NHS WASTE

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NHS workers who take sick leave are claiming tens of millions of pounds a year in overtime and anti-social hours allowances while off work. More than one million NHS staff are paid well above their basic salary when they are ill under a contract which guarantees them a far better deal than those working in the private sector. The generous terms mean that when they are on sick leave they receive full pay, plus a selection of benefits. These include supplements for unsocial hours and overtime for six months, with half pay for a further six. The deal means when an NHS worker, such as an ambulance worker, nurse, porter, or midwife, goes off sick they are paid according to an average of their total pay for the previous three months, rather than just their basic salary.

In many cases, workers have boosted their income by working nights or extra hours, or are paid a ‘recruitment and retention’ bonus, which can add tens of thousands of pounds to the basic salary of a middle grade worker living in London. The NHS has higher sickness rates than the rest of the public sector and enjoys the most generous terms and conditions while off work. The service loses 10.3 million working days annually due to sickness absence alone, costing £1.7 billion per year. Critics have said the scheme is "morally and ethically wrong" and should be reviewed. However, supporters said NHS workers are exposed to unique pressures, with 56,000 physically attacked each year, and they deserve to be looked after.

Stephen Alambritis, of the Federation of Small Businesses, said the sick pay terms should be reviewed, especially in light of the recession when all workers are being asked to make sacrifices. He said the organisation has been 'caught out'. He said, "To have sick pay going for six months and include overtime and extra payments does seem to be overly generous; an employee in the private sector would not expect that. NHS staff do a sterling job and there is huge stress involved in the work but the pensions are good, the sick leave is good, it is not brilliantly paid, but there is security of tenure. In the private sector the stress comes with the fact the job may not be there the next day."

The average NHS worker takes 10.7 days off sick a year, compared with 9.7 days for the public sector as a whole and 6.4 days in the private sector. The terms and conditions on sickness absence are included in the Agenda for Change contract which covers nurses, midwives, hospital porters, paramedics, ambulance workers and administration staff, but not doctors. The wage bill for the contract in England was more than £28bn in 2007/8, according to the National Audit Office. Under the contract, full pay is paid for the first six months off sick and then a further six months at half pay after five years’ service. Before then, the length of paid time off is on a sliding scale.

Overtime, over the standard 37.5 hours a week, and unsocial hours, for working nights or weekends, is payable at time and a half with public holidays paid at double time, or lieu time can be requested instead. Staff can also receive around £3,205 in 'recruitment and retention premia' where employers find it difficult to fill posts, while those in inner London are paid a 'high cost area supplement' worth 20% of basic salary, to a maximum of £6,080. In the private sector, standard sick leave normally includes a short period on full pay, around one month or six weeks, followed by statutory sick pay paid at £79.15 per week for people earning £95 or more. In many cases employees are automatically put on statutory sick pay, once they qualify - which is when they have been off sick for four days.

Dr John O'Sullivan, an occupational health consultant in the private sector, said the NHS terms were 'morally and ethically wrong' and there was little incentive for staff to return to work. He said, "This is taxpayers’ money. The NHS has the expertise to get people back to work but they just do not use it on their own staff." The Health Service terms and conditions also eclipse other areas of the public sector: police receive full pay for six months and then half pay for a further six, but do not receive any overtime. Teachers get full pay for 25 days off sick then half pay for 75 days in their first year, rising to 20 weeks’ full pay and 20 weeks on half pay after four years working.

Neil Carberry, Head of Employment Policy at employers’ group, the Confederation of British Industry, said, “The inclusion of overtime and other extras makes this a more generous scheme than the private sector norm, and the overall approach in the NHS to the management of absence and long-term sickness is a real concern. Firms use occupational health provision to ensure all absence is genuine, and innovative rehabilitation policies that get people back to work sooner. The NHS should do the same.”

However, Sian Thomas, director of NHS Employers, said, “There is no evidence that withholding pay leads to increased efficiency and improved staff morale. In fact, it can be counter productive because it leads to feelings of resentment and de-motivation among all staff. In order to successfully tackle sickness employers need to address the long-term problem. In the NHS this includes preventing injury from lifting and handling, helping staff build up their emotional resilience and reducing physical and mental abuse from patients.”

A spokesman for Unison, the union, said, "We have to look after our NHS staff. If they are not fit and safe they cannot look after patients. If you go to any A&E department at night at weekends you can see the levels of violence and abuse staff face. Paramedics in particular are at risk of attack." A spokesman for the Department of Health said, "Agenda for Change provides a fair pay system that recognises the dedicated work that over 1.1 million NHS staff do every day to help us deliver high quality patient care to all.” (Source: Daily Telegraph, Aug/09)

A baby was born in a hospital car park after being turned away from one hospital because it didn't have enough midwives. Sally West had booked into Malton Hospital in North Yorkshire for the birth but when she went into labour she was told there wasn't enough midwives. Sally was told to phone 999 for an ambulance and go to Scarborough, 20 miles away.

