimed power in may last year, went further, demanding a whopping £20 billion ($32 billion) be cut from the NHS budget – a move that a health select committee of influential mPs said could risk a health and social care meltdown.

The situation is already dire, with the vast majority (80%) of nurses saying they did not have enough staff to deliver good quality care to patients, according to a UK royal college of Nursing (RCN) survey. The RCN said it feared that NHS providers may become unable to provide high-quality care for all and that care might be ‘dumbed down’ as a result of not having the right number and balance of staff.

The survey revealed that nurses feel strongly that inadequate staffing levels could compromise patient safety, with 83% saying that this could be happening on a daily or weekly basis.

RCN chief Executive and General Secretary Dr Peter carter, said: ‘The results of our survey act as a reality check for those saying that cuts aren’t biting in the NhS. It is deeply worrying that some nurses are telling us they do not have enough staff to deliver quality care, and safety could be compromised. coupled with the drive to make efficiency savings, we are concerned at the NhS’s ability to cope, especially as staff are clearly under so much pressure.

‘What we are hearing is that there are fewer staff doing more work, and nurses themselves are saying it could have a damaging effect on patient care. The health service is facing unprecedented change, uncertainty and economic challenges. Throughout this period it is vital that managers do not lose sight of the basics – having the right number and balance of staff to provide safe care.’

Despite opposition from the RCN, British Medical Association, the Royal College of General Practitioners and all the major unions, Prime Minister David Cameron is ploughing ahead with the government’s health and Social care Bill.

This includes plans for a major overhaul of the NHS system, which will see GPs get control of $80bn of the NHS budget from 2013, with primary care trusts and strategic health authorities abolished.

The RCN estimates 27,000 health positions will be lost over the next five years.

Unions have rejected a proposal by NHS Employers (the body that represents health trusts) to freeze pay in return for job protection for some staff.

Unite national officer for health Karen Reay said: ‘Our members are completely opposed to these poisonous proposals that employers have no power to guarantee in any case.’

It’s a bleak situation, with rising unemployment that is expected to be exacerbated by these latest cuts.


Meanwhile in the US, right-wing forces are conspiring to repeal President Obama’s landmark healthcare reforms that would see around 36 million Americans gain access to affordable healthcare insurance as well as eliminating some of the insurance companies’ worst practices. These include denying insurance to the sickest people, pre-condition screening, premium loadings and lifetime and annual coverage caps.

The legislation – which was supported by american nursing unions – came into force last march. But several months later in November a federal judge in Florida deemed the Patient Protection and Affordable Care Act ‘unconstitutional’.

According to reuters news service, District Judge Roger Vinson claimed the legislation’s ‘individual mandate’ went too far in requiring that americans buy health insurance in 2014 or pay a penalty. ‘Because the individual mandate is unconstitutional and not severable, the entire act must be declared void,’ he wrote.

The case was brought by representatives of more than 26 US states, while several other similar lawsuits have been filed in federal courts. The plaintiffs are republicans, who have branded the reforms ‘Obamacare’, although some conservative Democrats are against the law. As of February 2011, House Republicans have vowed to ‘defund’ the act if the lawsuits fail to have it repealed.

The US Government is expected to appeal Judge Vinson’s decision, with both republican and Democrat State Senators urging a speedy process to avoid expenses being incurred by states in implementing the law if it is eventually repealed.

‘If one thing is clear from both these examples, it’s that nurses in Australia must not be complacent. Governments may promise sweeping reforms but a change in the economy or political power can result in them just as swiftly rescinding their commitments, leaving health-care staff without jobs and patients without access to high-quality care,’ said NSWNA assistant General Secretary Judith Kiejda.