The Week 9 August 2024
Research Manager and Head of Health
Summer recess consistently falls foul of a major misconception: that it will be a ‘quiet’ period. Naturally, life does not pause in the summer so neither does politics.
This year’s quiet-but-definitely-not-quiet recess has been no different. The appalling riots across the UK have shone a light on social cohesion, the police response, and the criminal justice system’s capacity. The latter of which our Policy Director, Joe Hill, wrote a blog about on Wednesday. It has, however, illuminated the remarkable power of people to come together in response to violence, as was seen in Walthamstow, Liverpool, Bristol and Newcastle.
Outside of the riots, politics has also been moving fast in the world of health. Last week we saw a multitude of announcements about GPs: their ballot for collective action, more Government funding to hire 1,000 more GPs, a 6 per cent pay rise for GPs, and a letter from the Secretary of State to GPs offering to “reset the relationship”.
And this week, the General Medical Council’s (GMC) annual report into the workplace experience of doctors in the UK illustrated a miserable state of affairs among doctors. 41 per cent refused to take on additional workload, 21 per cent were at a high risk of burnout and as a result, an astonishing 41 per cent had seen patient safety compromised. The experience of GPs is particularly poor.
However it is, extremely important to remember that the doctor workforce is not the NHS workforce. By far the worst experiences in the GMC report are from primary care. But primary care is composed of a wide variety of clinical staff. All of which are essential for the shift of care into the community, all of which are struggling, and few of which get the same level of recognition as GPs.
The number of district nurses has fallen by almost half – 46.9 per cent – since 2009. Like GPs, these nurses also work unpaid overtime, have unmanageable caseloads and insufficient time to devote proper care to patients. Also, little is known about the workplace experience of administrative staff, who are critical to the efficient operation of general practice as demand increases. From this survey, nearly half were dissatisfied.
The combination of poor workplace experience, overworked staff, and declining patient satisfaction clearly points to only one conclusion, that underpins our Reimagining Health programme: that the NHS is in desperate need of fundamental, not incremental, reform. Primary care is no exception. If you want to hear our case, listen to our Director, Charlotte Pickles, make it very compellingly on last week’s Any Questions on Radio 4.
Onto the read of the week...
One marker of an effective criminal justice system is a low rate of repeat offending (otherwise known as recidivism). And it is well documented that a small number of repeat offenders are responsible or a large share of crime, so with effective prisoner rehabilitation, the State can make huge improvements to public safety and savings to the public purse.
Reported recidivism rates vary extensively between countries. The US is often thought to be a particularly bad performer, with the Nordic countries – specifically Norway – used as shining example of how to effectively rehabilitate criminals. In this Substack, ‘Inquisitive Bird’ comprehensively breaks down the statistics, demystifying multiple common misconceptions about cross-national comparisons for recidivism and the factors outside the prison that might drive recidivism. It’s a highly educational read.