Carry on nursing

One in ten EU nurses quit the NHS last year. The number of new EU nurses arriving is down 96%. Just as worrying is the fact that British nurses are quitting too, with a 50% rise in the number leaving. 33,000 packed it in last year, and there are now more leavers each year than joiners. There are 40,000 nursing vacancies in England alone. Nationally only one nurse is appointed for every seven vacancies advertised - in some places it is one for every four hundred vacancies.

One wheeze being tried is to encourage overseas applicants by making the required English-language test easier or even waiving it altogether. Instead of using a general test the new test is specific to the job, checking that the applicant can at least understand the vocabulary needed even if their general English is poor.

Another idea being tried is asking medical students to help out on overstretched wards - the head of one medical school emailed the students, saying, "Do volunteer to help in any way possible, providing it's within your competence".

Meanwhile the NHS is planning to put recovering patients in people's spare rooms. Not a bad idea - the home owner can replace those missing nurses, though clearly there are some concerns about putting vulnerable people into the hands of a stranger.

It isn't only nurses - we are short of 5,000 GPs too. The government has decided to attempt to recruit 2,000 from overseas to make up some of the shortfall. The chief executive of NHS England called this an "industrial-scale international recruitment programme", as it is quadruple the previous target of 500 overseas GPs. Again only one doctor is appointed for every fifteen vacancies advertised.

Weirdly - though unsurprisingly given the shambles our government is in - overseas doctors who have accepted jobs are meanwhile being refused entry to the UK as there aren't enough visas to go around. Three doctors about to join Addenbrooke's hospital in Cambridge were told they couldn't start as they weren't in 'shortage areas'. Birmingham has had 16 doctors turned away. Inexplicably, the visa system gives priority to people being paid more than £55,000 or with PhDs rather than doctors.

The NHS is short of beds as well. 30 years ago England has 299,000 beds, we now have only 142,000. Meanwhile the population has grown, and has grown older, with more care required. Is it any wonder that patients are being treated on trolleys parked in corridors?

Quite apart from the staffing crisis and the bed crisis, it is also suffering a funding crisis. To keep going as it is the NHS will need an extra £4 billion a year. The chancellor, Mr Hammond, has promised only £1.6 billion as a one-off rather than on-going increased funding - and is demanding improved services and reduced waiting lists. How this is to be achieved he doesn't say.

Mr Stevens, chief executive of NHS England, has made a start by telling doctors to stop giving prescriptions for ailments that patients can treat themselves with over-the-counter medicines. He has also rejected the government's waiting list demands. This is only the start, though, as much bigger savings will need to be made.

Another cost saving measure is to make patients pay for 'poor-value' treatments. Essentially rationing what is available. Treatments that may be no longer available on the NHS are shoulder surgery and hormone tests. Already homeopathy and expensive painkillers are off the list.

We Britons are justly proud of our NHS. However, to keep it functioning effectively it needs 100,000 more clinical staff, 20,000 more beds and £4 billion in extra annual funding. It is becoming increasingly unclear how we are going to find the staff or the funding, and increasingly clear that the government's strategy is not to improve the service but to keep cutting it.