Political and Parliamentary Monitoring
Week Commencing 8th October 2018
Healthcare leaders in the UK must have a voice in the Brexit negotiations due to the expected impact on workforce, an expert on global nursing policy has warned. Howard Catton, Director of Nursing, Policy and Programmes at the International Council of Nurses, intervened in the Brexit debate due to the tremendous impact the negotiations were having on nurse recruitment. Speaking to the Nursing Times, Mr Catton said “the impact of Brexit on the health workforce could be really significant and I don’t know how close health is to these Brexit negotiations.”
Mr Catton’s call comes just a day after the Care Quality Commission published its ‘State of Care’ document, which outlined that the EU referendum outcomes had added “to the uncertainty in health and care in the challenge to recruit and retain staff.” The report shows the number of EU nurses and midwives registering to work in the UK fell from 9,389 in the year to March 2016 to just 805. The decline was only “slightly offset” by a rise in the new nurse and midwives from countries outside the EU, the report added.
Speaking to the Nursing Times, Mr Catton said employers must be mindful of the state of health services and workforce in a country when deciding where to recruit nurses from, adding that “If you are recruiting in a country the impact on a country already short on nurses could mean services close or waiting times increase”. He urged for those negotiating a Brexit deal to listen to the concerns of nursing leads about a broad range of issues, including language testing and identifying qualifications.
The PCF will welcome the calls by Mr Catton and agree that, in order to ensure that there are enough nurses in the UK (including the paediatric continence sector), the Government needs to have a clear policy in place on skilled migration in to the UK.
- Territorial injustice likely to increase
- School toilet policies breach child rights
- Charities fear over children’s centres cuts
Territorial injustice may rise in England
Disproportionately harsh spending cuts to local public services in England’s poorest areas are likely to intensify perceived “territorial injustice” between deprived and wealthy parts of the country, study has shown. Research from the University of Cambridge has shown that Post-industrial cities in the north of England, together with some inner-city London Boroughs, have been hit by the deepest cuts to local government spending. Mia Gray, an economic and social geographer at Cambridge who co-authored the study, said that “the idea that austerity has hit all areas equally is nonsense”.
More than 30 council areas in England have experienced cuts in spending of over 30 per cent between 2010 and 2017, with seven councils, Westminster, Salford, South Tyneside, Slough, Wigan, Oldham and Gateshead having budgets cuts of more than 40 per cent. The smallest reductions in budget have been in East Riding of Yorkshire, Hampshire, Surrey and Somerset. The cuts in England, on average, have been twice as deep as in Scotland and Wales. Ms Gray waned that the government needed to decide whether it was prepared to see more local authorities go bust in the manner of Northamptonshire County Council, which took the unusual step of declaring insolvency this year after being unable to balance its budget.
A spokesperson for the Ministry of Housing, Communities and Local Government said the funding its gave councils was based on the relative needs of different areas, adding that “the average spending power per dwelling for the 10 per cent most deprived authorities is around 23 per cent more than for the least deprived 10 per cent in 2018-19”. Soon, local authorities will also have full-control over business rates tax receipts, thus increasing inequality between areas with high-value business outlets, and low-value areas.
The PCF will be concerned that any future decrease in local government spending could negatively affect school nurses, who now fall under the oversight of local councils, and thus efforts to treat bladder and bowel issues in young people.
School toilet policies breach child rights
School pupils’ rights to leave a classroom to use the toilet has hit the headlines recently. In one case, reported in The Independent this week, a girl was left to bleed through her clothes after being refused permission to go to the toilet while she was menstruating, whilst parents have reported that children who need to use the toilet are having their requests refused because it could lead to disruption in the classroom.
The National Education Union’s own guidance raises the concerns of reducing bladder capacity, saying that the practice of only letting pupils go to the toilet at a certain time can cause ‘I’ll just go in case practices’ whereby the bladder does get used o holding on until it’s full. Over time the bladder capacity can reduce, increasing the need to visit the toilet more frequently. Another impact of this practice is that a child may consciously or unconsciously ration their fluid intake, or avoid drinking altogether, or they fear not being able to go to the toilet when they need to.
A recent American study concluded that young people with continence problems often require unrestricted access to private and adequate toilet facilities during the school day. It added that there is a need for inclusive toilet access policies and improved toilet standards in schools, and notes that children with continence issues are at greater risk of not achieving their full academic potential. The Department for Education has said that, in order to reduce disruption, and to prevent poor behaviour, teachers are able to limit toilet breaks where they deem necessary.
This news will cause concern for the PCF. Without the freedom to use toilets when necessary, young people risk exacerbating bladder and bowel issues. As in the case of the young girl mentioned above, it can cause embarrassment for pupils, and can indicate a deep lack of understanding on the part of teachers to the needs of those with continence issues.
Charities fear over children’s centres cuts
Planned spending on children’s Sure Start centres has fallen by more than a third since 2014, Government figures reveal, from nearly £1 billion four years ago to less than £650 million today. Imran Hussain, Director of Policy and Campaigns at the charity Action for Children, said “we known from our own work that without the safety net of well-funded early help services like children’s centres, thousands of children at risk of abuse, neglect or domestic violence are being left to fend for themselves until problems spiral out of control.” Sure Start and children’s centres act as a main gateway for advice for new parents, or those parents and carers who do not have traditional sources of support in order to seek advice. This incudes paediatric and continence care advice.
Peter Lampl, founder of the Sutton Trust, echoed Mr Hussain’s calls, adding that “high quality early years provision is crucial to the development of children from the poorest homes”, whilst the Government indicated that spending by both the Department for Education and Department of Health and Social Care continues to rise. This news comes just a month after the Local Government Association warned of a real-terms cut to school spending and the need for the Government to introduce “greater certainty over future funding by introducing three-year budgets, and ensure that the overall level [of spending] is sufficient”.
This news will interest the PCF, given its campaign for increased paediatric continence provision. Reduction in school nursing positions by local authorities, coupled with a lack of investment in Sure Start and children’s centres, risks resulting in a situation whereby parents and carers are forced to turn to their GP for advice, which is often a long process. Alternatively, continence issues are left untreated.