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Tackling the agency spend problem the wrong way

The unlawful imposition of IR35 rules without recourse to challenge or consultation was met with mixed views. I am sure independent health professionals gasp in astonishment when NHSI state that capping agency spend provides “fairness to substantive staff“. 

Agency and Independent health professionals do not enjoy any of the benefits that their substantive colleagues have

  • Sick pay
  • Paid annual leave
  • Paid maternity leave
  • Paid appraisal and training
  • Death in service benefits
  • Access to NHS pension
  • No recourse to employee protection

and being taxed as an employee means that locum doctors will be put in positions where they have to fund all their work related expenses out of their own pocket.

This statement from an independent doctor captures the mood in the health service.

“Independent Doctors support their substantive colleagues, we’re all exposed to the same workplace pressures. More of them are being forced to strike out as Locums because pay and working conditions for substantive colleagues are intolerable. Rate caps won’t solve our substantive colleagues problems but rather deny them relief worker help – in turn making conditions worse and driving rates at which people will take extra hours up, not down. Our rates are governed by workplace environment, and what is driving them up is how horrendous the working conditions are. We will continue to advocate for our substantive colleagues to have better pay and conditions and support those who find the conditions of substantive work so intolerable that they strike out on their own.”

There has been a retention crisis in the NHS which has been made worse by the Secretary of State pushing the 7 day working agenda despite reservations from all corners. This led to the junior doctors contract disputes of 2017, the first full scale walkout of doctors in decades. Morale within the NHS is at an all time low, a decline that has been evident for several years.  The root causes of the disaffection remains untackled yet, locum doctors and independent agency workers are seen as the easy scapegoats to apportion the blame on.

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