Leaders we can do without


News and Comment from Roy Lilley.

The three pillars of a good life; someone to love, a safe place to live and a job.

Mess with any one of them… you’ve a problem.  Personal bust-ups, rows with neighbours, issues at work… ready for any of us.

We’ll have the usual ups and downs but by and large, with any luck, not to have to worry, too much, about the three.  Certainly not, for most, working in the NHS.

With the pressures of the day-to-day we need stability.  Good old, boring stability!  

You can’t control what happens if the love of your life decides you don’t press the buttons any more and there isn’t much you can do if your landlord wants to sell the flat and turf you out.  You have to deal with it.

What you are entitled to expect is an employer, with the standing of the NHS, with a purpose and reputation for caring about people, not to mess you about.  

I was sent this local newspaper clipping...

Harrogate FT have decided to ship out three hundred-odd staff, to a tax-fiddle company, employ them at arms length, contract them back, to benefit from a loop-hole in the VAT regulations.

As you’d imagine the staff don’t like it.  They want to be employed by the NHS… thank you very much.  

The NHS is a fine institution, looking to celebrating its 70th year of public service and the staff at Harrogate Hospital would like to be part of that, not a cowboy company.

In my view, it’s highly likely that these fiddles will fall foul of Treasury Guidance (Box 2.3)

  • unusual financial transactions, eg imposing lasting commitments or using tax avoidance
  • unusual schemes or policies using novel techniques

Then there is The Health and Medicines Act 1988 (Subject to various updates and amendments) Sec 7 (7a) which allows the SoS to set up companies, a power and authority devolved to NHSI and Foundation Trusts own powers… but not, as far as I can tell… to fiddle the VAT-man.

Can Trusts do this?  

Why would they want to?  

Several Trusts have copy-cat schemes.  They claim the New-Co’s will bid for work from other entities and ‘grow a business’.  Poppycock.  

Who will sell the services and to whom?  At what margin?  How will the sales-staff salaries be funded, who will do the contract and legal work, at what cost?  Who will manage the ‘expansion’, what happens if it fails?  Are NHS assets, computers and the like, involved?

Can Trusts do this?  

They can set up companies and yes they can transfer staff, even against their wishes.  

What kind of a Board would want to?  What sort of an employer is it that would upset the working lives of good honest people who come to work, with pride, in the NHS.

You don’t have to be a clinician to have a strong sense of vocation. 

What sort of an employer is it that treats its staff as commodities, to be shipped around the system, under a flag of convenience, to fiddle the VAT man.  

What happens when the loophole is closed… and it will be… is there a way back to the NHS? 

Can the staff do anything about it?  

Yes, they can refuse to be transferred.  However, they then open themselves to the possibility of being declared redundant and the value of some redundancy settlements might, then, be in jeopardy. 

Pensions?  There are technical reasons why individuals must take independent advice, particularly if it is the intention NewCo might offer services to non-NHS organisations.  This gets complicated.

However, I imagine, if 300 staff in Harrogate (and everywhere else this cockamamie proliferates) got together and said, ‘no’, Harrogate hospital would have a problem replacing 300 people with equal skills and experience and the non-executive directors might have a problem explaining to the communities of 300 families, perhaps 1,000 people, why their breadwinner is out of a job.

This is no way for a decent employer to behave.  However pressed they may be to balance their books and meet their targets.

There are no benefits for staff, only risks, uncertainty and something else to worry about. This sends a message from the boardroom table, to the breakfast-table, ‘we’ll shove you around if it suits us’.

Are nurses next?  I wouldn’t bet against it…

Are these Trusts well led?  

No.  These are staff we need and leaders we can do without.


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