Vol­un­teers are no so­lu­tion to the NHS cri­sis

The Guardian - Journal - - Front page - Han­nah Jane Parkin­son,

When is a record num­ber of peo­ple vol­un­teer­ing to help the NHS not as great as it seems? Per­haps when the health sys­tem is tee­ter­ing on the brink. Vol­un­teer­ing loses a bit of that feel­good fac­tor when the stakes are as high as this. The Daily Mail has launched a Christ­mas cam­paign for more vol­un­teers to help out, re­port­ing that 11,000 peo­ple have signed up in a mat­ter of days. This kind of vol­un­teer­ing is mostly a good and valu­able thing. A study by the King’s Fund think­tank of 300 NHS staff, re­flect­ing on the roles of the cur­rent 78,000 vol­un­teers, found that a third of staff said that vol­un­teers helped them to free up time and a quar­ter said that vol­un­teers helped care for pa­tients.

How­ever, the study also re­ported sig­nif­i­cant ten­sions con­cern­ing the scope of the vol­un­teers’ roles and, to put it bluntly, their ten­dency to some­times get in the way of the pro­fes­sion­als’ work. The vol­un­teers, it was es­tab­lished, were a great help, “pro­vided they were not be­ing used as sub­sti­tutes for paid staff ”.

The true value of vol­un­teers, then, is as friendly faces to sup­port pa­tients dur­ing what is, by the very na­ture of be­ing ad­mit­ted to hospi­tal, a dif­fi­cult time. They are great at tea runs and valu­able for fetch­ing med­i­ca­tions. Sim­i­lar ac­tiv­i­ties are a bonus in the com­mu­nity, too – where out­pa­tient ser­vices have suf­fered sav­age cuts and adult so­cial ser­vices are said to be “on the brink of col­lapse”. Since 2010, £7bn has been cut from their bud­gets. We are in the grip, too, of a lone­li­ness epi­demic.

So we can all agree that vol­un­teers have a key place in the NHS. And that role will only grow in im­por­tance as our pop­u­la­tion ages (one in 12 Bri­tons will be over the age of 80 by 2039, ac­cord­ing to cur­rent trends). But do you know what the NHS also needs? Re­ally, re­ally needs? More doc­tors, es­pe­cially GPs and psy­chi­a­trists. More nurses and more spe­cial­ists. The for­mer health sec­re­tary, Jeremy Hunt, has ad­mit­ted the govern­ment is strug­gling to re­cruit the 5,000 more GPs he had promised by

2020. Churchill hospi­tal in Ox­ford con­sid­ered de­lay­ing chemo­ther­apy for pa­tients be­cause of a short­age of spe­cial­ist can­cer nurses to ad­min­is­ter the drugs. Pa­tients don’t just need cups of tea; they need anaes­thetists (head­ing for a 33% short­fall), and men­tal health nurses (whose num­bers have dropped by 15% since the Tories came to power).

The de­ploy­ment of “vol­un­teer armies”, as they are in­vari­ably re­ferred to, is not new. The in­di­vid­u­als who held the 2012 Olympics to­gether were part of one (along­side the ac­tual army), when the govern­ment’s con­tracted choice of G4S failed to pro­vide the se­cu­rity ser­vices for which it had been paid £284m. David Cameron’s famed “big so­ci­ety” came from the hope that he could shrink the state and we’d all step in to help. But it’s one thing the na­tion pulling to­gether through­out his­tory – in times of world wars, for ex­am­ple – quite an­other scyth­ing through the wel­fare state. No­body is doubt­ing that vol­un­teer­ing is an ad­mirable thing to do – and the mark of a func­tion­ing civic so­ci­ety – but it should never re­place cen­tral and lo­cal govern­ment in­vest­ment in things that need fund­ing and per­son­nel to work ef­fi­ciently. It’s no sur­prise that the govern­ment and the pri­vate com­pa­nies that run cer­tain NHS ser­vices de­light in shift­ing the bur­den to vol­un­teers in or­der to re­lieve bud­getary strain or widen profit mar­gins.

In­di­vid­u­als and lo­cal col­lec­tives have been re­spon­si­ble for great changes (in par­tic­u­lar, in the case of en­vi­ron­men­tal­ism). But com­mu­nity groups as well as the char­ity sec­tor should not have to pick up the slack for a shrink­ing state, com­pen­sat­ing for the govern­ment’s re­lent­less aus­ter­ity agenda. Ja­cob Rees-Mogg in­fa­mously opined that a rise in food banks was “up­lift­ing”, rather than in­dica­tive of wide­spread food poverty. He was quite wrong.

Part of the rea­son the NHS is con­sis­tently rated as the UK’s most “cher­ished in­sti­tu­tion” is the highly skilled pro­fes­sion­als work­ing within it – wher­ever they are from. Now, thanks to Brexit, we are both los­ing these skilled prac­ti­tion­ers and putting them off join­ing in the first place.

Mak­ing peo­ple com­fort­able in their health­care ex­pe­ri­ences is the progress we should be mak­ing, but even the best brew won’t sat­isfy the pa­tient wait­ing months for an op­er­a­tion only to have it can­celled for the third time. Even the nicest of smiles won’t ease the stress of wait­ing on trol­leys in cor­ri­dors.

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