Gilly Collinson, spokeswoman for Scarborough and North East Yorkshire NHS Trust, said, "We are glad that baby arrived safely but we were sorry that staffing levels didn't enable the birth to take place at Malton Hospital. The plan for the future is to have a high quality home-from-home unit at Scarborough Hospital which we believe will give all mums the greater opportunity of enjoying a midwife-led birth. (Source: Daily Mail, Aug/07)

English taxpayers are to foot the bill for Scots to have free prescriptions which will cost English taxpayers £50 million a year. Chronically-ill patients north of the border will not have to pay a penny for their drugs from April and the Scottish National Party plans to extend the benefit to all within four years. Among the many benefits enjoyed by the Scots are:

• Free tuition fees for all students from 2009, while students in England and Wales must pay up to £3,000 a year for their studies.

• Access to expensive state-of-the-art drugs for illnesses such as Alzheimer's and eye disease, which are not available on the NHS in England.

• Free personal care for the elderly.

• Free central heating installation for all pensioners.

• Free eye tests and, by the end of the year, free dental checks.

• Discounted bus travel for teenagers and free travel for pensioners.

Prescription charges have already been abolished in Wales, where they ended in April, with politicians claiming that it was "the biggest move to improve public health in decades". While in England, the charges have recently risen by 3% to £6.85 per item. Scottish public health minister Shona Robison said, "We feel that prescription charges are a tax on ill health and we feel very strongly that those who suffer from a chronic condition shouldn't be penalised." It's interesting to note that Scottish MPs can vote on issues which affect only England but English MPs are unable to vote on the same issues in Scotland. (Source: Daily Mail, Jun/07)

Hospital boss Douglas Pattisson, who helped rack up £23million debts has a new job, telling the government how to save NHS money. Mr Pattisson landed the cushy post despite astonishing gaffes that could cost 200 staff their jobs. He left a trail of financial havoc when he resigned as chief executive at Hinchingbrooke Hospital, Cambridge, in September 2006. During his six years at the hospital, which is threatened with closure, he:

Misjudged the cost of a new treatment centre, handed back £9million to the Department of Health after ticking the wrong box on a government form and repaid a £2.6million loan in error. Yet he walked away with his pension intact. He inherited a £2million deficit when he took over at Hinchingbrooke, and left it ten times worse. The chaos led to about 30 nurses being axed, including an entire theatre team from the new treatment centre. This year more than 200 staff could face the sack. (Source: Sunday People, May/07)

An NHS trust has refused to pay for a woman's £10,000 eye care but paid out £500,000 to accountants for advice on how to save money. Thelma Nixon, of York has had to remortgage her home to pay for treatments to her eye but now her money is running out and she is likely to go blind. At the same time, her NHS trust have paid £500,000 to a firm of accountants to tell them how to save money. The Department of Health guidance advised NHS organisations that, until the National Institute for Health and Clinical Excellence (NIHCE) had published final guidance on a treatment NHS bodies should continue with local arrangements for the managed introduction of new technologies.

The trust said there was no NIHCE guidance for the treatment of age-related macular degeneration with drugs including Lucentis and in agreement with other PCTs in the region, but it had agreed to fund such drugs for patients where there was evidence it would be an effective treatment. The latest criticism of North Yorkshire and York Primary Care Trust comes the day after it made national headlines for refusing to give a dad-of-two and leukaemia victim the drugs he needs to save him from death. (Source: Daily Mail, May/07)

Millions of people face being barred from NHS treatment when they are sick because they have unhealthy lifestyles. Health Secretary Patricia Hewitt says the bans are “perfectly legitimate”. Obese patients have been denied hip and knee replacements, they are told that being overweight raises the risks of an operation and will wear out an artificial joint quicker. Smokers are banned from certain types of surgery because of higher risk of complications.

North Staffordshire has some of the toughest rules. Patients qualify for routine operations only if they have not smoked for three months and have a body mass index below 30, the generally accepted starting point for obesity. The rules do not apply to patients needing emergency treatment or life-saving operations but those requiring routine surgery on a joint, for example, are required to be non-smokers and not clinically obese.

Mrs Hewitt said, “Decisions are being made by individual doctors all over the country. I support doctors making clinical decisions in the interests of their patients.” So when can we opt out of paying National Insurance? It won't be long until the only people the NHS treat will be those with nothing wrong with them. (Source: The Sun, May/07)

Millions of pounds of health service funds are being wasted employing agency nurses on up to £128 an hour. This is almost ten times the amount paid to an experienced staff nurse, and equates to a salary of £250,000. Overall, the health service spent almost £800million on agency doctors, nurses and consultants in 2006-07, according to the figures uncovered in a Freedom of Information request. That could fund around ten hospitals or employ 30,000 full- time experienced nurses. Agency staff are plugging the holes left by the 11,000 nurses who left to work overseas last year, seeking better pay and conditions.

The gap between rates for NHS workers and agency locums exists at every level including managers and even prison GPs, who have been paid up to £158 an hour. The figures also show that much of the money goes into the pockets of agency bosses rather than to the workers, who can earn less than two-thirds of what the NHS pays out. The Department of Health insists that the amount spent on agency staff is falling, year on year. (Source: Daily Mail, Jan/09)