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Last Updated: Friday, 2 June 2006, 16:24 GMT 17:24 UK
Nurse's view
Spiralling debts and job cuts are plaguing the NHS in England, bringing a new focus to how it operates in the 21st century.

Health workers in a variety of sectors - plus the BBC's Home Editor, Mark Easton - offer their views on what is wrong with the National Health Service and prescribe their own remedies.

Mike Travis, a staff nurse in the children's intensive care at Alder Hey Hospital in Liverpool, gives his assessment.

DIAGNOSIS

Mike Travis

I'm really proud to be a children's nurse and to be working in the NHS.

And in many ways this is the best of times and the worst of times.

This government has put a lot of 'new' money into the NHS and really revitalised the service.

At the heart of the NHS is its workforce. At the heart of its workforce are its nurses.

Nurses are the largest workforce in the health service. We deliver care.

We are the people who drive the NHS along.

However, the government's appetite for reforms has become relentless.

Nurses have always supported reform, but the latest round of changes are regarded as a dogma that is forcing NHS managers to cut jobs and services to meet ill-defined short term targets.

Every nurse's job lost is a real cut in services to the patient. What the patient needs is smart long term planning.

PROGNOSIS

There are huge pitfalls for the future of the NHS.

Patient choice will dominate the provision of service, possibly at the expense of the more vulnerable in society.

I am concerned about the increasing role of the private sector in the NHS and worried that the private sector will 'cream off' the more profitable services.

The NHS could be reduced to little more than a logo.

There may be a spilt in how much the public purse pays for the NHS, and how insurance will pick up the shortage of funding.

The NHS has also got to treasure its greatest resource.

We can't simply get rid of nurses during the 'bad' times and then launch huge recruitment drives when times are better.

This 'boom and bust' approach puts cost before care - and it just won't work.

Healthcare will increasingly take place in community settings and the biggest challenge for primary care will be to look after an increasingly ageing population.

It is essential the government have resources in place to meet the challenge



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