Roy Lilley's NHSManagers.net e-Letter Podcasts
Dawn on you
(upbeat guitar music) Hello, this is Roy Lilly. Well, if you're an early riser, and I know so many of you are, you all know there is a time of day that is only known to the larks and the worm catches when the sky starts to lighten up. It's about half an hour before the sunrise. The world is yawning, stretching, hesitation, a moment of uncertainty, getting ready for the day. It's a private moment, a time for reflection. The sky starts to lighten. The highest clouds catch the first blush of pink, and a streak of tangerine appears across the horizon. The features of the fields and the trees, the roofs and the houses and the towel blocks, start to show themselves. It has a name, it's called Civil Twilight, and only occurs when the sun is exactly 6% below the horizon. It's the time of day when you stand with yourself, perhaps wondering, or worrying, or anticipating, dreading, or looking forward. It's the time of day when you know you're with the right person or not. It's the time of day when you know you're in the right job or not. It's the time of day when you know you're doing the right thing or not. It's the time of day for the sort of truth only you can tell yourself. If you have experience that time of day, then you will know there is no other time like it. If a brief moment like that, so full of truth can be translated, amplified into a moment in history, this must be the time. The Civil Twilight in the long history of the NHS, from its robustest birth at golden years, demolition by austerity, the destruction of COVID, and the promise of a new dawn. We're up and waiting for the streak of warm colour. It's the moment when we must tell ourselves the blunt truth, carrying on, soldiering on, pushing on, won't do. The winter is almost here and we have a plan that's little more than do what you did last year and make more effort. That's because there's nothing else that can be done. The most frequent uses of the NHS, you know, are the elderly, and because of tightening eligibility criteria, the Health Foundation, and I link to their report this morning, and others, have estimated one in seven over 65s have unmet care needs, unmet care needs. Now, there are about 12 million over 65s, and that might mean an indeterminate number up to 1.7 million at risking cold weather. The changes to the winter fuel payments eligibility, which limits support to those on means tested benefits like pension credit, could leave around 2 million pensioners without help, and I link to a report on that this morning. These cuts mean some pensioners, particularly those slightly above the qualifying threshold for benefits or unaware of their eligibility, will lose up to 300 pounds. Increases in the national minimum and living wage will result in additional costs that care providers will struggle to absorb. For the domicillary care sector, staffing costs typically account for 80 to 90% of total expenses, and care England estimates, and I link to a report this morning that national insurance costs, the rises of national insurance, alongside wage increases, could contribute to a £2.4 billion funding shortfall across adult social care and the sector. There are predictions of widespread financial instability in the sector, and we know what that means. The rise in national insurance and wage increases will be significant in the cost of running GP practices, and I link to some data on that this morning. For some, this could mean around £40,000 or more a year, depending on their size and staffing levels, translating inevitably into a diminution of services. The availability of ambulances per 100,000 population in England is approximately four. France has seven. Germany has around eight to 10 ambulances in Austria 15. In the NHS, there are almost 500 less full-time ambulance staff compared to 2015, and I link to that this morning. Since the election, there is nothing that the government has done to make any of this better or easier. In fact, it's worse. And by now, a truth should be starting to dawn on you. Thanks for listening. I hope you have a good day. Keep warm. Bye-bye now. Keep warm. Bye-bye now. [Music] [BLANK_AUDIO]