Andrew Lansley - vote of no confidence from Nurses

[wideawakenurse]

here

Watching this with much interest.

Really hope the nursing unions get this right this time, and don't just roll over and take this.

"We have one of the highest tax burdens in the EU"

No we don't...

The actual "tax burden" is a very controversial calculation but we're not one of the highest in Europe.

Here are some figures that go up to 2004.
epp.eurostat.ec.europa.eu/tgm/table.do?tab=table&init=1&plugin=1&language=en&pcode=tsiem050

It gives the EU average tax burden for an employed person as being just over 40%. We were down under that average at 30%. Belgium, Germany, France and the Netherlands were all above 40%.

More recent EU released estimates (up to 2008) are available here:
ec.europa.eu/taxation_customs/taxation/gen_info/economic_analysis/tax_structures/index_en.htm and they show that once again the average tax burden in the UK is assessed as being substantially lower than in many other European countries.

And this is the crux of my argument about our economy. We want a European model of social provision but are utterly unwilling to pay the taxes required to support it. We need to either dip into our wallets and pay the price or we go the American way and scale back what we provide.

Personally I hope we go with the European model, but we at least need to have that conversation and agree a way forward. The longer we refuse to have that chat the longer we'll keep on funding our spending by hitting the Government's equivalent of credit cards and landing our children and grandchildren with a massive pile of debt and a problem still unresolved.

Badger - I agree about our relative average 'tax burden'.

However, now that our top tax rate is 50%, it is amongst the highest in Europe. So we don't have much (if any) headroom. We also rely on 1% of our income tax payers for 25% income tax. (Top 5% for 50%). Which appears top heavy!

I believe (correct me if I'm wrong) most European countries have a 'broader tax base'. I doubt UK tax payers have the appetite for that.

But I do agree that we need an honest discussion about this. However, IMO, our politicians (on both sides) avoid honest debates because there are no easy answers.

"However, now that our top tax rate is 50%, it is amongst the highest in Europe... We also rely on 1% of our income tax payers for 25% income tax. (Top 5% for 50%)... I believe (correct me if I'm wrong) most European countries have a 'broader tax base'."

I agree, I'm not talking about the top tax rates but the general taxation burden upon all the people in the country, the burden upon the "average" working person, which is what those figures attempt to show.

I'm not suggesting that we squeeze the top 1%, if we're going to be able to afford the social system that we've become used to then we all need to pay for it, and our tax burden needs to approach that of the rest of Europe.

"However, IMO, our politicians (on both sides) avoid honest debates because there are no easy answers."

It's not the politicians fault. They avoid it because we don't want to hear it and short sightedly we won't face up to the need to either dramatically slash social spending or to ramp up taxation upon everyone.

Even now they're only tackling the issue because we've all got someone to blame. Lefties can blame the banks while the right wing can blame Labour. The fundamental issue is that both sides were happy to give us the vision of buying our future on the never never because that is all we would vote for. Both sides failed to balance the books and got this country deeper and deeper into debt.

If we miss this opportunity now and don't sort things out our children and grandchildren will be left to carry not only all our current debts but all the debts that we will continue to build up while we pretend that our lifestyle is affordable.

Oh no badgerpaws, we would never want to 'sqeeze' the top 1%. They only hold about 80% of the country's entire wealth, so we couldnt ask anything of them could we?

"They only hold about 80% of the country's entire wealth, so we couldnt ask anything of them could we?"

Where on earth did you get those figures?

The HMRC figures for 2004 to 2005 (www.hmrc.gov.uk/stats/personal_wealth/13-5-table-2005.pdf) say that the top 1% own 21% of the wealth. I know that "about" is a flexible term but you're out by a factor of about 400%.

Even the top 25% still don't own 80% of the wealth, they come in at 72%.

And in case you believe that HMRC are somehow covering up the figures here's a more "left wing" set of numbers which broadly agree with what the HMRC say makewealthhistory.org/2009/12/16/wealth-distribution-in-britain/

If we want a European style of social care then we need a European style of taxation system which means that the burden on everyone increases (in proportion of course to their means).

Chasing that top 1% isn't going to do it.

And making up figures certainly isn't going to help either.

Fine. Complete reform of the tax system is needed more urgently than a botched reform of the NHS. Acknowledge the reality and increase taxes seeing as we've been underpaying for years. Income tax is less regressive than VAT and will do less harm to the economy. As long as we don't bail out the banks again or finance any more unjustified wars.

THE RCN is technically a union but yet it cannot do anything about pay and conditions for Nurses. This particular vote was for NHS reform not for Nurse's working life anyway.

