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Thursday, 25 April, 2002, 11:51 GMT 12:51 UK
NHS funding: The RCN's Tom Bolger
Tom Bolger, Assistant General Secretary of the Royal College of Nursing took your questions from the RCN annual congress in Harrogate.

  Click here to watch the forum.  


The Royal College of Nursing is holding its annual conference in Harrogate a week after the NHS was promised extra money in the Budget.

There have already been calls made for part of this money to be spent on pay rises to encourage the recruitment of nurses.

Concerns have also been raised about the role of the Government's private finance initiative (PFI) in funding the health service.

Do you think the extra money that has been promised to the NHS will make any difference to quality of healthcare? What can be done to improve the conditions of nurses and other health service staff? How do you see the role of the NHS in the future?


Highlights of the interview


Newshost:

Fi, UK: I am told that the extra money promised by the Government for the NHS will not even cover the debts of the health service and that all of the money is already spoken for. Is this true? If not where will the money be going?


Tom Bolger:

No, this is real money. We know they're very clever at spinning around with figures but this is clearly the right kind of investment that we need in order to sort out the health service in this country. The fact is that money will need to come from taxation or from private insurance - one way or another we need that sort of money. We're quite clear and the Government is quite clear that the best way of doing that is through taxation.


Newshost:

But with this money - I've heard doctors complain that they are worried that NHS managers, if they get their hands on this money, will spent it paying off debts - lots of trusts have got debts. How can we be sure that they won't spend it on paying off debts?


Tom Bolger:

No doubt some debts will have to be paid off but you can't run your business in debt indefinitely - that's a huge government problem. But one of the things the Government has built into all of this is a system of checking - an auditing system. So basically, what they're saying is - you'll only get the money when we know what you're to do with it and when you say you're going to do it we'll check to see if you have done it.


Newshost:

Rob Douglas, England: Having been with the NHS for over twenty years I am appalled at the prospect of paying more of my earnings into a system that (on the whole) breeds inept financial management. Does Tom feel that it would have been more appropriate to sack wasteful managers and boards who actively support overspending rather than raise taxes to compensate for their failings?


Tom Bolger:

I think that part of problem is - I worked for 30 years in the health service myself - that when you're in there and you're under pressure you can see and feel the angst and anger that people feel because they haven't got enough resources and then you take it out on somebody and the person saying - I can't give you any money, who is that manager.

One of the things that we really need to look at is have we got the right kind of managers and have we got enough managers. People say the health service is over-managed - the fact is it is over-administered, it is not over-managed - you need people to manage resources.


Newshost:

Toby, UK: My wife is a part-time nurse considering going back full-time once our children are older. However, she can earn more money working in a supermarket and won't have to pay thousands of pounds to do diplomas etc to catch up with nurses who have superior qualifications but frequently care little about their patients as anything other than statistics. What should the NHS do to help people in our position?


Tom Bolger:

I would say to that nurse, please come back if you're looking to return to work - please give up the supermarket job if you can afford to but please don't be frightened by all these fancy diplomas. We all have to be good at our jobs and we all have to be kept up to date - I don't have a fancy diploma. I'm a State Registered Nurse who qualified 30 years ago and I'm able to practise now and I feel confident to do so. People need to do some add-on training - so what could the NHS do about that? Well the NHS could provide that training.


Newshost:

Gwyn Jones, Germany: Has there been a systematic study of the methods of funding healthcare in other European countries? If so why don't we simply follow their lead, rather than agonising for years about how to proceed?


Tom Bolger:

There've been many studies - the most recent one that Chancellor has used is the Wanless Report which looks at different systems, not just throughout Europe but throughout the world. The most popular system in Europe is called social insurance but quite frankly when you look at it and then you look at the British system and the direction the Chancellor is taking, which is the increase in National Insurance, they are probably more or less the same thing. So when you really do the comparison - they key to it is they spend more in Germany, France and Spain and other countries in Europe - so we've just got to put more money in the pot.


Newshost:

Helen Ward, England: Where do you see the future of the NHS Walk-in-Centres in relation to the recently announced GP reforms as GPs will no longer be obliged to provide a 24 hour service to their patients?


Tom Bolger:

I think one of the biggest and most exciting initiatives since the Labour Government came in, in 1997 is the introduction of the walk-in centres. There's still going to be teething problems but it has opened access so much that you don't have to worry about that queuing system.


Newshost:

Janet Cole, UK: Shouldn't the RCN do more to improve the conditions of other low paid workers in the NHS such as secretaries, clerical staff and porters? They are equally important to the smooth running of the health service.


Tom Bolger:

We're the Royal College of Nursing so we don't apologise for trying to push the nursing case. But at the same time we're committed to team work and we understand the importance of everybody working in health care. So certainly at the local level and more discretely at a national level, we are working with the other unions to support them.


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See also:

23 Apr 02 | Health
22 Apr 02 | Health
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