In many ways the student loan system is a way of the government funding the qualifications as only the highest earners will ever pay it back. However, it's not well understood, and it puts off people, as who wants a large debt around your neck increasing with high interest rates for your working life?

I am conflicted as my wife is a nurse who works in the way we all hope to be cared for, with devotion, skill and compassion. She deserves more money, but I also know that we cannot afford to give her it at the moment. She works in a clinic, but also does bank shifts on wards. How anyone can handle the pressures on some wards is a wonder. Only today I saw three security officers having to restrain a patient. In my youth you would not see a security officer in a hospital! Imagine the Emergency Department at midnight on Saturday, already overrun with delays, having to deal with abusive, aggressive, drunken men and women who have injured one another. Who wants to willingly care for them, let alone show compassion? Yet they do.

I also hear of situations which are very wasteful. Low quality administration managed by unimpressive people. This isn't so unusual in any big organisation, but it still irks to see it.

I don't see a quick and easy solution to any of the issues. Each one will need its own new long term strategy, with an overall destination as the aim. I do though wonder if the current banding system for pay rates needs to be revisited. There are already higher rates in London and the SE. Maybe we need to pay much higher rates to those who work in the most challenging areas, like the ED and neurological wards? Thus reducing the need to pay agency staff at even higher rates. The qualifications are equal, but the work isn't.

I am sure that some costs can be saved by better management, efficient use of resources and technology, but ultimately we are going to have to pay more. I stopped paying NI 13 years ago, but use the NHS more now than ever. That seems to me to be an obvious change that will have to be made before too long.

This can be a big problem and over the years many of my wife's colleagues have left because of the way that they have been treated by their managers who are obviously unsuited for the job.

Wifey was entitled to seven weeks holiday a year and her manager wanted her to take them in one week slots outside of school holidays despite have an autistic son at school. After several years I finally managed to persuade her to leave and join another hospital where they would treat her as a human being and not just as an asset.

Last week she volunteered to be seconded to a local hospital for the winter months and arrived to be given just two shifts totalling 14 hours for the first week. When saying to her ward sister (who looks to be in her twenties) that she couldn't survive on 14 hours and needed more shifts the response was "If you don't want to work here you don't have to"

Train all Doctors, nursing, clinical staff etc.for free.
They sign a Contract before training that they are obligated to work in the NHS for "x" years after they are fully qualified.
Say 5 years for nurses, 10 years for Doctors and so on.
Anyone who leaves - unless through illness - in those periods should have to repay the cost of training which will reduce pro-rata as the cut off date approaches.
This would get more people in the system, better working conditions working with fellow employees rather than agency staff and in the long term save the NHS a fortune because agency staff are charged out at huge rates per day.
This is an idea that could work in my opinion.

The reason they won't do it is the initial cost and the fact that politicians only seem to think in terms of 3-5 years.
If this Government started this now it would be a vote winner and people could look forward to a better NHS in 5-10 years time.
Degrees for nurses should be a no no and there should also be a commitment to reduce management staff by say 50% over ten years while at the same time increasing clinical staff by the same amount.
Commit to building "x" hospitals over a ten year period as well.
All enshrined in statute so that if another party pulls the plug they will as such be wrecking the NHS in the eyes of the public.
It is all so easy if they had the guts to implement it

Edited by The Dolphin (16 Dec 2022 8.48am)

Employment law wouldn’t allow this and changing the law will mean any firm in any profession training an employee can obligate in the same way. It would be a legal minefield.