‘Volunteer army’ is no substitute for doctors and nurses the NHS needsRuth Mabhiza
It is admirable that people want to help our health service, but the shrunken state needs to do far more too.
‘Volunteers are great at tea runs and valuable for fetching medications. Similar activities are a bonus in the community volunteers, too.’ Photograph: David Sillitoe/the Guardian
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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