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At last…
Some good news.
Err… well, I think it’s good news.
We are about to have thousands more nurses and midwives. Well, not exactly ‘more’ and not exactly ‘thousands’… actually, not much at all.
True, the NHS is training record numbers of nurses and midwives, with 24,870 due to graduate in the next six months.
However, according to the BBC, about 4,000 who are bedside ready, won’t be able to find a job.
(Note: those leaving within five years of qualifying rose a staggering 67% and is a much bigger problem)
Anyway, Tra-La-La...
Streeting’s new Graduate Guarantee scheme says it will ensure every nurse and midwife has a job.
Strip away the razzmatazz…
... in England, around 25,000 nurses qualify each year. About 4,000 of them aren’t in an NHS job 6 months later…
… some work privately, some take a break, some leave nursing altogether.
Some can’t find a job... less than 4K, but we'll stick with that number.
In very basic terms, the ‘guarantee’ just sweeps up those... 'four thousand'. Adding maybe, £172m a year extra pay-bill, across 200-odd Trusts. Not game-changing.
HMG is not actually creating new jobs. They’re removing hiring restrictions so Trusts can appoint people even if a vacancy isn’t formally logged yet.
This is more about cash-flow flexibility than recruitment expansion.
Trusts already hire most graduates. The ‘guarantee' just smooths the pipeline, so none are left dangling.
The announcement is written to make it sound bigger than it is.
Streeting talks about 'every graduate’ to make it sound like tens of thousands of new jobs but almost all those jobs already exist.
The ‘thousands unlocked’ headline is really about the tail-end cohort of 4,000, or so.
Politically, it is presented as a ribbon-cutting moment, but operationally it’s a tidy-up measure, not a transformative workforce expansion.
The upshot…
… this is not a huge-scale recruitment revolution.
… this is a fix for the small proportion left jobless.
A bureaucratic loosening so Trusts, who are under pressure to cut posts to balance their books, can start people earlier or without waiting for posts to be vacated.
A low-cost, high-visibility political win…
… until it’s unpicked.
The Guarantee sounds like a game-changer; ‘NHS to open thousands of roles for new graduates.’
In real terms it's about 18 posts at every hospital, fewer if you include the community.
In truth, most already get a job. This scheme scoops <4,000 and yes, for them it’s good news.
It’s a tidy-up job, not a workforce revolution. The headline is bigger than the reality. More a tweak to hiring rules than a flood of new posts. Politically neat, operationally modest.
Murray Edelman tells us what's happening here... in his book; The Symbolic Uses of Politics (1964).
Edelman argued;
‘… much of politics is about symbolic reassurance. Using carefully chosen narratives, ceremonies and announcements to convey progress or competence, even when the underlying reality may be unchanged.'
It’s a familiar Westminster party trick… dress the facts in their Sunday best and hope no one checks the laundry label.
We’ve had:
- 'record NHS funding’ that barely kept pace with inflation;
- ’40 new hospitals’ that turned out to be refurbishments and new wings;
- ‘5,000 more GPs’, when numbers actually fell.
Now we have the graduate guarantee….
… once unwrapped, it’s not the big new idea it sounds. Just another headline dressed up for a photo-op in a luckless hospital playing host to, you-know-who.
Have a look at McCombs & Shaw’s Agenda-Setting Theory (1972).
They showed us how the media shape public priorities. How selective emphasis determines what the public ‘thinks about’, rather than what they ‘think’.
Only 4% of us will be using the NHS at any one time.
Most will think they've had a positive experience.
The other 96% will think about the NHS, and that it's broken.
The image of ‘more nurses’ looks like Streeting wears his underpants over his trousers and leaps tall buildings in a single stride…
He doesn't.
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