Every fresh batch of statistics about the NHS spawns a cacophony of political claim and counter-claim about the health of the service. Yesterday, figures came out showing that there are 45 fewer nurses and midwives – out of a total nursing workforce of 56,000 – than there were a year ago.
Spokespeople for nursing unions quickly pointed out that this is continuing a downward trend that began in 2009 and that there are now 2,000 fewer nurses and midwives tending to patients than four years ago.
Does this mean that the NHS is better or worse? Health minister Alex Neil avoided answering that question, saying that it was merely a reflection of a changing pattern of care. More people – who might previously have required a hospital stay – are now being treated in the community. So the implication is that not so many hospital nurses are required.
But according to the Royal College of Nursing, these cuts are bad for patients as the remaining staff are over-stretched. Jackie Baillie, Scottish Labour’s health spokesperson, agreed, offering up as evidence the rising numbers of patient complaints.
A more interesting point was highlighted by Jackson Carlaw, the Conservative spokesman. He noted that there are some 1,400 vacant nursing posts, which translates into 2.5 per cent of nursing and midwifery jobs being unfilled. This is a lot more than might be expected from routine staff turnover and has risen by 400 since June.
The figure comes from the RCN, which says that it results from reconfiguration of the workforce. Roles are being downgraded, causing nurses who were doing that job having to take a pay cut. Other jobs are being turned from general to specialised nursing, for which the general nurse is unable to apply.
If so, it seems rather odd that a process – which is presumably planned and, therefore, has foreseeable outcomes in terms of the number and type of nurses that will be required – is running into the problem of there being nobody available to do the work. Surely this type of change could have been planned so that there is a much better match between the work and the workforce?
But perhaps another announcement by Mr Neil provides a clue that NHS managers have either not been able to, or don’t know how to do the necessary planning. From next year, he said, staffing numbers and appropriate skill levels will be “informed by the mandatory use of evidence-based workforce planning tools”. That sounds as though workforce planning hitherto has been done by guesswork rather than by facts, figures and forecasts.
And if ministers, managers, and nurses are all agreed that these 1,400 posts should be filled, then it does mean that the current staff are being put under extra pressure, which will have adverse consequences for the quality of patient care. Mr Neil needs to fix this problem.
Seeking a happy medium over dolphins
Most nature lovers, should they be standing on the shores of the Moray Firth and seeing big commercial ships thrashing up and down the seaway, would be bound to think that they must be a threat to the dolphins that enliven the firth and bring so much delight to thousands of visitors. It turns out they would be wrong and it is the thousands of tourists who may be the problem.
Scottish Natural Heritage (SNH) has been studying the dolphin population for some time. The growth of offshore wind farms and other developments in and around the firth mean an
increase in seagoing traffic, so SNH has been trying to work out what that might mean for the mammals.
Though the researchers and SNH are cautious about the findings, the computer modelling they have done suggests that the dolphins are not much bothered by commercial vessels that plough steady courses and speeds in and out of port. But they are disturbed, it seems, by boatloads of rubberneckers that clatter erratically around the areas where they are most like to forage and frolic. Given that they are intelligent creatures, this looks like an entirely reasonable conclusion.
That, however, poses a problem. Nature conservation demands not just that important populations of flora and fauna be protected from human interference, but also that people should be able to see them. And for businesses that facilitate that viewing, they are playing a vital part in the chain. Here, it is in everybody’s interests that the dolphins do not feel so unhappy they change their environment. This research should serve as the starting point for constructive talks to keep