Private sector management in the NHS is more efficient and effective.

Or not. Private company cant balance the books and wants to quit.

http://www.bbc.co.uk/news/uk-england-cambridgeshire-30740956

Oh, go on then, I'll bite....

http://www.theguardian.com/society/2010/feb/19/hinchingbrooke-huntington-hospital-nhs-private

Looks like they might hand it over in better shape than when they took it over...

http://www.dailymail.co.uk/news/article-2632191/Private-firm-turned-failing-NHS-hospital-award-winner-From-basket-case-best-country-patient-care.html

Oh, go on then, I'll bite....

 

http://www.theguardian.com/society/2010/feb/19/hinchingbrooke-huntington-hospital-nhs-private

So the unions were right then? blimey!

So the unions were right then? blimey!

First time for everything

First time for everything

You do need some kind mechanism to deal with occasional failing management in public institutions but private sector management trying to take 10% of income out as profit isnt the answer. Management of the NHS is far more complex and demanding than most private businesses - as Circle have found out.

You do need some kind mechanism to deal with occasional failing management in public institutions but private sector management trying to take 10% of income out as profit isnt the answer. Management of the NHS is far more complex and demanding than most private businesses - as Circle have found out.

It would appear that there is no easy solution here (said I, stating the bleedin' obvious). What's worse? The danger of a hospital being turned into a "basket case" by poor management in the public sector or a hospital, having been transformed into an award winning establishment by private sector management, seemingly not sustainable as a business in the current climate.

Looks like they might hand it over in better shape than when they took it over...

 

http://www.dailymail.co.uk/news/article-2632191/Private-firm-turned-failing-NHS-hospital-award-winner-From-basket-case-best-country-patient-care.html

 

That Daily Mail piece was HIGHLY selective and misleading (I know I couldnt believe it either). Care standards dropped and the deficit increased.

Trust criticised for poor quality care by inspectors.

http://www.bbc.co.uk/news/uk-england-cambridgeshire-29383247

http://www.independent.co.uk/life-style/health-and-families/health-news/hospital-lifesaver-circle-loses-extra-22m-8294660.html

Deficit (in breach of statutory duty)

http://www.hsj.co.uk/news/finance/exclusive-nhs-trust-under-private-management-faces-deficit-again/5069465.article#.U0sNClego8Y

The bottom line is that the new private sector management came in to take over a hospital which everyone acknowledged was failing (ie it was crap and therefore fairly easy to improve) and then proceeded to lose even more money, didnt pay back any of the deficit as promised, didn't make any profit and care standards were poor and abusive. They wrewnt worse than the previous failing management, but weren't any better either.

My missus uses the private sector to work I the NHS and earns a fortune. Happy days

My missus uses the private sector to work I the NHS and earns a fortune. Happy days

Woah, you have a missus?

My missus uses the private sector to work I the NHS and earns a fortune. Happy days

Thats just a long winded way of saying your carer is an agency nurse.

Thats just a long winded way of saying your missus is an agency nurse.

my sister is a sister and she went agency so she could go back to same hospital and do same job for twice the money or something. Bit scandal really.

Thats just a long winded way of saying your missus is an agency nurse.

Yep. So many of her and her mates won't work for the NHS.

About £75 an hour bank holiday Sunday's for 12 hour shift.

Over half that before even considering doing a normal day.

my sister is a sister and she went agency so she could go back to same hospital and do same job for twice the money or something. Bit scandal really.

Forget about the crap about the hospital. Tell me about the scandal with your sister.

you have pm

Yep. So many of her and her mates won't work for the NHS.

 

About £75 an hour bank holiday Sunday's for 12 hour shift.

 

Over half that before even considering doing a normal day.

The government cut back on nurse training and created a nursing shortage and now have a problem they cant get out of. The need the agency nurses to cover the shortage, but the more hospitals use them the more incentive there is for more staff to leave and go the agency route for twice the money.

my sister is a sister and she went agency so she could go back to same hospital and do same job for twice the money or something. Bit scandal really.

Same for all contractors.

The deal is supposed to be that you swap job security for a higher rate of pay. However, in many industries, my own included, shortages can be so acute that the job security part is never really threatened.

The other thing is the theoretical headcount trick that accountants like to play. They're like:-

"Hey wow. Our permanent headcount is really low. Check out our low wage bill!"

"What about all them contractors? They cost loads."

"Them? Oh we can get rid of them tomorrow if we want to."

They rarely want to. As you say, a scandal.

The government cut back on nurse training and created a nursing shortage and now have a problem they cant get out of. The need the agency nurses to cover the shortage, but the more hospitals use them the more incentive there is for more staff to leave and go the agency route for twice the money.

Yep. When she left the NHS last time she was not allowed to work for the same trust for 6 months. Which was fine.

