WES STREETING’S admission that promising a specific reduction in NHS waiting lists would create a “hostage to fortune” reflects the tenuous nature of Labour’s offer.
Reducing waiting times through funding additional overtime, as Streeting proposes, is an uncertain strategy which could exacerbate staffing problems.
Many doctors and nurses report hospitals struggling to maintain safe staffing levels on weekdays. Given that, looking to extra weekend shifts to address an operations backlog is hardly a sustainable solution.
Doctors and nurses already work weekends. Normalising weekend work for routine rather than urgent care is anti-social, further disrupting work-life balance in a sector where most will be giving up a large number of weekends already — something of particular concern to staff with families and likely in practice to hit female workers hardest.
Cash-strapped hospital trusts, juggling costs from PFI debt to medicines, may seek to normalise weekend working as an expectation rather than pay overtime premiums.
And the NHS, with its 100,000-plus staffing vacancies, has a limited pool to draw overtime labour from. Had Labour spent more time listening to the voices of doctors, nurses and paramedics on picket lines this year rather than ordering MPs not to attend them, it would have clocked concerns about burnout alongside those about pay: health workers terrified of making mistakes because they are working while exhausted and hungry, unable to take breaks because there are too many patients and too few staff.
More overtime can only worsen the problem of overwork, while an expectation of more weekend work could hit recruitment targets. And when it comes to making the NHS an attractive place to work, Labour’s plans still fall short.
Streeting is right to blame the government for the junior doctors’ strikes due to resume tomorrow. He qualifies that by asserting that Labour, too, would refuse doctors the raise the British Medical Association (BMA) is demanding — 35 per cent, to reflect the cumulative loss in real-terms income since the bankers’ crash.
Importantly, he concedes the principle of pay restoration: “the road back to fair pay [is] a journey, not an event.”
Fine: the BMA has already said it is happy to discuss a roadmap to bring pay back up to its 2008 value. Public service unions which secured moderate pay increases through strikes earlier this year take a similar line; the National Education Union’s Daniel Kebede spoke in September of “looking to restore teacher pay over the next five years” as a target.
But this “journey” needs to be mapped. Labour will not convince workers with a vague claim that economic growth will bring pay rises. It needs to say by how much it intends to raise public-sector pay and how it intends to restore its value over a parliamentary term.
Its failure to do so is tied to the shadow health secretary’s excuse, the “complete mess” of public finances, a problem Labour could easily address through taxing the super-profits of big corporations, wealth and land.
Nor is it at all clear how Labour intends to tackle recruitment problems while simultaneously vowing to reduce legal immigration by more than two-thirds, as shadow chief secretary to the Treasury Darren Jones said it would last month. Most of the rise in legal migration has been through recruitment to the health and care sectors.
The NHS continues to top polls as voters’ main concern, ahead of the cost of living and well ahead of immigration.
A serious pitch on the NHS, with a significant increase in investment to bring per capita spending into line with our European neighbours, could be a major vote winner: while negative messaging about the impact of immigration on public services can be turned on its head through a celebration of the contribution of migrant workers to our health service, promoted through NHS blocs on anti-racism marches or woven into campaigning on industrial issues.
