Soaring bills

Health secretary Jeremy Hunt announced today (June 2) a pledge to clamp down on the health service’s soaring agency staff bill – a bill that’s spiralled out of control after his own government’s reckless mismanagement of the NHS.

 

Hunt has vowed to put a stop to “exorbitant” fees for temporary doctors and nurses that he said was “ripping off” the health service.

 

The government plans to introduce a new maximum hourly rate that an agency may charge an agency doctor or nurse’s services, as well as a cap on how much any trust with financial troubles can spend on them.

 

No mention was made, however, of NHS health staff who’ve been ripped off for years under the previous government – a combination of paralyzing pay freezes, impossible workloads and bureaucratic mismanagement has made once valued professions such as general practice and nursing among the least desirable occupations.

 

This severe underinvestment in the permanent workforce, health professionals and think tank experts have said, is what has caused the massive reliance on agency staff in the first place.

 

Out of control

 

Hunt is right that the agency staff bill has skyrocketed – figures cited by the Nuffield Trust today (June 2) point to a 31 per cent increase in spending on agency staff in one year alone.

 

This, the Nuffield Trust notes, largely accounts for the ÂŁ800m hole in hospital and community service finances.

 

The total bill for agency staff now stands at ÂŁ3.3bn.

 

The overreliance on agency staff is an issue that Unite head of health Barrie Brown said has been a central concern for the union and its health staff members.

 

“Unite and the other health unions raised this very issue with Jeremy Hunt on 20 January this year during the pay negotiations,” he said. “The health secretary has been slow to get to grips with the spiralling out of control agency budget.”

 

Brown argued that the only way to slash the bill is to support, recruit and retain permanent staff.

 

“Unite wants the agency bill slashed and permanent nursing staff and other health professionals employed with proper training and development in place, coupled with robust recruitment and retention policies,” he said.

 

He noted that Hunt’s announcement to cut agency staff expenditure by simply saying he’ll put a stop to the exorbitant cost per agency worker does nothing to address the root cause of the problem.

 

“As a supporter of the free market, does he not realise that the charges made by the agencies are an outcome of the market where supply and demand determine prices?” Brown pointed out.

 

He went on to say that under Hunt’s government, the nursing profession has been decimated, which makes agency working a more desirable option for many nurses.

 

“Since 2010 there has been a drop in student nurses being trained and over the past 5 years nurses have had a real drop in income of 15% – not surprising that they are tempted to work for agencies,” he said.

 

Brown’s arguments were supported by the Nuffield Trust’s recent findings that has served as the basis for the think tank’s new briefing, which outlines 10 key health and social care priorities for the new government.

 

“The NHS needs to hit very ambitious efficiency targets, at the same time as fundamentally changing the way care is delivered and moving to a seven day service,” said Nuffield Trust executive Nigel Edwards.

 

”That can only be done if it has the right staff in the right places. Yet there are not enough staff to fill gaps in key areas, and we are seeing clear signs of stress and disengagement.”

 

Unprecedented efficiency savings

 

Hunt’s vow to cut spending on agency staff in the NHS was coupled with a demand that the health service “stop making excuses” about a lack of funding now that the government has pledged an extra £8bn a year.

 

The health secretary argued his case in a comment piece published in the Telegraph today.

 

“Eight billion was what the NHS asked for. But with that commitment from taxpayers, the time for debating whether or not it is enough is over: the NHS now needs to deliver its side of the bargain, which is to make substantial and significant efficiency savings,” he wrote.

 

The efficiency savings that the government has called for in the next five years stand at a stark ÂŁ22bn.

 

The Nuffield Trust contended that these unprecedented savings levels, added with the Tory plan for a seven-day NHS, will not be realised “unless the health service reconnects with staff and develops their skills to better meet changing patient needs.”

 

Brown added that Hunt, even after three years as health secretary, “doesn’t understand the demands on the health service” and argued against the ruthless cutting of costs, which will have dire consequences for patients.

 

“Since 2010, the spending on the NHS has reduced as a percentage of GDP and previously had risen to the same level as countries such as France and Germany,” he noted.

 

Brown added that much of the health service’s current financial woes were caused by the previous government itself.

 

“Hunt ignores the decision made by his predecessor to re-organise the NHS at a cost of £3 billion which has now contributed to the financial problems of the NHS in England,” he said.

 

While the health secretary argued that “safer services cost less; and controlling costs funds safer services”, Brown decried this logic.

 

“All commentators and organisations who do understand the NHS and the budgets required to maintain the volume and quality of services expected have made it clear that the NHS is underfunded, since NHS costs will always exceed inflation levels,” he said.