The work is mental. She is currently booked up until May and she gets contacted every single day asking if she can work elsewhere. The money she earns is usually crazy if she does full time hours over a month.

Especially in her line of work (ICU)

I worked for Ordnance Survey. Job satisfaction wise, was brilliant. Hasn't really been bettered. Seeing stuff you've worked on out in the wild in map form, doing interesting things with vast sets of geographical data, maps and did I mention maps? Everyone who works at OS gets geeky about maps. It's the law.

Anyway, all the pay grades were tied to the civil service structure, so you didn't even have to go contracting to get a big rise. A market-rate gig in the private sector was a bump for nearly everyone that left. A lot of people left. Some, including myself, even came back as contractors for certain projects.

I still love the OS now, but I can't help feeling that if the government were realistic about salary levels they would avoid the huge and volatile costs of the temporary labour market across all its institutions.

As I heard a GM remark on signing yet another six month contract for an already long-term contractor, "who are we kidding?".

Yep. So many of her and her mates won't work for the NHS.

 

About £75 an hour bank holiday Sunday's for 12 hour shift.

 

Over half that before even considering doing a normal day.

I wouldn't take the pay cut myself...

I wouldn't take the pay cut myself...

She doesn't when she works private. Of course, this was about the NHS and for the South west, where everything is a lot cheaper than most places

She doesn't when she works private. Of course, this was about the NHS and for the South west, where everything is a lot cheaper than most places

I was talking about working for £75 an hour

I was talking about working for £75 an hour

So was i. She gets way more than that if she works private.

But this was a thread about the NHS

So was i. She gets way more than that if she works private.

 

But this was a thread about the NHS

And I was joking...

Mrs Goat is NHS. Has been for over 20 years.

Money is good but not wholly relevant to her. Could earn much more elsewhere.

Without people like her, healthcare in this country would be in a sorry state.

Thanks to Mrs Goat, and Mrs Bat for that matter. Nurses always tend to go unheralded (or is this like Davis being underrated, ie they actually aren't).

Thanks to Mrs Goat, and Mrs Bat for that matter. Nurses always tend to go unheralded (or is this like Davis being underrated, ie they actually aren't).

Quite a good comparison but you wouldn't want SD to treat you next time you get a light bulb stuck up your arse would you?

I still think charities are the way forward. No shareholders getting rich from the public purse, and no ingrained bureaucracy because you can kick them out if they are no good

So was i. She gets way more than that if she works private.

 

But this was a thread about the NHS

£75 a hour (sometimes way more than that) across a standard year would be £146k a year.

So fair play to your missus for pulling that kind of wedge for nursing.

I think it's silly to generalise about whether individual hospitals are managed privately or by the state. The same with railways, bin collections and energy generation. It should be about how they are operated, rather than who operates them.

I used to be a dyed in wool supporter of entirely publicly run services until I realised how much waste and inefficiency often occurs in such institutions and organisations. I also disagree with excessive profits that the private sector can make by having too much control of such facilities. But a mixed market keeps the checks and balances in most sectors and can be shifted as required from time to time by legislation or the private sector.

In my view, anybody who demands one over the other on principle is at best naive, at worst a zealot.

It's funny really - all this noise about Hinchingbrooke being privately run, Circle pulling out, bad reports from the care quality commission etc etc and yet nobody in the media or any politicians have mentioned that it's where I had my tonsils taken out.

£75 a hour (sometimes way more than that) across a standard year would be £146k a year.

 

So fair play to your missus for pulling that kind of wedge for nursing.

That for bank holidays. And I did say if she works full time hours. Which most weeks, she doesn't

That for bank holidays. And I did say if she works full time hours. Which most weeks, she doesn't

Pro rata that is extraordinarily good money if she's getting that.

Same for all contractors.

 

The deal is supposed to be that you swap job security for a higher rate of pay. However, in many industries, my own included, shortages can be so acute that the job security part is never really threatened.

 

The other thing is the theoretical headcount trick that accountants like to play. They're like:-

 

"Hey wow. Our permanent headcount is really low. Check out our low wage bill!"

"What about all them contractors? They cost loads."

"Them? Oh we can get rid of them tomorrow if we want to."

 

They rarely want to. As you say, a scandal.

Yup, exactly the same in my chosen profession. I am litterally on the edge of staying and going. I have never been a person obsessed with money, I earn a good living, live in a nice house in Fair Oak and have a healthy balance between work and social life.

The problem is the same contractors that I am told I have to use are now offering me double my salary (before the overtime they cream in) to make the jump.

Like you say, the flip side is apparantly less benefits and guarantees, except they get the same holidays, car schemes etc amd I have been told by senior management (when complaining we need to gain control back) that contractors are here to stay and we are too reliant.