When I worked as a Nurse in the NHS I was a member of the RCN. We kind of had to be. THe RCN is really a form of liability insurance for the Nurse. If I were to make a mistake and end up getting charged with manslaughter or sued the RCN would hold my hand through it and help with costs.

As an NHS nurse I was always forced to take on more patients than I could handle. This made it highly likely that I would make an error that killed or maimed a patient. Even the most hardworking, smart, and dedicated Nurse will make errors in these kinds of (NHS) working conditions. There is more information than the Nurse can keep track of for her assignment of patients and she is interrupted so frequently whilst on duty that she can barely cast an eye over her patients. This makes things like a death due to failure to rescue or delays in care very very likely. The Nurse would get the full blame for that, not hospital managagement or the doctor. If that happens to me I want someone to hold my hand and help with legal fees. That is the only reason I am in the RCN.

So really, most of us are RCN members for the liability insurance part. We are very aware that they cannot do anything about the medieval nurse to patient ratios in this country. The RCN cannot do anything about a Nurse having to stay on and work a double shift (a 16 hour day rather than an 8 with no notice) because management won't pay for another Nurse to take over your patients so that you can go home. And it is illegal to leave the ward if you don't have another Nurse to hand over to.

The RCN cannot do anything about management replacing nurse's with untrained carers, kitchen and pharmacy refusing to supply Nurses with what we need for the patients etc etc etc. No one can force NHS management to spend money, not the RCN, not the Nursing and Midwifery council and not Unison. They just do not have the power to do that. Nurse's will not strike so their unions have no leverage regarding improving their working conditions.

The vote against Langly was a vote against NHS reform that will lead crimes against patient safety. The Nurses will be the ones held responsible for any poor standards of patient care even though we have absolutely no control over anything. That is why they gave him the two finger salute. If the NHS goes the way the Tories want the Nurse's will be even more cut off from resources that they need and even more damned and abused by the public.

Hope that clears things up. Thank god I got out of the NHS. Another poster said that there are plenty of staffordshires out there. This is very true.

"As long as we don't bail out the banks again or finance any more unjustified wars."

Neither are really responsible for our overspend and are both convenient excuses held by people trying to divert attention from the real cause, which is simply the idea that we can keep spending more than we earn.

In terms of "unjustified wars" I presume you mean Iraq (which was very dubious) and Afghanistan (which was a commitment under the NATO treaty). The actual extra cost of those wars on top of the NHS budget was £20 billion over ten years, so £2 billion a year for both conflicts. Here's a very left wing paper which quotes that figure, other places do to, so it's presumably accepted: /view/full/91782

To put that £2 billion a year into context over the last financial year the Government overspent by £140 billion. In comparison we spend about £95 billion a year on the NHS and £135 billion on benefits. £2 billion a year would barely make a difference, it certainly wouldn't fix our problems. That's not to say that it wouldn't help, but that it's not the answer.

And as to the bankers I don't believe that any of that £140 billion overspend was given to banks. Most of what we've done with the banks is to guarantee bad debts rather than pay out hard cash. So even giving money to the banks is not responsible for out £140 billion overspend either.

Neither our military conflicts or our bankers are responsible for the hole that we're in. They're both excuses offered up primarily by the left wing to cover up the mess that refusing to tackle this problem has lead to. The excuse given by the right wing is usually to blame Labour when while they were in power they refused to balance the books and ignored the problem too.

"Complete reform of the tax system is needed more urgently than a botched reform of the NHS."

Yes. We need to bring the books into balance and live within our means rather than pay for our lifestyles with credit and lumber our children with the pain later. Every day that we run around kidding ourselves that wars, bankers or socialism are the cause is just another day spent with our heads buried in the sand.

"THE RCN is technically a union but yet it cannot do anything about pay and conditions for Nurses."

It can and will do the same as pretty much any other Union.

Yes it does lots of other things for its members, as do most other Unions, but an element of what it is about is collective bargaining for terms and conditions for its members.

Here's the RCN talking very clearly about itself as being a Trade Union connected with work place rights for its members:
www.rcn.org.uk/support/activist/becoming_activist/what_is_a_representative

Another story from the conference that you hear less about is that 97% of the delegates voted in favour of balloting the membership over industrial action if there was any challenge (yet alone change) to their pay agreements (www.managementinpractice.com/article/25217/Nurses_could_strike_over_pay_deal and www.thisislondon.co.uk/standard/article-23941548-nurses-move-step-closer-to-strike.do).

