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UNISON's health group executive voted 2-1 on Friday 7 March to recommend that the union go forward on the basis of Early Implementers on Agenda for Change, before full involvement can be recommended to members. The vote followed a day-long debate in which it was clear that many members held concerns about some aspects of the proposals. Health secretary Alan Milburn predicts that all hospitals will become foundation hospitals in the next few years. The first foundation hospitals are expected to come into legal force in spring next year. UNISON has published a critique of foundation hospitals which warns that health care could become a “lottery”, heralding “a return to the fear and uncertainty that were part and parcel of life before the NHS.” To read Acrobat PDF files you need Acrobat Reader software, which is available free of charge from the
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Peggy Brame is cleaning a hospital corridor when she spots something on the floor. "Oh, I've found 20p. Someone's left me a tip!" She laughs, but it's not at all funny. Peggy has worked at the same hospital for 18 years - and she is still on the minumum wage. Demetrios Matheou reports
A day in the life
Peggy Brame is cleaning a hospital corridor when she spots something on
the ground.
"Oh, I’ve found 20p. Someone’s left me a tip!" She
laughs, but in many ways it’s not at all funny. Peggy has worked
at the same hospital for 18 years. She is still on the minimum wage.
The UNISON member is one of 10 NHS workers featured in a thought-provoking
fly-on-the-wall documentary, A Picture of Health, to be shown on BBC1
on Tuesday 22 April at 10.35pm.
Charting a day in the life of the NHS, the programme paints a picture
of a service staffed by dedicated, hard-working, skilled people –
but which is seriously compromised by under-funding, under-staffing and
a government philosophy which appears to be moving away from the founding
principals of state health care.
The people chosen for the programme cover the gamut of the NHS workforce:
a brain surgeon, a consultant pediatrician, a cleaner, a porter, a midwife,
a sister in an elderly rehabilitation ward, an A&E nurse, a GP, a
paramedic and a health visitor.
Nine separate film crews followed them during the course of one long day
last November. The result shifts to and fro between their very different
experiences, from the Shetlands to Essex, Liverpool to Belfast. Its stories
include:
- a brain surgeon performs a life or death operation using state of
the art technology
- a nurse works on one of the country’s busiest A&E wards,
in Redhill, struggling to find beds for the number of patients
- a pediatrician on a 24-hour shift in Belfast cares for a baby with
a life-threatening infection, and is only able to make a brief appearance
at his own daughter’s birthday celebration
- a paramedic, whose timesaving, life-saving air ambulance is paid for by a charity, airlifts a scalded baby to hospital.
Equally as important as the dramatic moments, are those that reveal the
day-to-day demands of the service: the sister who, try as she might, cannot
release her charges from the elderly rehabilitation ward and back into
the community, because there is nowhere for them to go; the revelation
that half of the beds in the children’s intensive care unit in Belfast
cannot be used – despite demand for them - because there are not
the nurses to oversee them; or that on some days there are not enough
midwives or beds to deal with the number of babies being born.
The problems with pay are highlighted by Peggy and her fellow UNISON member
and colleague John Hutchinson, a porter at the Bury St Edmonds hospital
for 24 years.
John, who by mid-morning has moved 23 trolleys over three miles, is seen
to be brimming with pride for the way in which he helps to keep the hospital
ticking over. But he says: “We still work for the minimum wage. It’s
not even £6 an hour.”
Peggy, more than just a cleaner but someone who dispenses bonhomie to
the people in the waiting rooms and wards, adds that: “We’re
definitely not here for the money… This has definitely got to be
a labour of love.”
The pair of them are seen watching the Queen’s Speech in which the
government’s plans for foundation hospitals were announced. The programme’s
narrator describes the proposals as being "all about giving carrots
to the best hospitals and taking sticks to the worst".
Peggy’s response is vehement. “That has made me really angry,
actually, it really has,” she says. “They’re going to give
high finance to high-performing hospitals. Surely to God the hospitals
that are not performing, or they think are not performing, should be given
the money to bring them up to standard.”
The film then switches to Newcastle General Hospital, where surgeon Robin
Sengupta has just successfully completed his tricky operation on an aneurysm.
He tells the camera: “I am very worried about the foundation hospitals,
which is a kind of privatisation in the back door.
“I think the NHS is the best institution in the world,” he adds.
“This lady had a very major surgery which would have cost her between
£12,000-15,000 privately. She and her family did not have to worry
about where the money was coming from.”
The programme then features another member of the surgery team arguing
strongly against the NHS. To which Dr Sengupta, who has been at Newcastle
General for 40 years, answers that his colleague “has not seen the
worst in the world. He has not seen West Bengal.”
The NHS depicted by A Picture of Health is a million miles away from the
drab and cheesy worlds of Casualty or Holby City. The wards and corridors
of the hospitals are clean and tidy, busy but with a calm that contrasts
strongly with the melodramatic frenzy of TV hospitals.
“We found a great sense of humour on the wards where we filmed,”
says the programme’s producer Steve Greenwood. “It’s a
constant chitchat and backchat, which is there to make the daily life
of the hospitals work.
“You don’t get that in Casualty, where everything is about high
adrenalin, or love, or people’s dramatic stories. Real life in the
NHS isn’t like that.”
Greenwood believes it is difficult to make a sweeping assessment of the
NHS.
“There are certain parts of the service that work fantastically well
and other parts that do not. For example the link between the NHS and
social services really doesn’t work; the flow of patients through
hospitals and the consequent waiting lists and cancelled operations is
a big problem.
“But one single thing does come across, which is that the NHS largely
works because a lot of people in the service are prepared to go that extra
mile. After all those years of Thatcherism, when we were left to believe
that people regard money as the motivating force for everything, it’s
obviously not the case. I do believe that staff in the NHS are motivated
by that desire to help other people.”
If the subjects of Greenwood’s documentary are a representative cross
section, that is certainly the case. Admittedly, the 10 people under the
spotlight know that they are on camera; but their calm professionalism
cannot be feigned, and the sense of pride in their work seems genuine.
Their sacrifices, too, are evident. Pediatrician Dr Bob Taylor is seen
angering his wife because he is again going to be late for an important
family gathering. “I spend a lot of time apologising to my family,”
he says with a shrug. Not only is he late for his daughter’s birthday
bash, but he also leaves early in order to return to a baby in intensive
care.
Creenagh Williamson, the senior nurse in East Surrey Hospital’s casualty
ward, also has one of the longest and most difficult days, losing one
patient who the doctors were unable to save. She is one of the most stoic
people in the programme.
“As long as people are prepared to give that bit extra for the NHS,
the system will survive,’ she says. “But management needs to
understand that it needs supporting and nurturing and close control.”
A Picture of Health will be broadcast on BBC1 on Tuesday 22 April at
10.35pm.
Contact the article's author Demetrios Matheou
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