I respect the RCN both as a professional organisation (I studied for my BSc through them) and as a Union. But I wonder why they have chosen now to declare outright opposition. Is it as Andrew Lansley says that they are doing this because of the changes to public sector pensions? Because nursing is getting a bad press right now? Or is it because at long last people are realising that the current pressures on nurses which appear to be resulting in a deterioration in the level of care nurses are able to provide will only get worse? Nurses have been telling whoever will listen to them that this reorganisation is being done for its own sake and that services are being affected and people are losing their jobs. It is good to know we are being listened to by someone – at last!

This weekend I am meeting up with some of the people I trained with 30 years ago. Over lunch we will no doubt reminisce about the good old days and will talk about nursing today. We may well talk about the mess that political meddling has done and will do in the future to the NHS and to our profession. We will also wonder how on earth patient care will improve as a result. We might wonder if actually it is too late and we are lucky that we are approaching 50 rather than just starting on our careers.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 23,000 times in 2011. If it were a concert at Sydney Opera House, it would take about 9 sold-out performances for that many people to see it.

Click here to see the complete report.

The nation’s debt is thankfully much greater than anything I could conceive personally, but the principles are the same. The causes of this are well written about, but in my opinion not worthy of mention since it can’t help us now. The Government takes an interesting approach to trying to balance the books. Reducing the size of the public sector I can understand; it hurts me to say but a lot of jobs were created and money was wasted. You need to be careful about the ways in which you cut services and with them jobs, it creates uncertainty and fear and leads to risk aversion. More jobs are lost and less created because of this. If jobs and services don’t spring up elsewhere then some of those people become unemployed or else take lower paid, lower status jobs. This in turn means that those who might have taken those jobs are shifted further down the pile. The most vulnerable in society suffer most from this approach.

In turn the Government has taken a look at the growing benefits bill and decided that this can and must be reduced. dependency on the state needs to be reduced (even as someone who believes in the welfare state) I can hardly argue with this desire. But by starting with the most vulnerable in society this Government risks the label so often given to the Tories of the past. It feels nasty to target benefits to disabled children and those with cancer. Especially in a week when Cameron has said that he would like to see the 50% tax rate for those earning £100k to be abolished even though it is bringing plenty of tax revenue into the exchequer.

Tonight the House of Lords has shown it’s worth and voted for changes to the Welfare bill associated with these elements of cuts. It is a shame that they haven’t shown the same approach with the Health and Social Care Bill!

When I go on holiday though, I have been known to take half a dozen books with me. There have been occasions that I have forgone articles of clothing or shoes for books. I have packed them into my hand luggage and bought more at the airport. This has to be madness if there is an alternative.

When I went on a coach trip to Germany recently I looked over the kindle of my friend Sue and decided that this was a good idea for ease when travelling and subsequently made my request. I have to admit that I quite like my new toy, even if I do feel a bit guilty every time I turn it on that I might be putting printing companies out of work. I love the way you can download a sample of a book and I like the way you can turn the page forwards and backwards so easily. I also like the fact that you can enlarge the text (I know I need to get the optician to review my contacts but until then..)  I am less keen  that I never know quite what page I am on, instead I know what percentage of the book I have read. But I am willing to give the whole thing a go. Today I have downloaded a couple of travel guides for my upcoming trip to the States. I think this is going to be great for checking out things to do and places to go on the go! We shall see.

Over the last decade or more, nurse training in the UK has been split into different areas of care – adult, children, mental health and learning disabilities. In the main nurses remain within their sphere of practice, despite the obvious cross over between disciplines. My own training failed to prepare me to care for many people I have encountered along the way, but there are ample opportunities to learn along the way. There can be compassion and there can be kindness. Yet again today I am ashamed and embarrassed by a report that suggests that nursing care in this country isn’t all it is cracked up to be. But I refuse to believe it has to be like this!

I am also pleased to report that my dad, who was coincidentally diagnosed with cancer around the time of my interview, has completed chemotherapy and at present seems to be doing well. This is a huge relief as the cancer is secondary and probably cannot be cured. It was great to see him eating and drinking well and buzzing around us all as usual. Fingers crossed that the scan he had a few days ago confirms this.

My son, who is studying in California for a year is home for Christmas. It has been great having him home even if it seems to have doubled the amount of washing and ironing I have to do and has increased the food bills considerably. He goes back on January 15th, but this time we can look forward to seeing him just a month later when hubby and I visit for his 21st birthday.

So I start 2012 hopeful that this might be a reasonable one for me personally. At work we continue to live through the protracted process of the new NHS Bill which is not yet law, but which is causing a fair amount of change for the sake of change. The GP commissioners are flexing their muscles but at the same time discovering that commissioning is not about telling people what to do and expecting it to just be done. From my new position within a clinical network which will be part of the Commissioning Board I am finding all of the PCT related stuff interesting. People are not surprisingly positioning themselves and that is always fun to observe!

