North Wing Magazine

The mental health crisis within the NHS: A deadly mix of government idolisation and disregard.

Naomi Nelson

If you were asked what the underlying principle of the NHS was, your answer might be along the lines of ‘to allow everyone to have access to free healthcare’ and ‘to promote physical and mental health’. This care is supposedly universal and one of the country’s top priorities. It is ironic, then, that the government has left the NHS workforce themselves in an emotionally untenable environment for years.

 

Even before COVID-19 hit the NHS, equipment scarcities were rife and pay rises were plateauing alongside a steep national inflation rate; trusts struggled with staff shortages. Emotional and financial pressures were immense inside and outside the workplace and it is no surprise that mental health difficulties were a big problem for NHS employees. Staff members have faced elevated personal risks of infection worsened by lack of sufficient PPE, high rates of overtime and increasingly overwhelming decisions including the fine balancing of resources between patients. All of this contributes to a work environment where stress and distress go unchecked and untreated. 

 

In April 2020, 60% of healthcare workers reported that more priority needed to be placed on NHS workers’ mental health during the pandemic according to a report by the Institute for Public Policy Research. Policy suggestions from the report included a fast track service to counselling resources, increasing personalisation of healthcare workers’ mental health treatment and extending the current mental health specialist provision to all health and care workers, as it currently only provides for doctors and dentists. 

 

These suggestions have not yet been implemented as of February 2022, and the dire consequences are reflected in the statistics. A report of a recent study by the Laura Hyde Foundation – a charity set up by the cousin of Army Nurse Laura who took her own life in 2016 – found that 322 healthcare professionals attempted suicide in 2020 following immense work pressures. Dr Zudin Puthucheary of the Intensive Care Society, interviewed by i Newspaper in February 2021, stated that one in seven doctors have shown signs of PTSD following traumatic experiences especially from the frontline. Additionally, according to a survey by NHS Charities Together, 54% of health worker respondents felt they had received more abuse from members of the public in the year since January 2021. This highlights how the pressures created by the pandemic across society is making the working environment of healthcare workers even more hostile.

 

In response to these jarring figures, in October 2020, NHS England was provided with a further £15m to aid mental health support for its workers. However, given that the NHS employs 1.3 million people and the most effective measures required – psychological therapies and much needed time off work – are notably costly, this seems like a pitiable amount especially when compared to the billions of pounds syphoned off to failed privatised administration such as Test and Trace. The immeasurable pressure of the pandemic has not pushed the government to prioritise support funding for NHS staff.

 

Moreover, the failure to aid the NHS workforce’s mental health goes deeper than the lack of support services. Although many factors can contribute to developing mental health problems, external factors such as stress and pressure in the workplace seem to be likely contributors to the increased cases of mental health conditions among staff as depicted by the statistics above. Changing the working environment is a strategy that will reap the best reward and act as a preventative measure against worsening mental health. To make a lasting difference to employees’ wellbeing, this needs to be tackled head on as soon as possible. 

 

Despite the pressing nature of these issues, the government is failing to give an appropriate response to these needs. One example of this failure is the recruitment of nursing students on the frontlines to assist in the national effort during the pandemic. This exposed them to potential trauma and overwhelming decision making, where even the most experienced had significant unfamiliarity to the global crisis. Yet, the students were placed in unpaid positions and abominably expected to continue to pay tuition fees.

 

Another prominent blow came with the pay rise suggested in the 2021 Budget. The government initially proposed a one per cent pay rise for nurses and hospital doctors, stating that this is all that can be afforded. They then raised this to three per cent but, despite pushes from 14 healthcare unions, have not yet agreed to make this level inflation-proof. The three per cent still falls greatly below the Royal College of Nursing’s campaign for a 12.5% pay rise. It expresses that the value of healthcare workers during the pandemic has not been recognised, and in many cases, adds financial pressures to the list of problems staff have to overcome. 

 

In addition to the complete disregard of harmful working conditions and calls for adequate pay, there is another detrimental government campaign: the constant mission to portray the NHS workforce as ‘heroes’. In the podcast ‘How to Fail with Elizabeth Day’ released in June 2021, interviewee Christie Watson, patron of the Royal College of Nursing Foundation, spoke about her view that the NHS workforce are not heroes –  they are just people. She expressed how when the physical realities of being a healthcare professional were not addressed by the government, its lauding of their heroism during the pandemic became insulting. This idea of NHS heroes has been extremely pervasive in the 2020 zeitgeist. When coming from the public it is able to express meaning and gratitude, but when used by the government it becomes two-faced and patronising. 

 

How exactly may the ‘heroes’ label be harmful? Not only does this narrative heighten pressure on healthcare workers by portraying them as infallible, it paints them as angels who can overcome material obstacles such as insufficient resources or working rights. It perpetuates the idea that they should keep going and be selfless no matter what. The only thing that could make a high-pressure job worse is the feeling that it should be done with ease – without support and without mistakes. Statistics reflect this – another LHF survey found that more than 70% of NHS workers had not wanted to admit that time taken off was for mental health reasons, and over 50% didn’t wish to use NHS workforce support services in case they lost their jobs or let other colleagues down.

 

In sharp contrast to this worshipping narrative – and indeed, highlighting its key flaws – is the fact that time and time again the NHS workforce have been insulted by the actions of key government figures. Despite ‘heroes’ being the parroted government line in regard to the NHS, certain discussions have been handled extraordinarily insensitively. 

 

Firstly, Conservative peer, Dido Harding, who headed the Test and Trace programme announced that she would like to make the health service ‘less reliant on foreigners’. Given that 28% of nurses in 2019 and 19.9% of hospital doctors in 2020 joining the NHS were non-EU nationals, her statement  insulted a large number of hardworking professionals who form the backbone of our NHS. She implied that these employees are only being ‘used’ by the UK to assist in our nationalistic end-goal and will later be dropped accordingly. This conveys the government’s true indifference to the mental well-being of NHS employees, especially those born outside of the UK.

 

Another revealing moment was when the Minister for Mental Health, Nadine Dorries, stated that nurses should be happy to accept the one per cent pay rise. Her stance conveyed a lack of respect and reinforced the message that the current government does not comprehend the increased mental health risks associated with financial stress. Dorries argued that ‘nurses with…husbands will understand [the one per cent pay rise]’ because the financial decisions allowed the funding of the furlough scheme – an outdated and misogynistic comment and a feeble defence of the budget plans.

 

We therefore observe the government’s narrative of ‘NHS heroes’ repeatedly colliding with its actions. While painting a story of infallible workers with one hand, they refuse to allocate more pay and support or even provide sensitive cooperation with the other. These combined create an environment that has been extremely emotionally damaging to NHS employees. Fresh headlines of clapping for carers and praise alongside the one per cent pay rise, has thrown this account into sharp relief.

 

There is no magic trick to ‘solve’ the economic problems of the NHS. Staff shortages, salaries and resource allocation are all intricate problems and the pandemic has put our economy under excessive strain. Some may also argue that the NHS’ economic decisions should primarily be patient-oriented. However, by listening to healthcare professionals’ needs with compassion rather than layering bureaucratic advice, the right monetary allocations can be made to complement both the workforce and the patients. 

 

Tactically and sensitively tackling workplace stressors with financial commitment is imperative in order to save those who have saved so many this year. With sensible prioritisation and a holistic approach, improvement to working conditions resulting in mental well-being of the workforce is a possibility. Continuing to do nothing when lives can clearly be saved by taking action would be, put simply, criminal.