Madness

Pro rata that is extraordinarily good money if she's getting that.

If every day was a bank holiday, yes.

You should see the money being ploughed into district nursing down here also

£75 a hour (sometimes way more than that) across a standard year would be £146k a year.

 

So fair play to your missus for pulling that kind of wedge for nursing.

This was my thinking

And if true, shows just why the NHS is struggling.

The more I hear of businesses being run by accountants the more I despair, they seem to just be interested in the bottom line of certain budgets and completely oblivious to anything based in reality

This was my thinking

 

And if true, shows just why the NHS is struggling.

 

The more I hear of businesses being run by accountants the more I despair, they seem to just be interested in the bottom line of certain budgets and completely oblivious to anything based in reality

What doctors/consultants get paid by agencies is staggering.

There are loads of health care agencies who operate in major hospitals. She (and some of her friends) are signed up to a few of them and depends who they do a shift for, depends on what set of scrubs they wear.

Just an example of rates.

http://www.thornbury-nursing.com/File.ashx?path=Root/Documents/DECEMBER%202014%20PAYRATES%20NEW!/TNS_SOUTH_PAY_RATES_Std.pdf

Some agencies will haggle with you if they are are struggling to fill their shifts

If every day was a bank holiday, yes.

You should see the money being ploughed into district nursing down here also

She must be on pretty good pay the rest of the year too? Does she work everyday?

The shift to agency work must have a lot to do with the state's pension obligations/liabilities -whether you're on the inside or outside does make a material difference, even if contractors do not see an increase in job insecurity etc.

What doctors/consultants get paid by agencies is staggering.

 

There are loads of health care agencies who operate in major hospitals. She (and some of her friends) are signed up to a few of them and depends who they do a shift for, depends on what set of scrubs they wear.

Well there is no blame for them following the money, I just dispair that agencies are able to claim that sort of money for their service (they'll be getting something ontop of that wage too). Which means it is pretty obvious why the NHS is struggling in most services and losing money here there and everywhere.

Its a long term fix aswell, all the time you depend on agencies/contractors you struggle to keep your own staff due to the wages elsewhere. This over-reliance is dangerous IMO.

Its all well and good looking at your revenue and claiming cutting staff numbers helps cut that budget by removing commitments (holiday/sick etc) but whats the point if you are paying over the odds for an agency that innevitably you will be committed to anyway ?

Nb - Im not an accountant

She must be on pretty good pay the rest of the year too? Does she work everyday?

Most of her and her mates who do it hire an accounting firm (same one) and they sort the tax out themselves the firm down here give them a free mobile phone and sort all their self assessed tax returns etc.

she will work 1 day a week some times usually two.

Obviously there is zero job security but the work seems endless at the mo

Well there is no blame for them following the money, I just dispair that agencies are able to claim that sort of money for their service (they'll be getting something ontop of that wage too). Which means it is pretty obvious why the NHS is struggling in most services and losing money here there and everywhere.

 

Its a long term fix aswell, all the time you depend on agencies/contractors you struggle to keep your own staff due to the wages elsewhere. This over-reliance is dangerous IMO.

 

Its all well and good looking at your revenue and claiming cutting staff numbers helps cut that budget by removing commitments (holiday/sick etc) but whats the point if you are paying over the odds for an agency that innevitably you will be committed to anyway ?

 

 

 

 

Nb - Im not an accountant

The agencies get this money, they don't claim it. If the agencies got less the rates would be less. The government will pay hand over fist to ensure we get the treatment we need and under 4 hours in AE etc

As I type this she is looking at district nursing as the money been released since xmas for that is immense. To try and take the pressure off of hospitals. They are even looking at a non emergency ambulance service (or something like that)

One agency she does work for will even sort out a B&B if for example she does 2 or 3 days in a row further away (like Truro)... She doesn't but that is the level of service (and money) some of these nursing agencies have

As for over reliance on this. She has been in the game for a long time and remembers when agencies were not as popular and the govt at the time (around 2003) seemed to be hiring more and more from the Philippines etc. now, hardly any remain in the UK as they got their qualifications and experience and went back home after a few years. (This is obviously South west experiences) leaving large holes in the numbers

What doctors/consultants get paid by agencies is staggering.

 

There are loads of health care agencies who operate in major hospitals. She (and some of her friends) are signed up to a few of them and depends who they do a shift for, depends on what set of scrubs they wear.

 

Just an example of rates.

 

http://www.thornbury-nursing.com/File.ashx?path=Root/Documents/DECEMBER%202014%20PAYRATES%20NEW!/TNS_SOUTH_PAY_RATES_Std.pdf

 

Some agencies will haggle with you if they are are struggling to fill their shifts

Thornbury nurses are the more extreme end of the pay scale.

