The cultural imperative for us to hate everyone and everything is damaging. Photo: Getty
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Westminster might be nerdy, but we should stop pouring juvenile scorn on people trying to make a difference

Defend the mouthbreathers!

“Well, there’s the goofy bastard, the posh bastard, the treacherous bastard and the racist bastard. And they’re all the same,” goes pretty much any given twentysomething’s analysis of the lead-up to this godforsaken election happening in weeks.

I’d know because, for at least the past month, most conversations with my friends have involved me trying to persuade them not to draw dicks all over their ballots. Whenever politics happen, the pressure on my generation to hate builds and builds. And the more political the politics, the more pressure there is to hate. And a general election is about as political as politics get.

So, in a strange contraption that defies the laws of physics, we spur each other on to be as jaded as possible. It isn’t hard to understand why we do this. We’re just about creeping out of a recession that’s left so many of us fearing for our futures and Ed Miliband is hardly The Answer.

But he’s also not not the answer. And that’s so hard for us to admit because of this post-adolescent cultural imperative for us to hate everyone and everything. I’ve been obedient to that imperative for too long. Hating is just so easy. “Haters gonna hate,” says Taylor Swift (and about a billion rappers well before she made that a thing that white people say). Scroll through your Twitter feed right now and count the number of positive sentiments. Especially if you follow a lot of people in their twenties, I can almost guarantee that they’ll be rare. And I’m not talking about inspirational quotes superimposed on a picture of a lake. Those don’t count. That’s just stolen positivity regurgitated by people who’ve been dead inside since Gordon Brown’s premiership at the latest.

Similarly, I’m not talking about hype. It seems that the only things we’re allowed to like publicly are those that have been deemed worthy by Guardian reading Twitter. Last year it was Serial and Kate Bush and ramen. Those were the only things we were permitted to endorse. And they’re all perfectly nice things, but they’re apolitical. For me, and so many others around my age, the fear attached to having anything other than “Ugh” to say about politics is huge. The problem is that showing anything other than the utmost disdain for Westminster is just so nerdy. And not the good kind of “I like graphic novels and David Attenborough” nerdy. I mean, straight-up mouthbreather nerdy.

In the realm of millennial Twitter, you’d be hard-pressed to find a good solid, “You know what? Labour aren’t perfect but they have some legitimately good ideas and Ed is an OK guy. And it’s not his fault he seems like he probably has a lot of allergies.” I mean, that would make a shit tweet and posting Vines of Miliband being a thundering dork is way more fun. But in an electoral race that’s consisted almost entirely of negging the other guy, I wish that more people could be brave enough to talk about the positives. I’m definitely not one of those brave people. I’m just as addicted to hating as nearly everyone I know. It’s a disease. I can barely look at a tree without being all, “nice branches, fuckhead. Where did you get them, Rubbish Branches ‘R’ Us?”

Just for once, I wish we could channel all of our angst into hating something that truly deserves to be hated. Like Sambuca or George Galloway. Only then can we begin to admit that some stuff is actually, sort of, slightly a little bit OK. And only then can we stop pouring juvenile scorn on people who are actually trying to make a difference.

Eleanor Margolis is a freelance journalist, whose "Lez Miserable" column appears weekly on the New Statesman website.

Photo: Getty
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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