Nottingham City NHS and the cuts – a healthworker speaks out

Nottingham City NHS and the cuts – a healthworker speaks out

Due to an ever increasing number of service users the very modest budget increases in the upcoming years do not allow us to maintain the current level of service provision. Frontline services have been cut despite political promises to the contrary. The community podiatrists have recently had an approximate 15% reduction in staffing; resulting in over 200 complaints in the last couple of months from angry service users who were informed they were no longer eligible for treatment and new patients unable to get initial appointments. Also a number of support staff in the trust HQ are currently in the process of being made redundant. Redeployment is unlikely especially with the current recruitment freeze that sees staff retiring not being replaced.


In our workplace, Ingeus, a private sector employment services company (who are also currently expressing an interest in the ‘work for your benefits’ workfare pilot in Manchester), have been brought in to try and arbitrarily reduce sickness and absence rates that are already well below the NHS average. All those earning over £21,000 a year will have a pay freeze, while all those earning less than this will get a mere £250 a year increase. For me this works out at a 1.5% rise in earnings this year, with the RPI inflation index running at 4.6% currently, this is a real terms pay cut for every single person who works here for the next two years.

People I speak to at work are extremely worried about the future; the constant reforming of the organisation over the past decade has left morale extremely low. Many people have felt that there is absolutely no security in the health sector even before the current crisis that is certainly well founded with the government having put aside a pot of £2 billion for upcoming redundancies this year. To add to this the 3,000 staff employed by the trust are also currently in the process of a Labour introduced initiative called ‘Transforming Community Services’. This initiative aims to finally separate commissioning from provision in the trust. What this boils down to is the organisation being a tiny core of public sector workers who purchase services from whichever private, social enterprise or charity choose to tender for the service. Very often this is the cheapest bidder. The NHS is in the process of becoming little more than a brand, one that hides the fact that sometimes you are being treated by a private company. This is a model you can expect the government to try and replicate across many services, indeed Suffolk County Council are looking to do this to every last one of their services to slash costs.

Though not fully clear what the implications of this development are at this stage, what we are likely to see is deterioration in the quality of services, as companies seeking to cut corners in order to make profit become more and more a reality in the healthcare sector. This is also part of the race to the bottom in wages and terms and conditions as we are all forced to compete with each other to be the cheapest and work the hardest in order to keep our jobs. The more people who are unemployed the greater this pressure will be and with predications of massive redundancies to come this pressure will grow ever greater, something that affects everyone of us. There are also possible pension implications with staff being transferred to non NHS organisations, as well as issues with trade union recognition if the workforce is split into many small chunks.

Outside of work my rent has gone up 10% this year as the number of people buying mortgages stagnates, pushing up prices. If I do get made redundant my reemployment prospects look fairly dismal. In June to August this year were 467,000 job vacancies created and 2,448,000 unemployed people. That’s 5.2 people per job and this is before the vast majority of the cuts start to appear.

My mum is currently in the process of losing her admin job at the local regional development agency. As an admin worker in the current labour market in her 50s will face a grim time finding a new job. My dad is on disability allowance and faces increasingly stringent and unfair pressure on him as the government seeks to slash the claimant count and reduce benefits. With the current cap on housing benefits being forced to sell his house could become a real possibility. Anecdotally my friends all tell me there is increasing pressure for them to work outside their contracted hours unpaid with little prospect of a pay rise and I can’t think of anyone I know who doesn’t have some form of debt be it mortgage, overdraft and credit card. Some have already lost their jobs including one who was forced to move back in with her parents when the City Council withdrew funding from Action for Children, a charity which provided various therapies to young victims of child sex abuse, forcing it to close. The council no longer has a dedicated service specifically for helping child sex abuse victims. They are now seen by the already overstretched local social services and mental health services.

I would urge all staff and all the service users to get involved with the Notts SOS campaign, that is all those who have midwives, health visitors, podiatrists, district nurses come to their homes or have their blood taken, have tried to give up smoking using the NHS, use the continence service, the contraception and sexual health advice or health shop services. We didn’t cause these cuts, so why should we be paying for them?