Temporary workers are not to blame for the NHS deficit

The use of temporary workers in the NHS, including PR practitioners, has been blamed for the deficit - but this smacks of scapegoating.

Don't shoot the messengers, writes Steve Gladwin
Don't shoot the messengers, writes Steve Gladwin

War has been declared on recruitment agencies in the NHS – and those specialising in PR have been caught in the crossfire.

Simon Stevens, NHS England CEO, has told the Public Accounts Committee that the use of temporary workers explained "the vast majority, if not all" of the record £2bn-plus deficit forecast by trusts.

At the back end of last year, the health regulators Monitor and the Trust Development Authority consulted on setting limits on daily rates for non-clinical interims. Surprisingly there was very little resistance put up by the industry.

Partly that may have been because the upper limits were relatively high and comms professionals were less likely to be hit compared with some astronomically paid stop-gap managers. In inner London, the most highly paid comms professional would have to earn above £700 a day.

It’s also likely the recruitment agencies were trying to wade through the confusion around the detail and spending more time working out wheezes to get round the limits. They are alr­eady working with NHS trusts, which are trying to push temporary staff on to their cheaper ‘bank’ supply of clinical interims.

And who could blame the Government for declaring recruitment agencies as the new public enemy number one? Their fees add on average 20 per cent to the interim’s day rate. And what for? Finding candidates who have come to them in the first place rather than been sought out? An occasional three-month catch-up with the client? I sometimes wonder how much vetting goes on as I see the endless churn of candidates who are on the interim circuit because they’ve failed in salaried jobs.

I know of some NHS trusts that would clear their entire deficits if they got rid of their total agency costs. But therein lies the weakness in the argument for upper limits. By focusing on agency costs as a specific target, the job of reducing deficits has been made harder with too many eggs put into one basket.

As the fourth biggest employer in the world, the NHS will always need temporary staff and with 1.4 million employees, that is likely to be a substantial number.

Where it’s unforgiveable is when permanent jobs have been left vacant for too long, often because they’re unable to recruit.

So will the limits make a difference? In PR, which is a small part of the overall NHS spend, almost certainly not. In fact setting rates may have the opposite effect with interims emboldened to demand the ‘going rate’.

It smacks of a panic measure arising from the classic political tactic of scapegoating – in this case of recruitment agencies – and the need to be seen to be doing something about the deficit.

Ironically the bigger day rates are charged not by recruitment agencies but by PR agencies supplying staff. I’ve frequently seen junior PRs supplied for £600 a day at short notice. And for all the changes, it’s unclear whether PR agencies will be covered by the same arrangements covering recruitment agencies.

Steve Gladwin is MD of On The Level PR and previously held senior positions in the NHS and local government

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