Letter from the Editor - Dion Smyth

Published: 04 July 2012

There are some things in life that are obvious and foreseeable. We know that Wimbledon will more often than not need to use the all-weather covers because the summer weather is poor and unpredictable and, at some stage of international football, the England team will lose out in a penalty shoot-out. Often to Germany.

We know also that politicians court popular acclaim and so will criticise people of a particular form of tax avoidance, which is not illegal per se but nevertheless described as "morally repugnant", forgetting perhaps that only a few years ago the Houses of Parliament were mired in a financial scandal of their own regarding expenses claims that were often explained by many as a genuine "mistake" and that those expenses, including the fitting of "modest" chandeliers, were ‘within the rules’ and also not illegal in most instances.

Paying taxes might be considered a necessary price for funding the public services that reflect the civilisation of a society that provides for the less able, more vulnerable, members of that population. And we all appreciate that the technological and medical advances in cancer care alone are costly, requiring all of us to make a fair contribution to the provision of these treatments.

As the country and other major world economies struggle to manage the on-going fiscal crisis, balancing the books and belt tightening have become the norm and nursing staff shoulder that burden in part through pay freezes and changes to pension contributions. But as the first trust to be placed in a form of financial administration special measures hits the news at the time of writing this editorial, we have to remember that crude and unsophisticated measures to manage finances can contribute to poor consequences.

The Prime Minister might have been right to comment on the principle of aggressive tax evasion, but has invited criticism in the national press and among opposition MPs for not doing more to close such legal loopholes for all. Equally, the financial cropping that formed part of Stafford’s forceful drive to become a foundation trust, which was legal but saw large numbers of nursing posts lost at its hospital and is alleged to have contributed to the poor care witnessed there, should serve as a warning to all and is, perhaps, the more proper concern and one that we should hope not to ever repeat.

The value of all our contribution to care is questioned every time a news report features the thankfully rare occasions of immoral behaviour by a nurse, and the value of our care is always questioned when the costs are being calculated; the nursing budget is a significant part of any organisation's overall cost and often the first to feel the threat of cuts.

Earlier this year we saw that the Health and Social Care Act 2012 has passed and, although there is still much uncertainty, it indicated significant changes to care delivery and service development so nursing staff, and perhaps especially nurse specialists, need to present and promote themselves and their services to commissioning boards so that their input leads the provision of care that profoundly improves the patient outcome and experience and that this role, and that of all specialist cancer nursing, is not downsized, decreased, diminished or in any other way perceptibly repugnant to the professionals within a system that wants to improve the overall quality of care.