On Saturday night and throughout Sunday, NHS staff in London worked flat out in the aftermath of yet another awful terrorist attack. Their work is as admirable as it is professional. Yet moral in the NHS is pitifully low and resources are stretched to breaking point. In rural counties like Shropshire, it is proving near impossible to recruit staff while the uncertainty about reorganisation of the service under Future Fit and the Sustainability and Transformation Plan continues.

Before last weekend’s attack, Eric Smith on Radio Shropshire asked the Ludlow candidates for their views on the NHS during two live hustings – one in the studio and a second on Events Square. My notes below are from these debates. A third husting took place at St Laurence’s Church.

Conservatives, Philip Dunne. Lot of pressure in the NHS due to increased demand, which is a result of the NHS doing its job very well and more people are living longer. The NHS requires more investment of more funding to recruit more doctors and more nurses to share the burden and the pressure from the extra demand. There has been an increase in NHS funding locally and nationally. We are going to put in £8 billion over the course of the parliament. There is no plan to cut 2,000 Shropshire health jobs. Ludlow Community Hospital is not threatened with closure. Older GPs are choosing to retire early. Younger doctors are choosing not to become GPs. Will train an additional 25% doctors starting from next year, helping reduce requirement for EU and non-EU workers. We have made commitment to increase GPs by 5,000 by 2020. Need to train doctors in rural areas. Need to look at way NHS is organised to make pressure appear in right places. For example, in Telford A&E between 25% & 30% who attend could be treated elsewhere. Some could be treated, frankly in a pharmacy. In Shropshire, I think we will be moving towards one A&E trauma centre for blue light ambulances. The people to best decide where this is located are the NHS clinicians. I personally think it should be in Shrewsbury, because of its centrality to transport links and because 10% of the patients coming into A&E are from mid-Wales. Whatever happens through the [Future Fit] review, substantial emergency services will be retained in at the Prince Royal. Because of this long running inability to make a decision, we find it very difficult to recruit consultants to come and work, in A&E in particular, in this county. The risk that we run by continuing to fail to make a decision is that we will not have enough consultants to meet the continually rising safety requirements. Therefore, we risk more services being taken out of county. We need to make a decision, we need to get on with it. It is a ludicrous claim that we are privatising the NHS bit by bit. We have to meet increased demand in different ways and one of those ways is putting more services into local communities. There has been a contraction of beds in Ludlow over the last 30 years, partly because of technical advance. I am of the view that that has gone far enough.

Labour, Julia Buckley. Ludlow has a community hospital which will be under threat from the cuts. Problems with lack of rural bus services for people needing to get to medical services. People who regularly use health services will tell you that theirs is not one of feeling that there is increased spending and doctors. Everybody saw the seeds of crisis this winter, where people were treated on trolleys. This decade has seen to the least funding for the NHS since it was founded. Agree with Philip Dunne that a problem with the NHS is the way it is organised following the Health and Social Care Act, with privatisation taking over the NHS. It’s all around profit margins. Money wasted on admin. We would invest an extra £30 billion in the NHS from the income tax of those earning over £80,000 a year and increase corporation tax for large companies. The biggest concern is that central government cuts have been passed on to local health trusts, which will only be funded if they meet those cuts. They need to lose 2,000 staff in the NHS across Shropshire and they will be obliged to close hospitals down. We will immediately stop the cuts. We won’t ask hospitals to be like businesses and pay business rates and ground rent. The trust [SaTH] are closing the maternity unit at weekends to build a case for long term closure.

Liberal Democrats, Heather Kidd. There lots of things wrong with the way the health service is organised. The NHS needs major investment. There is a fundamental problem with staffing across the country. Future Fit is probably going to cost us in the region of £5 million, money that could have been put into the front line. The government is meant to be strategic and is meant to guide where these things are going. Nothing is accountable at the present time in the health service. We have lots of different trusts, all with their own sovereignty, all with their own back room services. We have problems recruiting rural GPs, problems recruiting all sorts of people. That is not unique to Shropshire. Ludlow Hospital had a bright future when there was a plan to bring GPs together with the hospital onto a new site [the Eco Park]. The real problem with Ludlow Hospital is that we have several trusts running it that are not coordinated. As wards close, it becomes less viable. When services go out of the county, as has happened with ambulances and mental health, we begin to be the poor relations. The public have lost trust in the way things are run.

Greens, Hilary Wendt. NHS is underfunded, meaning that hospital services aren’t adequate, mistakes happen in overstretched systems, staff are placed under intolerable levels of stress, and are forced to make daily compromises. We are the fifth or sixth wealthiest country in the world, yet we spend 26-30% on healthcare than other wealthy countries. It doesn’t have to be like this. We could do things differently. We could have properly funded public services returned to public ownership. It is very disappointing that health service visitors are out to tender. Profit does not have a place in dealing with ill health.

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