On Short-sighted Executives

February 28, 2013 at 1:29 pm | Posted in Nursing, Politics | Leave a comment

Nurses in Britain will probably have at least some peripheral awareness that national negotiations are currently in progress to determine our Agenda for Change terms and conditions (i.e. what we get paid).

What a lot will not be aware of, however, is that our colleagues working for 19 NHS trusts in the South West of England are facing real terms cuts to their pay and conditions, thanks to the South West Pay Cartel – Basically, 19 trusts in the South West have banded together in an attempt to adopt a regional pay structure. This despite the Health Minister telling the Cartel that regional pay is a terrible idea, and they have no legal right to leave the Agenda for Change T&Cs.

Well, this is depressing.

I think I need to address the people who live in the South West of England at this point. It’s an older population than most parts of England, because many people retire there, and the economy is not vibrant, so many young people leave to work elsewhere. In other words, it is disproportionately dependant on the NHS, because older people = more use of healthcare.

So to the people of the South West: Let me tell you what is going to happen where you live, if regional pay is adopted there, and pay is cut as a result (it will be, that’s been the transparent goal of the Cartel from day one).

Medical schools, nursing schools and schools for allied practitioners such as physiotherapists, occupational therapists, radiologists, turn out a class of fresh, eager new professionals every year. And those professionals look for jobs. Do they look for work in a part of the country they know to be more expensive than average in terms of living cost, and where they know they’ll get paid less? No. They do not.

Existing healthcare professionals in the South West will suddenly be faced with a choice: Stay and get paid less, or go and get paid more. What happens? Those who can move away, move away. It’s not hard to get a job as a qualified healthcare professional. Really. I get sounded out or asked to apply for one at least once a month. We can work anywhere; our qualifications are universal, and our professional registrations are good enough for the whole world.

So at this point, no newly qualified professionals will be moving to the South West, and a lot will have left, leaving hospitals desperately short-staffed. What do they do? The only thing they can do; they’re legally obliged to maintain safe staffing levels, so they get agency staff at an average cost of £146 per hour to cover the shortfall.

So what do you, the patient, get? You get inconsistent care, where you rarely see the same nurse twice during your hospital stay. You get a lack of continuity because the nurses looking after you are not a part of the team, and they have no real incentive to make sure your needs and requirements are handed over to the next nurse on shift.

What do the trusts get? Well, let’s just look at nursing a minute, because that’s what I know: A newly qualified nurse on Agenda for Change terms costs employers around £11 per hour in all. That’s about £125 for a twelve hour shift (note: That’s not what the nurse takes home, that’s what they cost the employer including pay). An agency nurse, on the other hand, costs £146 per hour (the best paying agency offers a flat rate of £32 per hour, the rest goes to them), or around £1750 for a twelve hour shift.

In other words, by cutting pay for nurses the South West Pay Cartel will ensure that everybody, including themselves, loses out financially. The only people who win will be nursing agencies and their very well paid employees.

And let’s not forget the bigger picture: We need newly qualified staff, who’ve been trained in the newest and best ways of doing things, to come and tell us when we’re doing something in an old-fashioned way. Medicine should be evidence based, and evidence improves and changes. We don’t all have the benefit of being able to sit down and plough through the journals every day to stay up to date, so those new staff are a crucial part of keeping our practice up-to-date.

I think what scares me the most is how very obvious this all is. Executives at those trusts are in dire need of opening their eyes, taking off their financial blinkers, use whatever metaphor you like. They’re going to bankrupt their trusts, and they’re going to do real harm to patients in the process.

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