New years resolutions? Well probably best not to promise anything but I will try to blog more (but then I have tried that before).

I wish everyone who takes the time to read this blog post a happy and healthy new year. I hope 2012 is full of promise for you too!

I moved desks, within the same building, on 3rd Oct and since then have combined induction into the world of cancer and palliative care with managing what I can physically do in the world of maternity and acute children’s commissioning. I am really pleased to say that the new team have been really welcoming, my old team gave me a good send off and all of the people within the network that I have met so far have been friendly.

My new job started with a 2 day meeting in London which was great for giving me a grounding on current issues in cancer services and also in working through some issues about how we can best approach the issue of needing to make sure the voice of the patient / user / carer heard in the way services are planned and provided. I think that hopefully there will be lots for me to write about on this topic once I get my brain properly into gear.

As for the old job, there is plenty that I would like to write about how you should not manage people, and about the emotional mechanisms a person may use to cover up their own short comings and make you feel guilty for them. However that may be difficult and what is more I think moving on rather than going on about it might be more healthy!

The Health and Social Care Bill has this week progressed further on its slow and painful journey to some brave new world that is only clear to people like Andrew Lansley. But it is now inevitable that it will soon be law; it pains me to say but the sooner the better now. We cannot continue with all of this uncertainty and what is more the PCTs are busy making the necessary changes to make it happen and it would be a crime to put the brakes on and go into reverse now. My hope is that the review of clinical networks comes out clearly saying that they need to be developed and strengthened and that what is more that my job needs to be made permanent. There is no way on earth that once I say a final goodbye to commissioning that I intend to go back. But I guess they say never say never!!

One of the reasons I am still quite reticent about posting my thoughts is that the kinds of things I would like to say could get me sacked. It would be enough to say that the passage towards my new position has not been facilitated well by my employer. But good news, following my impending holiday (starts next Friday, yipee!) I will at last be able to start the job secured as a secondment in June.The urge to badmouth ones managers is something that you are always wise to suppress especially since I have been hearing stories of people being disciplined and sacked for doing so.

I am part way through a course to become an RCN Steward and the days spent with fellow trainees have been enlightening particularly when it comes to hearing about some of the things that nurses get up to and what is more say online. Whether it is using work computers to run some kind of raunchy dating agency, browse the kind of information they shouldn’t or else posting derisory information on facebook for the world to see apparently people are out there doing it all. What is more, my steward colleagues are kept busy providing them with support and managers are kept busy taking the errant employees down a disciplinary route. I do not intend to have the same thing happen to me!

Of course there is plenty more to write about, or there most certainly will be when I get stuck into working through the world of quality improvements to cancer care. This much I promise.

Wisely, it seemed at the time, the government who had not thought through their NHS changes, realised their may be fundamental problems in winning the hearts and minds of both those working within healthcare and those using it. The key problem was that they couldn’t adequately articulate how the new NHS would be better than the old one. They couldn’t tell us how the fundamental ethos of the NHS (free at the point of contact for all of those in need) would be retained. Essentially they couldn’t tell us how this wasn’t privatisation by the back door. The whole pause thing was, just as most consultations are, pretty much paying lip service to the doubters. Some changes were announced but it is clear that the Health Secretary is determined to push things through.

Further announcements about structural changes go on unchecked, despite the fact that the Bill is no further forward today than it pretty much was in April. The SHAs have clustered, specialist commissioners are preparing for a rationalisation complete with redundancies; those who remain will be footprints or some such! Yesterday this diagram appeared in the Guardian to demonstrate what the new leaner, less bureaucratic NHS will look like.

While all of this has been going on my own employer has tried to keep us informed and up to date. The truth is that there has been little to keep us up to date with except perhaps the fact that the changes continue. The GP consortia may now be Clinical Commissioning Groups, but that hasn’t changed the level of positioning and posturing being undertaken by senior colleagues. The extent to which everyone worries about what the consortia want is at times paralysing. This makes for a less than cheery working environment.

Time then for a secondment. A trip to the Cancer Network, which you will see from the diagram will be an advisor to the commissioners, and indeed to the provider. It will report to the National Commissioning Board. If things go well, then perhaps this will be a permanent move. What is sure though, is that my mood is lifting and I know I will have the chance to learn and do new things and for me that can only be good.

In other news my son will soon be off to California to study at Pitzer College for a year. He is excited and I am excited for him.  It will feel pretty strange though to have him so far away.

The NHS pause, a general feeling of malaise with my current job and some family health troubles have prevented me from feeling inclined to post to my blog. Guess what though? I am now feeling more inclined to write more and I’ll be back soon!