I think that there's debate as to exactly what action the Union is allowed under its own rules to take. But it is a Union, it can take legally allowed industrial action following a ballot of its members and it has threatened to do so a few times over the last few years.

And that is the sort of story that the right wing and its press are going to start to push more often in order to discredit the RCN vote as being just another Union opposing them.

And just to make perfectly clear I've got no problem with the RCN, believe that Unions can fulfil a very important role in our society and can also see a very big difference between the RCN and Bob Crow's activities. But they are a Union and the Tories are Tories.

To be honest, Badgers, the right wing aren't going to get very far attacking the nurses as the public won't take any notice and the tabloids won't dare join in.

The bailout did burden us with debt and this low interest rate, high inflation climate is really damaging. I don't think there was much choice about the banks in 2007-8 but Labour should bear responsibility for the light touch regulation and timidity about tax just as the Tories should stop pretending that when the sun comes out, they can cut our taxes further as a bribe for support.

Either way, the answer is not Lansley's Bill. And newjobthankgod describes really well how cuts affect staff. In no way will private health care be cheaper without a massive drop in quality - and/or reliance on immigration and even lower salaries. Health 'services' (if you are lucky enough to have a one-off, curable problem) aren't like a gadget manufactured more cheaply in China and you can't outsource it to India.

Badger,

A. I witnessed many, many of my colleagues (myself included) make complaint after complaint to the RCN. Working conditions only get worse.

B. If NHS Nurses strike, thousands will die. The public will be coming after the Nurses with torches and pitchforks.

There will be no Nurse's strike. NHS management knows it. The RCN will remain completely ineffective.

Nurses won't strike but firefighters did, and though they did get more criticism than previously, they still get lots of public support. I wish there could be some form of effective protest which the public could join in with as well, anything to get the message across. What exactly did it take for the Tories to back down on the poll tax?

NewJob, I think the RCN have done the best thing it could do in the vote of no confidence. You also need more brave whistle-blowers, maybe.

Threads like this are good too. I've learnt a lot.

What we need is a campaign for nurse/patient ratios to become a legal issue.Currently there are only guidelines.

We are about the only country where there are legal carer/child ratios in Nurseries etc but we dont have the same in hospitals - a colleague has just returned from Australia and only had to look after 4 patients per shift.

Compare this with current UK practices-1:10 is not unheard of. If your colleagues go off sick or actually take their break you could be caring for 20 patients.

Any one who cares about the safety of patients please right to the government and the RCN and demand that that this becomes a legal issue.
Is it any wonder that Nurses are leaving to work abroad.

write to the government even

Good idea, Sarah.

Good idea SarahLundsJumper and really shocking to hear the statistics.

Mellow,

Do you have any idea who many whistle blower Nurses there were at staffordshire who were deemed "mentally unstable" and ignored. Funny, no one thought that they were crazy prior to their whistle blowing. At my hospital we have filled in hundreds upon hundreds of incident forms and official complaints. We have gone to the Doh, the CQC and every other alphabet organisation that you can think of.

It really pissed me off when people insinuate that the Nurse's are not whistleblowing. I have been blogging about this shit for years and have been published in major papers. I have really put my ass on the line trying to whistleblow. So have countless, countless other Nurses and Doctors.

Anyway now that I am out of the UK I am going to step it up a bit.

Housekeepers at mid staffs reported hundreds of incident forms in rubbish bins (forms that were completed by Nurses to bring attention to the shit standards of care) that was located in managers' offices.

Sarah, at my hospital it is one RN to 15. Patients have a 31% higher chance of dying for each additional patient their RN cares for above 4.

and the fuckers are still refusing to hire.

Sorry, Newjob - never meant to insinuate they weren't whistle-blowing. I have huge admiration for nurses, whether they speak up or just doggedly keep on doing their jobs. It has to be each person's choice. I realise people's careers can be wrecked if they do speak out, and really appreciate the risks they are taking.

There were whistleblowing doctors at Staffs too. There were hounded out and sent half mad with the pressure. This is a decade after Bristol when the DH and NHS management structures were meant to ensure 'never again'.

Have you ever heard of Dr. Rita Pal? She was a junior doc somewhere in Staffs. She had a great record as a doc...until she whistle blew and the GMC etc made her out to be mentally ill or something like that. I think she lost her license to practice medicine for refusing to admit that she was "crazy" and now works as a writer. This all happened a few years before the situation at Staffs hit the mainstream media.

I think we are probably referring to the same person, Newjob. Although sadly it's entirely possible there was more than one doctor hounded out...