Crossing the red line: when government abuses the goodwill of professionals and volunteers

Photo by Nick Fewings on Unsplash

“War! Huh! What is it good for? Absolutely nothing!”

Many of us will relate to this sentiment, but when we look at the history of war, we see that there are many complexities of human life reflected in these ultimate situations. And when we look closely it gets ever harder to say what’s absolutely right and wrong. 

Does this apply to ‘volunteering’ too? The first response might well be, ‘Oh, yes, that’s a good thing!’ And generally speaking, it is for a whole range of reasons. But sometimes when you look a little closer and think about the history of ‘unintended consequences’ which litter, exalt and mar human lives, is there room to just pause and reflect for a moment before diving in? 

Jenny Kartupelis in Central Bylines, 26 February 2021 paints a heart-warming picture of volunteering that speaks to the best in people. An appropriate and welcome chance to serve one’s community and participate. But what are the boundaries of volunteering? Is there anything that becomes inappropriate in the context of the misuse of people’s time and goodwill? Are there gaps that should not be filled by volunteers, simply because to do so would not be right? Because these are skilled, professional jobs we should be paying for, or because they replace jobs lost because of persistent underfunding of services.

In asking this, let’s be clear that volunteers are blameless decent people offering to help and give of themselves with nothing but a big heart and time to share with others. For such people, nothing seems to be too much to be asked.

Here we ask if it is right for a government (one that claims the NHS is ‘safe in their hands’ yet has more than once been found to lie or mislead) that has systematically, intentionally run down the NHS, in a way that they promised never to do, to seek volunteer support that aims to cover the ‘disaster’ being experienced in several hospital Critical Care Units (CCUs)? It is one thing to ask volunteers to help in a crisis, but the adverts for volunteers paint a different picture. A disaster relief charity is asking volunteers, via NHS England, to staff intensive care; to monitor critical care medical information equipment; turn comatose patients to prevent bed sores; empty catheter bags and lay out those who succumb to Covid-19 in preparation for their last trip from critical care to the mortuary.

Of course, volunteers will do this work, even in full PPE, masked for full shifts working alongside medical professionals. They will work hard at physically exhausting, emotionally demanding work for nothing but altruistic service to others. In most cases they will do it brilliantly, exceptionally. But should they be asked to? When is the engagement of volunteers so cynically an exploitation of willing labour that it amounts to abuse?

These are not hypothetical questions. At least one organisation (for retired police officers, NARPO) recently circulated advertisements by RE:ACT Disaster Response, asking for volunteers to respond to the roles we have outlined. RE:ACT are a properly constituted and responsible international humanitarian aid organisation. We understand they have been called in by NHS England to assist. They list the roles soberly and carefully, stressing the difficulties and the need for volunteers to be totally aware of what is required. This commentary is about the use and abuse of volunteers by politicians and government, reach and over-reach. It is not about the voluntary organisations, the NHS or volunteers themselves.

Politicians have clapped for nurses. Called them heroes. Said they are owed a huge debt of gratitude but failed to acknowledge their mortal sacrifices and openly abused them through systematic failures of a duty to protect. Nurses have been insulted with a 1 per cent pay rise. Nurse pay has declined in real terms under this Tory government (since 2010) by very significant amounts. The trauma they have been exposed to is beyond fiscal calculation, but that does not mean that it’s ok to bring volunteers into CCUs to show ‘support’, when what NHS staff need are proper, professional, medically trained workers who are properly, professionally rewarded for their physical and emotional labour.

But perhaps the government does not care? Does not care for the feelings of the hundreds of thousands of bereaved family members who know that the last days on earth for their relatives has been the sterile, inhuman, electronic CCU, staffed by dedicated, vastly over-worked and exhausted, desperate nurses and doctors. Perhaps they think that the public meekly accepts that their loved ones will be intimately treated by volunteers?

However, it is more likely that the public expect CCUs to be staffed with well-meaning and compassionate professionals. There are many places on the Green (Covid-safe) side of hospital work to engage with volunteers, but not the Red (Covid-active) side.

CCU staff are also likely to be shocked to find themselves assigned a couple of volunteers, no doubt amazing individuals, but volunteers. People that they need to train and watch and worry about for 12 hours on top of a maximised patient-load. This is surely going to add to their sense of feeling devalued, undermined and justifiably resentful that their training, dedication and professionalism is worth no more than a resentful 1% pay rise. It seems the Government was expecting gratitude, not understanding that asking volunteers to do their most gruelling work with nothing but a short induction and a few quick checks, was more akin to an insult.

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It’s hard to see that insult as unintended. Despite countless protestations to the contrary, the government is selling off as much of the NHS to private providers as it can. It is part of an emerging picture. Stories abound across the media and petitions are raised in many, many places.

Given that the latest estimates following the budget proposals show the NHS as having an operational shortfall of £30 billion, it is hard to see the use of volunteers as anything but a niche-but-useful narrative to undermine the value and professionalism of NHS workers. Although volunteers are by definition exceptional people, they are technically ‘free’ and this also seems to be how this Government likes the work of public servants to be viewed; optional, low-value, replaceable. Are NHS workers just supposed to be grateful for a role to play? The evidence is mounting that they are not.

To return to the theme of the use and abuse of volunteers, the issue of NHS professional staff and volunteers arises under the Kings Fund report of 2018 under the ‘substitution or complementarity’ question on page twelve. Note that, “there was a potential for tension where staff perceived that volunteers were taking the place of paid staff.” A key finding concludes that, “Volunteers provide vital practical support that enables frontline staff to prioritise clinical care. Frontline staff clearly appreciate that volunteers can bring additional human kindness into busy hospital life – often by carrying out the smaller, non-clinical actions…” (page 39). Here, what we are asking is ‘where we draw the line.’