A Country Fit for Carers

After the First World War, David Lloyd George promised 'a fit country for heroes.' The carers at the frontline of Covid-19 deserve the same commitment – because when Britain looks after our health system, we all benefit.

Throughout Covid-19, the Prime Minister has drawn frequent comparisons between the pandemic and war. It’s a comparison that highlights a political danger. After catastrophic events, parties who fail in their duty to workers—and particularly the workers most central to getting us through the crisis—face disaster.

The post-First World War collapse of the Liberal Party is one of the most sudden changes in modern UK political history. Led by the charismatic David Lloyd George—the ‘man who won the war’—most would have given them every chance of sustained electoral success.

A range of factors underpinned their demise. Key among them was a fundamental discrepancy between the boldness of their rhetoric and the timidity of their policy. On 23 November 1918, Lloyd George arrived to cheering crowds to give a major speech in Wolverhampton. It’s since gone down as one of the greats, perhaps not least for its crescendo:

‘What is our task? To make Britain a fit country for heroes to live in. I am not using the word ‘heroes’ in any spirit of boastfulness, but in the spirit of humble recognition of fact.’

But Britain did not become a home fit for heroes – and a failure to deliver on the promise of improved living standards contributed to the Liberal Party’s rapid downfall. Having delivered three consecutive Prime Ministers, they never won another election after 1918.

In the aftermath of Covid-19, that must be a lesson to political parties considering their approach to healthcare workforce policy. Now is no time for timidity or tight-fistedness on pay. Rather, it is time all parties brought forward detailed plans to create a country fit for carers to live in.

The Consequences of the Pandemic

Better policy must begin with an understanding of just how severe the pandemic’s impact has been on the healthcare workforce.

Today, brand new polling from the Institute for Public Policy Research (IPPR) and YouGov shows the dire impact of a year of unprecedented pressure on health and care workers. Half of healthcare staff have worked understaffed shifts at least once a week. Another half have been unable to provide the requisite levels of patient care. All have faced regular physical and emotional exhaustion.

This reality is making a severe mental health crisis worse. Before the pandemic, half a million NHS workers said work-related stress had made them sick during 2019. Today, our polling reveals that one in four healthcare workers are using alcohol and/or drugs to deal with work related stress at least once a week – and more than one in twenty thinks about self-harm or suicide once a week or more.

The pandemic has been bleak for healthcare workers. This polling now quantifies the consequences. It will take more than applause to reverse these trends: it will take a new deal for workers.

What Should a New Deal Look Like?

Indisputably, better pay must be central to any new deal for healthcare workers. Having been among the worst hit by the impact of austerity on wages, lots are struggling.

Many nurses find themselves forced into debt to pay for bills or faced with a choice between eating themselves or feeding their families. In IPPR’s new poll, seven in ten healthcare workers say pay is the most important thing to them at this time. There is an overwhelming coalition building behind pay justice.

But pay cannot be where the conversation ends. We need a solution on burnout, too. Many healthcare workers have put in hours of unpaid overtime, held off taking any leave, and sacrificed flexible working to meet new shift schedules. Before the pandemic, standards of flexible working weren’t good enough, and short staffing meant leave dates were often dictated. That must be challenged after Covid-19 – for example, through a right to compensation for staff whose annual leave is rejected. And there must be the right mental health support, easily available, for all who need it.

There is also a need to tackle discrimination. Twice as many workers from a minority ethnic background have experienced unfair treatment or discrimination at work compared to white workers. They are being unfairly held back by institutional racism within the health service. Anti-racism should also be a key tenet in a post-pandemic new deal for workers.

Inaction Has Consequences

If the government don’t do right by healthcare workers, they risk a deadly exodus. As many as one in four healthcare workers say they are more likely to leave as a result of the year they’ve faced: that’s the equivalent of 330,000 NHS workers. Not all of them will leave, but without action now, some will. Who could blame them?

Every lost worker will be dearly missed in a system stretched to breaking point even before the pandemic. This would impact us all, particularly since Covid-19’s consequences look set to go far beyond the pandemic itself.

Two weeks ago, new modelling revealed the legacy Covid-19 will leave behind. It predicted 4,500 more cancer deaths this year, as progress on survival is reversed. It predicted 12,000 more heart attacks and strokes in the next five years. And it showed how eating disorders for children have doubled, while waiting lists have reached a five-year high. How our workforce is treated now will define how successfully we meet this challenge.

Going into the pandemic, workforce shortages were a key reason the health and care service lacked resilience. Compared to the top quarter of OECD countries, we were tens of thousands of doctors and hundreds of thousands of nurses short.  Serious reform is needed to address these workforce shortages and prevent the crisis deepening.

Time For Action

Doing better for the healthcare workforce makes clear logical sense. It is good for our health: when the government does right by the workforce, it helps them do right by us when we fall ill. It is good for our economy: a healthy, well-paid NHS workforce generate tax receipts and spend money locally. Most importantly, it is good for simple social justice.

The public are likely to support better support for healthcare workers. Catastrophe brings desire for change, whether that be a land fit for heroes in 1918, or a ‘from cradle to grave’ approach to social security and health that peaked in 1948.

The rhetoric of both major political parties has looked to harness that public appetite. The Prime Minister has echoed David Lloyd George, with bold promises of ‘build, build, build’, ‘levelling-up’, and ‘build back better’. The Leader of the Opposition has looked to evoke another post-war leader—Clement Atlee—whose government founded the welfare state.

But political success—and the health, economy, and justice of our country—rely on policy. Empty plaudits are not a workforce strategy. After the pandemic, we must see a plan to build a country fit for carers.