Ministers should address mounting disquiet among NHS staff about pay and recruitment if the health service is to avoid a full-blown staffing crisis, the head of the official body that represents hospital trusts and mental health services says today.
The stark warning from Niall Dickson, chief executive of the NHS Confederation, comes as GP leaders predict that 2,000 European-born doctors could leave the country because of uncertainty about their status caused by Brexit, with disastrous consequences for patient care.
Writing on theguardian.com, Dickson says nurses who complain about pay increases being capped at 1% – meaning they suffer real terms decreases– “have a point” and suggests the government think again about the effects of stagnating pay on morale and rates of staff retention.
“There may now be a case for looking again at pay,” he writes. “Given the financial and demand pressures on the service in recent years, some pay restraint has been necessary and inevitable. But it is also obvious there will be a limit on how far this can be taken before it affects recruitment and morale.”
The intervention by the confederation, whose chairman is former Tory health secretary Stephen Dorrell, is significant on an issue as sensitive as pay rates for NHS workers.
Last weekend, the Royal College of Nursing announced that nearly four out of five of its members (78%) who had taken part in a consultative vote backed a walkout in protest over pay while 91% favoured industrial action short of a strike.
Dickson says the RCN should not resort to any form of action that would harm patients but highlights rising vacancy rates as evidence of a problem that must be addressed. Nearly a quarter of NHS trusts now have a vacancy rate for registered nurses of more than 15%, he says. Specialities such as psychiatry face a constant struggle to fill training places and the number of child and adolescent, and old-age psychiatry posts. has declined.
Parts of the country, Dickson says, are finding it “almost impossible” to entice GPs, while some hospitals are being propped up by doctors in training because they can’t fill consultants’ posts.
The Royal College of GPs, the professional body for family doctors, says today that the manpower problems will be exacerbated as GPs from EU countries return home, because of Brexit. A total of 2,137 GPs in surgeries across Britain are from countries in the European Economic Area: the other 27 EU members plus Switzerland, Norway and Iceland.
Dr Helen Stokes-Lampard, chair of the RCGP, said: “We risk losing well over 2,000 family doctors from the NHS if their position is not secured as part of Brexit negotiations, and that is just not safe or acceptable.
“Our greatest fear is that hardworking, dedicated doctors from EU countries will simply cut their losses and leave, instead of waiting to have their fate determined for them. This would be a disaster for patient care, and it also makes long-term workforce planning for GP practices impossible.”
The RCGP wants the next government to stem the potential outflow of EU national GPs by guaranteeing their future status. Ministers should add family doctors to the migration advisory committee’s shortage occupation list, as happened several years ago with nurses, to make it easier to recruit GPs, it argues.
The British Medical Association claimed last week that general practice “is on the brink of collapse” because it is “several thousand GPs short”, and that family doctors are buckling under an “avalanche of work”.
Research published last week by NHS Improvement warned of “future supply problems” in many parts of England in which large proportions of GPs are over 55 and thus likely to retire in the next few years, including Kent and Medway (24.2%) and Somerset (24%).
Jonathan Ashworth, shadow health secretary for Labour – which has said it will end the pay cap for public sectors workers – said: “The NHS should be an absolute priority in the Brexit negotiations. The Tories’ chaotic approach to workforce management in the NHS has already left us thousands short of the number of GPs we need, and we simply can’t afford to lose the 2000 European GPs working here. Labour are pledging … to guarantee the rights of EU citizens working in our health and care system.”
A Conservative spokesman said only that: “Our manifesto said explicitly that we will make it a priority in negotiations with the EU that the 140,000 health and care staff from EU countries can carry on making their vital contribution.”