Tuesday, 2 June 2015

Jeremy Hunt on top form.

From the BBC:

... the pay packets of some NHS senior managers will also be trimmed. Currently, more than a fifth of all directors in the NHS earn more than £142,500 - the amount the Prime Minister is paid. Mr Hunt is asking Trust bosses to justify why.

Mr Hunt said: "The NHS is a public service and needs to show restraint on handing out generous pay packages as a matter of course.

"Expensive staffing agencies are quite simply ripping off the NHS. It's outrageous that taxpayers are being taken for a ride by companies charging up to £3,500 a shift for a doctor. The NHS is bigger than all of these companies, so we'll use that bargaining power to drive down rates and beat them at their own game."

Simon Stevens, chief executive of NHS England, has said the rising costs are partly due to hospitals putting more nurses on wards, following the public inquiry into the Stafford Hospital scandal. Others blame government mismanagement of the NHS.


I'm not sure that the NHS is "being ripped off" so much as "chucking money down the toilet", so Hunt is being generous to them. If you need permanent staff, then employ permanent staff; and to the extent that they have to balance out peaks and troughs, there is no earthly reason why the NHS can have its own pool of nurses in each area, it can't be rocket science to co-ordinate this.

10 comments:

Sobers said...

One wonders to what extent the requirement for emergency and temporary staff in the NHS is down to those 'angels' in the NHS being somewhat less than angels when it comes to not taking random sickies, and days off for 'domestic emergencies' etc etc. One suspects that if person A just doesn't show up to work one day for some spurious reason, requiring an emergency cover (at some cost), that there is little the NHS can (or indeed is prepared) to do to discipline such behaviour.

This is not going to be solved by just employing more staff, if the ones that are scheduled to turn up for a shift don't, unless one plans to over man every shift and position to allow for the times when someone doesn't show.

JohnM said...

What I'm told by someone working in hospital admin that the agency staff are often markedly better than the permanent staff. The permanents are next to impossible to sack and they know it. Some will be conscientious whilst others are not. In comparison agency staff can be sacked at the end of the shift. Meanwhile anyone permanent with an ounce of gumption sees that agency staff are cleaning up and joins them.

I'm told this varies dramatically between hospitals. Incidentally this was told to me by a Labour voter who wanted to know "who were the selfish bastards who voted Tory" last month. He told me this as a indictment of the Tories.

mombers said...

I wonder how much of this is to do with the crushing burden of PAYE as a perm doctor vs the much lower tax possibilities as a contractor? Especially if you are a single earner household, you can split your income with your spouse.

Mark Wadsworth said...

S and JM yes that might explain some of it

M that is a minor issue I think as employment income from an agency is still taxed as employment income

mombers said...

MW but what about if Dr Smith runs his own employment agency and can avoid NI and all that nonsense, and also distribute profits as dividends?

Mark Wadsworth said...

M, well he could if he wanted but that's against the law and he'l be knackered if and when HMRC ever catch up with him.

It's only the top quangocrats who do 'personal service companies' and get away with it, it's not for workers.

Sobers said...

One gets the impression these days that vast swathes of the State sector are held together by private agency staff, being paid handsomely to do the jobs that the incumbents either can't or won't do. Management are sh*t scared of things going t*ts up and the physical consequences for the poor benighted users of their 'services' becoming so bad as to bring the spotlight of public attention to them (and therefore damaging to management's continued employment and pensions) that they will pay some private contractor almost anything to make things 'work' in a practical sense, even if shoddily. Keep the show on the road at almost any cost, worry about the budget problems later.

Running out of money in the State sector is never the real problem - the responsibility for that can be shifted onto the government and the political masters. Whereas if your 'service' f*cks up awfully in a practical way, the civil servants themselves are on the firing line too. Thus money will be thrown at problems to try and make them go away. In the NHS there are a LOT of problems, and it takes a LOT of money to keep the show on the road.

Lola said...

"...and to the extent that they have to balance out peaks and troughs, there is no earthly reason why the NHS can have its own pool of nurses in each area, it can't be rocket science to co-ordinate this.. I should think that coordinating anything is precisely beyond the self serving bureaucratic insanity of the NHS. I mean, why should they even bother? What's in it for them? Where's the incentive?

H said...

My mum used to temp for the NHS (as a secretary, although I think the facts are similar for nurses). The temps get paid more than the permanent staff. Often, they turn down offers of permanent employment for that reason.

The NHS has nationally agreed pay rates. It would cost it a great deal of money to match or exceed the rates offered to individual temps, since it would have to do so across the board, rather than simply to a minority of temporary staff as at present. This more than compensates for the commissions etc. charged by the staffing agencies.

In short, you have a situation whereby a minority of staff get paid more in a way that costs the NHS less than raising pay across the board. Hard to see how such a situation can easily be resolved, in a service where vacancies must be filled immediately.

The Stigler said...

sobers,

"One gets the impression these days that vast swathes of the State sector are held together by private agency staff, being paid handsomely to do the jobs that the incumbents either can't or won't do. Management are sh*t scared of things going t*ts up and the physical consequences for the poor benighted users of their 'services' becoming so bad as to bring the spotlight of public attention to them (and therefore damaging to management's continued employment and pensions) that they will pay some private contractor almost anything to make things 'work' in a practical sense, even if shoddily"

What's their incentive to do otherwise? When are local council officers carried through the street or feted on national radio for finding a way to save money? Do NHS officers get a bigger car if they hire the best value nurses rather than going for the gold-plated option?

In the software business, you get incentives. If I find a quick way of doing something, or maybe farm work out to a good, cheap Indian guy, I get to keep some of that.

And that's one of the reason for favouring markets. Maybe if we had more of a market in healthcare, you'd have managers that tried to optimise their use of staff. Or ways to incentivise staff nurses to do a better job.