Asking too much

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News and Comment from Roy Lilley.

An organisation can only travel at the speed of its people, deliver what its people are trained to do and only what they're willing to do.

The last seven-odd years have been super-tough for the NHS.  The legacy of a forgotten generation of frail-elderly has caught up with us. 

Hand-to-mouth, flip-a-coin-funding.  Political bewilderment  The sky is dark with chickens coming home to roost.

We've no money, we're running short of recruits, patients queueing around the block.  It'll get worse.  

Huge pressure... everyone working at the ragged edge.  How do we show we care... say 'thank you' for what you do.

Here's one solution;

'... as our way of saying sorry about not treating you very well we are going to give you a pay rise.  We are going to tell the press it's a lot of money.  It isn't...  and, to help pay for it, we are going to cut your annual leave...'

That'll work... won't it?

After months of secret negotiations the cat is out of the bag.  According to the Guardian... 

'The government is set to offer around 1 million NHS staff a 6.5% pay rise over the next three years... insisting that [staff] give up a day's holiday in return...'

You couldn't make it up.  Maybe they have?  

First; no one seems exactly sure what the national pay bill is.  The National Treasure, Nigel Edwards at the Nuffs, says the holiday sacrifice is worth a pay-cut of 0.4% to the individual.

Next; no increase since 2010... roughly, a 14% cut in real money terms.

Third; the headline, '6.5% pay rise'.  It is actually 3% in the first year and then 1-2% in the following two years... inflation will erode its worth.

Last; the uplift is not universal, it's weighted to benefit lower paid staff.

The plans aren't agree and won't feature in Chancellor Hammond's Spring Statement.  Mmmm...

It is inconceivable unions will agree.  Three days leave, in exchange for a few quid, is a mugging; '... give me your phone and I'll give you back your trainers.'

The Treasury said, the NHS can't have any money without improvements in productivity. That's fair.

Here are some factoids...

  • Funding for health care as a proportion of GDP is forecast to fall from 7.6% in 2009/10, to 6.8% by 2019/20. 
  • Growth in health spending won't keep pace with the growing, ageing population.  
  • Spending per person will fall by 0.3% in 2018/19. 
  • From 1948 to 2010, the number of patients has doubled and the number of beds halved. 

NHS' productivity increase is about 1.2% a year and the wider, UK economy, under one percent.  As the FT reported;

'The most recent growth in [UK] productivity was due to the number of hours worked falling rather than an acceleration in the growth of output....'

The NHS is doing better than the rest.

You can see what's coming.  If you can't get outputs up, get the same stuff done by fewer people... call it productivity.  It's not.  It's more work for fewer people.

Lose 3 days leave... who cares?  Go sick - get them back. 

Here are a few more things to think about...

Business productivity is around 20% lower than pre-crash 2010.  

In the NHS it's up.

Companies, going broke, have invested too little.  

So has the government in the NHS but it's doing better.

Productivity is measured weirdly - dividing GDP by the number of hours worked... potty.  

High-value banking at the top end, versus high labour-intensive, caring for your granny's bottom end.

Low interest rates have made junk businesses seem profitable.  

When local health economies run dry, NHS Trusts are surcharged punitive interest rates.

Businesses have hung-on to unproductive workers, distorting productivity numbers.  

The NHS does not have enough workers.

If Unions agree to this pay deal... stop your subscriptions.  If hand-wringing Boards, grizzling about how they value staff, agree to this... take them to a quiet corner and put them out of our misery.

We go to work to earn the money to pay for the house we leave behind most days, to put the food on the table for the family we hardly ever see, to drive a car that sits in the carpark all day... the least that could happen, when we are working, is we are valued, prized and treated fairly.

Just who is asking too much?

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roy.lilley@nhsmanagers.net 

Know something I don't - email me in confidence.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.