IMHO as long as the Government are constantly shifting goalposts and shafting health secretaries, there will be stacks of cash 'wasted' on agency nursing.

Once upon a time the individual hospitals used to run their own 'banks' of clinical staff. They were forced to outsource this and set up contracts with a number of agencies. Nowadays, each Trust can do what it likes so there's no economy of scale.

Still, read this article - it explains such a lot

http://www.theguardian.com/society/guardianwitness-blog/2015/jan/08/surviving-night-nhs-hospital-a-and-e-doctors-story?CMP=share_btn_fb

I don't blame staff working for agencies if it suits their needs (eg not working in school holidays, only working at nights). I would be uncomfortable taking silly money out of the NHS in place of a permanent job but maybe I'm the crazy one

Once upon a time the individual hospitals used to run their own 'banks' of clinical staff. They were forced to outsource this and set up contracts with a number of agencies. Nowadays, each Trust can do what it likes so there's no economy of scale.

 

Still, read this article - it explains such a lot

 

http://www.theguardian.com/society/guardianwitness-blog/2015/jan/08/surviving-night-nhs-hospital-a-and-e-doctors-story?CMP=share_btn_fb

 

I don't blame staff working for agencies if it suits their needs (eg not working in school holidays, only working at nights). I would be uncomfortable taking silly money out of the NHS in place of a permanent job but maybe I'm the crazy one

Not at all but I fear you are of a dying breed:(

Yup, exactly the same in my chosen profession. I am litterally on the edge of staying and going. I have never been a person obsessed with money, I earn a good living, live in a nice house in Fair Oak and have a healthy balance between work and social life.

 

The problem is the same contractors that I am told I have to use are now offering me double my salary (before the overtime they cream in) to make the jump.

 

Like you say, the flip side is apparantly less benefits and guarantees, except they get the same holidays, car schemes etc amd I have been told by senior management (when complaining we need to gain control back) that contractors are here to stay and we are too reliant.

 

Madness

I left my job 18 months ago as a Business Analyst, and then went back 6 months ago on 3 times the pay I was on.

Insanity in my eyes, but hell, not my problem if they want to pay me that much.

Currently going through the process of making myself properly indispensable (which was why they wanted me back in the first place). Remember people, knowledge is power.

I left my job 18 months ago as a Business Analyst, and then went back 6 months ago on 3 times the pay I was on.

 

Insanity in my eyes, but hell, not my problem if they want to pay me that much.

 

Currently going through the process of making myself properly indispensable (which was why they wanted me back in the first place). Remember people, knowledge is power.

One of the first rules of business: if someone's indispensable, get rid of them. As an American company president once said to me: "nobody's indispensable, Kennedy gets shot, we've got a new president in 5 minutes". The man who said this to me dropped dead on a tennis court a few months later. His company continued without him.

One of the first rules of business: if someone's indispensable, get rid of them. As an American company president once said to me: "nobody's indispensable, Kennedy gets shot, we've got a new president in 5 minutes". The man who said this to me dropped dead on a tennis court a few months later. His company continued without him.

Yeah, that whole JFK thing turned out brilliantly for the late 1960s. Who wants a "peace at almost any price" President when you can napalm kids in the Far East?

I left my job 18 months ago as a Business Analyst, and then went back 6 months ago on 3 times the pay I was on.

 

Insanity in my eyes, but hell, not my problem if they want to pay me that much.

 

Currently going through the process of making myself properly indispensable (which was why they wanted me back in the first place). Remember people, knowledge is power.

As long as you do the latter in an honourable way, such as hard work and competence, that's fair enough.

It's the f##kers that deliberately withhold knowledge to retain power that irk me.

One of the first rules of business: if someone's indispensable, get rid of them. As an American company president once said to me: "nobody's indispensable, Kennedy gets shot, we've got a new president in 5 minutes". The man who said this to me dropped dead on a tennis court a few months later. His company continued without him.

Of course, and I won't ever be, but I know it would take 3 to 4 months to fully learn and understand the process for our International business that I put together, hence why they asked me to go back on such better terms. Not handed any of it over again yet...

As long as you do the latter in an honourable way, such as hard work and competence, that's fair enough.

 

It's the f##kers that deliberately withhold knowledge to retain power that irk me.

No chance. Don't want to be here more than 2 years anyway, due to IR35 issues if I am. I will have to hand it over again, but I have a lot to sort out that they screwed up when I left so until that time I will continue to work hard and sort it for them. They want me back permanent but won't change their wage structure to accomodate me currently...we'll see what happens in 6 months though as £300m of business going tits up was not good for them last time I left (or perhaps this time they'll get better analysts to outline systems changes instead).

No chance. Don't want to be here more than 2 years anyway, due to IR35 issues if I am.

You obviously know what you're doing. Congratulations, and good luck to you