The legacy of stress and misspending

An interesting picture of the NHS has emerged this week — or rather two opposing pictures.

On the one side we have prime minister Tony Blair’s echoes of Harold MacMillan with his ‘never had it so good in the NHS’ speech delivered as part of his legacy tour.The other face of our Janus-like health service came from two sets of statistics we carry in this week’s issue.

Health and social care is the most stressful employment sector according to a survey by our sister publication Human Resources with 97 per cents of respondents reporting problems with stress and two thirds saying the problem was getting worse. Both figures are far higher than the national average.

Reasons mooted for these exceedingly high stress levels include the ongoing pressures of organisational change from PCT reform to quality changes and the GP pay freeze. Mr Blair’s speech notwithstanding, the negative spin from the DoH can’t have helped either. Although it is possible you will be heartened by the news that he thinks the extra spending on general practice was worthwhile.

The stress data was followed by another worrying set of statistics. The latest set of NHS workforce figures for England will do nothing to reduce the stress in practices, revealing an 11 per cent fall in registrar numbers and a mere 1 per cent growth in actual GPs. When adjusted for part-time working this could mean an actual decline in whole-time equivalent numbers. With fewer young recruits a fifth of the profession are now over 55 and probably eyeing retirement with interest.

It is impossible to say whether the pressures adding the stress levels in the health sector are among the factors discouraging young medics into general practice or whether the recruitment woes are adding to the stress levels. Either way it is a situation unlikely to yield any easy answers.

But there are things the government could do to help: end the continuous rounds of restructuring; fund further occupational health services to reduce pressures on GPs; reverse the pay freeze; and regularly repeat Mr Blair’s assertion that the new GMS contract was money well spent.

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