Our elderly use a very large percentage of NHS of resources, unsurprisingly because they are more prone to disease, frailty, and dementia. They need more social care and hospital care as they get older. And they are living longer. (Immigrants, by the way, use much less care).

Over this period NHS funding has, broadly speaking, risen about 1-2% over inflation. If NHS funding increases with inflation yet demand increases, then clearly spend per person will drop. Demand has increased considerably above 2%, which is why the NHS is failing to manage it.

Secondly, the NHS is not responsible for social or community care. When elderly folk come into hospital they decondition very quickly and require physio and OT to get back on their feet. Often a care package is required, sometimes even a care home place.

This is the responsibility of the local council to sort out. But council funding has been cut and social workers are dealing with huge case loads. So there are big delays. And we can't send the patients safely home until their care package is sorted out. So they wait. And wait.

And they sit on hospital wards waiting. Often bored and frustrated. About 33% of hospital beds are filled with 'fit for discharge' patients. UK hospitals can do nothing about this. We are effectively working on 66% capacity. Which is one of the key reasons why A&E is rammed.

So when I do my 'emergency take' ward rounds I am seeing patients in chairs, in corridors, in the back of ambulances. There is little privacy and dignity is impaired. We all do the best we can but it is a poor environment. This has become much worse over the past 5 years.

No self-respecting doctor or nurse enjoys working in this environment. No care worker likes to deliver poor care. Salaries were frozen for 7 years of austerity, and have never caught up since. Doctors and nurses now leave university with large debts to pay off.(Not like me!)

One of the biggest perks of the job was the NHS pension. In 2015 this was rearranged to save money, and ensure people have to work longer. It was not done well and this has led to some facing bizarrely massive tax bills - 5 figure sums are common.

If the pension is no longer an incentive to remain working for the NHS then medical and nursing staff can leave the NHS and do agency work. It pays a much higher rate, and you can work as much or as little as you want. It gives you control back - very attractive for parents.

So lots of folk are leaving the NHS to do agency or locum work. Once this happens we have a tipping point. There are lots of vacancies in the NHS that have to be filled by agency nurses who cost much more to employ - there are agency fees as well.

We cannot recruit. About 30% of new consultant jobs in UK cannot be filled. There are simply not the people to fill the posts. The nurses are striking because they have to. Not just because they personally are not paid enough, but because they need the vacant posts filling.

They know that if they do not improve pay and working conditions very soon, morale will collapse and we will face mass resignations and retirements. Because when you can earn more driving an HGV than running a ward, you know your profession is in trouble.

They know that if the government wins this, nursing will collapse anyway. The junior doctors are militant. A strike vote very soon. This is about money. But it is also about working conditions. Because if conditions don't improve, the NHS will fall. The staff have had enough.

Please understand that the RCN has NEVER supported strike action. These are not militants. They are striking out of desperation. To try and make this morally bankrupt government understand that enough is enough. Because they cannot do this anymore.

I am taking my pension in 3 years. I have worked for the NHS all of my life. I have never known it anywhere near as bad as it is now. And this government are trying to blame it on the nurses. Shame on them.

Finally, don't be fooled by the comments about cost. The NHS needs more. If it doesn't get it, YOU will end up paying it somehow. Either through a new state insurance scheme. Or private insurance. Remember the UK spends 9% of GDP on healthcare. The USA spends about 15%.

All these people tweeting about how expensive the NHS should take a look overseas and see what people get for their money. Whatever happens the taxpayer will pay. I mean - who else is there?

@peteneville65 Excellent thread Peter. If the mainstream media would’ve had the decency to broadcast the points you have made maybe the NHS wouldn’t be in the mess it’s in.

@peteneville65 The vast majority of the UK population are with you and support the NHS workers.

@peteneville65 God bless all medical staff. What a sacrifice.❤️🩺😷

@peteneville65 My junior doctor son-in-law was contacted to see if he could cover an A&E shift he was already working on...

@peteneville65 @UKBreturn 💙💔😭

@peteneville65

@peteneville65 Thank you for all you & your colleagues dedication. We are all in fear for the future of our healthcare. The silence from our government is deafening 😢

@peteneville65 Nothing to do with a certain medical intervention which caused a lot of nurses and care workers to be lost to the system and cancers and other ailments to increase then?

@peteneville65 Also from a patients’ POV this means the staff are often different every shift, which means constantly having to explain everything again, hoping they’ve read the notes, there’s no sense of continuity

@peteneville65 The NHS is in crisis however, if its funding can I ask who pays for the care of illegal immigrants also do you treat tourist foc if they fall ill ?Having lived and worked in Spain our medical treatment when needed was not free payment up front or no treatment..just asking?

@peteneville65 Junior doctors leave early and don’t progress to consultant posts - they are over worked and often badly treated. Suicide rates in Jnr doctors is high. Bullying is endemic in the nhs. People don’t want to stay or progress any more !

@peteneville65 Sure are. Can concur