Letters: Nurses need a little TLC | Feeding with milk
Torsten Bell is correct in his analysis of the exodus of nurses from the profession (“When nurses head for the door, chief medical officers are right behind”, Commentary). As a now retired nurse with over 40 years of experience, I can speak with some authority as to why retention is so low. Nurses never expect huge salaries, otherwise they wouldn’t have entered the profession in the first place. They do, however, expect to feel valued. If offered incentives such as subsidized housing, parking and on-call meals (just as our MPs get), they would be less likely to leave. Most nurses are non-nomadic and appreciate the ability to work flexibly to accommodate family life. A little support would go a long way to improving retention.
Cheadle Hulme, Stockport
I am a consultant pediatric surgeon and cannot function without the trained, talented and experienced nurses who are part of our team. We do not delegate. We have our overlapping roles and we inform and guide each other. I am often guided by my nursing colleagues. They have skills that I will never achieve. My ability to work effectively depends on these nurses. Delegation involves a hierarchy between surgeons and nurses that exists only in their salaries, which in turn do not reflect relative value.
I was intrigued by the hierarchical world portrayed by Torsten Bell. He says if the nurses leave, the doctors will leave too, because they have “no nurses to delegate to”. As a retired senior nurse with 40 years of experience, I do not recognize this relationship. Nurses and doctors perform different but equally valuable work, within independent self-governing professions. Nurses do not wait for the physician to “delegate work” – they care for the patient using their own important clinical skills and expertise. They excel when working in teams that respect each other and plan patient care with physicians, physiotherapists, pharmacists, etc., and it is in these successful teams that job satisfaction and therefore job retention staff are the highest.
Bell rightly suggests that “low staff engagement, such as self-reported engagement with work, sees nurses headed for the exit.” However, ‘engagement’ in this context means that all staff, regardless of profession, feel involved and in control.
Trusts should not save
I’m not at all surprised that 90% of public schools have in-year budget deficits in the coming year, but I’m surprised that many academic trusts still claim to have reserves to draw on after a decade of government-inflicted real-term cuts (“90% of our schools will run out of money – heads”, News).
Why were such reserves maintained or even built up when they should have been spent on the education of their students at the time? Why have too many academic trusts incurred very high administrative/management costs during this time of financial stringency? Academy apologists claim that “many trusts have to use some or all of their reserves.” So they should.
Professor Colin Richards
Spark Bridge, Cumbria
Taxing the rich to level up
Will Hutton shows us how the government could “comfortably raise the £40 billion needed to close the fiscal black hole”, by concentrating taxes on “capital, property and wealth” (“The future only offers variants on austerity? Bunk. There are ways to invest and grow”, Commentary). But why stop there? Why not raise more revenue by taxing the income of the rich with higher rates than currently? Those earning over £150,000 could face a rate of 50% and over £250,000 possibly 60%, the same level, William Keegan reminds us, that for most Thatcher terms (“We have had enough austerity, thank you”, Focus) . Capital gains tax should equal income tax, bonus tax is definitely required (and a vote winner) and windfall taxes should include banks as well as oil companies and gas.
With so much talk of the need for efficiency and with a tax gap of £32billion a year, HMRC could certainly benefit from the return of many of the tax inspectors eliminated during George Osborne’s austerity years, to fight properly against tax evasion and evasion. Closing the fiscal black hole is the immediate priority, but high-quality public services and a properly funded race-to-the-top agenda are not beyond the country’s reach.
Focus on the early years
I enjoyed Kenan Malik’s article on rethinking our idea of the good society by focusing on “human flourishing” rather than how not to channel welfare to the “unworthy poor” (“If this chaos doesn’t make us rethink our idea of good society, what will?” Commentary). In pursuit of human flourishing, it tackles neglected policy areas: an appropriate publicly funded childcare system, a well-resourced transportation system, and a decent framework for social care for children. the elderly.
These areas are certainly important, but given our knowledge of what enables humans to thrive, we should focus our resources on improving the first 20 years of a person’s life: trying to ensure that every young person has competent and stable parenthood, a healthy lifestyle, housing located in a healthy communal and physical environment and access to excellent education/training facilities at all levels. We know that “deficits” in these aspects of early childhood make it extremely difficult to flourish later in life. If we take the principle of equal opportunity seriously and want everyone to have the chance to thrive, these aspects must become an essential part of contemporary politics.
David Mitchell has echoed so much I’ve been saying for years (“Pull out a chair for my anti-growth crusade,” New Review). Why are we always trying to grow? We are already overusing the Earth’s resources and continuing to do so in pursuit of “fashion”, especially in furniture, is indefensible. At 86, I have dining chairs that were bought used 40 years ago, through an ad in the local newspaper. They are made of oak and are still solid. A chair is bought to give us something to sit on, not to impress.