Boris and Dave bash transport unions to distract from the banks

A convenient distraction from the coalition’s failure on bankers’ bonuses.

Boris Johnson and David Cameron have a joint article in this morning's Sun condemning the rail unions for threatening to strike on the day of the royal weddding.

They write: "[Y]ou can try to drag this country back to the 1970s, to a time when militants held our country to ransom, but you will not succeed."

In reality, currently no union is planning to strike on that day. The Aslef general secretary, Keith Norman, says the question of possible industrial action on the day has not "even been discussed" by the union's executive. But, in the wake of the coalition's capitulation to the banks, Cameron and Johnson have spied a convenient opportunity to redirect public anger towards the unions.

As the Telegraph's Benedict Brogan noted yesterday, the Conservatives fear that the latest round of bonuses will further dent their popularity:

Tory high command wories that if it goes soft on the banks the numbers will get worse. Those who have pressed the coalition and specifically the Chancellor to speak out against banker-bashing are told each time that the coalition has to keep public attitudes in mind. Mr Osborne believes voters loathe the banks and blame them for the financial crisis.

On Twitter, Boris has called for the public to "bombard" Aslef's website with complaints, a useful distraction from his complete failure to secure his long-promised "no-strike deal". As I noted on Monday, there have been more Tube strikes during two and a half years of Boris than eight years of Ken Livingstone. In his 2008 manifesto, the Mayor of London promised:

I will look to reduce the disruption caused by strikes on the Tube by negotiating a no-strike deal, in good faith, with the Tube unions. In return for agreeing not to strike, the unions will get the security provided by having the pay negotiations conducted by an independent arbiter, whose final decision will be binding on both parties. I believe this is the fairest way to ensure that London is not brought to a standstill every time there is a pay negotiation, and to ensure union members get a secure deal.

But when asked in September if he had sat down with union leaders and had his "promised beer" with Bob Crow, the mayor replied: "I have not spoken directly with union leaders but with plenty of people in government." Inviting the public to "bombard" a website with complaints may be an example of the "big society" in action, but isn't it time for the mayor to adopt a more mature approach?

George Eaton is political editor of the New Statesman.

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The NHS's sustainability is under threat if more isn't done to look after its staff

More work is needed to develop the health service's most precious resource.

As the NHS nears its 70th anniversary, the time is ripe for a workforce rescue plan. Staffing worries, even more than funding pressures, are the biggest cause of concern for NHS trust leaders. There are not enough trained health workers in the UK to meet today’s needs, let alone those of the future.

Demands on hospitals, mental health and community trusts, and ambulance services are growing. More patients need treatment. Increasingly, they require complex care, with specialist expertise. This is not just about numbers. We need a clinical workforce that is skilled and equipped to work in new ways to deal with the changing needs of the population it serves. 

That means improving the supply of people coming to work for the NHS, and doing more to develop and motivate them so they want to stay. These problems are not new but the scale of the challenge has reached a tipping point which threatens the future sustainability of the NHS.

Ministers rightly point out that the NHS in England has more clinical staff than ever before, but numbers have not kept pace with rising demand. The official "shortfall rate" for nurses and midwives across England is close to 10 per cent, and in some places significantly higher. Part of this is down to the recognition, after the events at troubled health trust Mid Staffordshire, of the importance of safe staffing levels. Yet for successive years during the coalition government, the number of nurse training recruits fell.

Far from being a problem just for hospitals, there are major nursing shortages in mental health and community trusts. Between 2009 and 2016 the number of district nurses employed by the NHS in England fell by more than 40 per cent. Just as the health service tries to accelerate plans for more treatment closer to home, in key parts of the workforce the necessary resources are shrinking.

There are also worrying gaps in the supply of doctors. Even as the NHS gears up for what may prove to be its toughest winter yet, we see worrying shortfalls in A&E consultants. The health service is rightly committed to putting mental health on an equal footing with physical health. But many trusts are struggling to fill psychiatry posts. And we do not have enough GPs.

A key part of the problem is retention. Since 2010/11 there has been a worrying rise in “leaver rates” among nurses, midwives, ambulance staff and scientific technical staff. Many blame the pressures of workload, low staffing levels and disillusionment with the quality of care. Seventy per cent of NHS staff stay on for extra hours. Well over a third say they have felt unwell in the past year because of work-related stress.

Add in cuts to real basic pay, year after year, and it is hardly surprising that some are looking to other opportunities and careers outside the public sector. We need a strategy to end pay restraint in the NHS.

There is also a worrying demographic challenge. Almost one in three qualified nurses, midwives and health visitors is aged 50 or older. One in five GPs is at least 55. We have to give them reasons to stay.

NHS trusts have made important strides in engaging with their workforce. Staff ratings on being able to report concerns, feeling trusted to do their jobs, and being able to suggest improvements are encouraging. But there are still cultural problems – for example around discrimination and bullying – which must be addressed locally and nationally.

The NHS can no longer be sure that overseas recruits will step in to fill workforce gaps. In the early 2000s many trusts looked beyond Europe to meet nursing shortages. More recently, as tougher immigration and language rules took hold, a growing proportion came from the EU – though not enough to plug the gap.

Now we have all the uncertainty surrounding Brexit. We need urgent clarity on the status of current EU nationals working in the health and care systems. And we must recognise that for the foreseeable future, NHS trusts will need support to recruit and retain staff from overseas. The government says it will improve the home-grown supply, but that will clearly take time.

These problems have developed in plain sight. But leadership on this has been muddled or trumped by worries over funding. Responsibility for NHS workforce strategy is disjointed. We need a co-ordinated, realistic, long-term strategy to ensure that frontline organisations have the right number of staff with the right skills in the right place to deliver high quality care.

We must act now. This year's long-delayed workforce plan – to be published soon by Health Education England – could be a good place to start. But what we need is a more fundamental approach – with a clear vision of how the NHS must develop its workforce to meet these challenges, and a commitment to make it happen. 

Saffron Cordery is the director of policy and strategy at NHS Providers