Guest post: "Slashing pay for agency health workers won't solve the NHS's problems"

[MumsnetGuestPosts]

News of a surprise pay cut of 15%, effective immediately, landed in my inbox this week. The brief email made my chest tighten and I panicked. Our family, quite simply, can't afford it. Can anyone's?

The message told me that one of the hospitals I work in has cut its pay rates for agency nurses. So far it is only one hospital, but I know this is just the beginning as Health Secretary Jeremy Hunt has introduced a spending cap on agency workers to save the NHS money.

I have two toddlers and have faced the same career dilemmas as many mothers. If I put my children into full-time childcare, I would barely make any money after covering those costs. I didn't want to give up nursing after becoming a mother though. I love my career as a children's nurse, even on the most difficult days, giving it up wasn't an option, even if my family could afford for me to do so.

I never intended though to work as an agency nurse. In an ideal world, I would have continued to work part-time in the NHS after having children. That's what I did while my husband was self-employed and he could arrange his working days around mine. He's no longer self-employed though, and affordable, flexible childcare is a pipe dream.

Fewer hospital wards are offering set shifts - that is, the same days each week - so arranging childcare can be almost impossible. I don't know any childminder or nursery that would take two toddlers from 7:30am to 5.30pm (these are my husband's hours, mine are longer) on varying days each week.

I trained with the intention of working in the NHS, which I did before having children. But now it seems unwilling to offer me what I need: the flexibility to work when my husband is at home to provide childcare.

It was a tough decision to become an agency nurse. I gave up the guarantee of work every week, my pension, sick pay, the support of a team, and any chance of career progression or new training. What I gained was the flexibility to choose to work at the weekends while my husband is home.

As an agency nurse, the hospital and ward changes each week and some weeks my shift is cancelled. On those months we struggle or I give up a whole weekend the following week to make up the money - if I can get work. I don't see my children on Sundays, and I only see my husband for a few hours on a Saturday. It's a precarious situation but one that works for us.

So the agency pay caps won't just affect the consultants whose pay packets make the headlines. When the other hospitals follow suit - as they will - I will have to reduce those precious few hours a week we have together as a family to make my wages up to what they were previously.

I can no longer afford to work for the hospital that has already made the cut. I have cancelled my shift there this weekend.

I'm worried for my family as our already low income is slashed, but I'm also worried for the nurses employed there. They're already in an understaffed ward. This weekend will they have an even higher, possibly unsafe, workload when they struggle to get agency staff to fill the gaps? What will the impact be on patient care? Or patient safety?

When Jeremy Hunt announced the pay caps earlier this month, he said the days of companies charging up to ?3500 a shift for a doctor would be over.

"For too long staffing agencies have been able to rip off the NHS by charging extortionate hourly rates which cost billions of pounds a year and undermine staff working hard to deliver high-quality care. The tough new controls on spending that we're putting in place will help the NHS improve continuity of care for patients and invest in the frontline."

The caps are expected to save ?1 billion in agency spending over three years - but this absolutely must go back into frontline spending because otherwise cutting pay is short-sighted, in my view. Why aren't we working on attracting agency nurses back to the NHS with better pay, better working conditions and more flexible contracts to enhance staff retention rather than putting contracted staff under more pressure to cope without agency staff to fill in the gaps?

Slashing pay isn't really a solution - it's a good headline to make people feel like the NHS is saving money. In fact, the state of our beloved National Health Service is as dire today as it was yesterday, before pay cuts stretched my hardworking, low-income family - and the staff in that hospital - even further.

[duckwalk]

Very interesting read, thank you.
I gave up my much loved job in an NHS palliative care ward over 2 years ago due to the inflexible work pattern for parents. I worked for 18 months as an NHS bank nurse then took a job in a nursing home as I missed working within a team and all it brings. I now work set shifts every week and it really suits my family life but its just not what I want to do so I completely understand where you're coming from.
It's really worrying though for the NHS wards and the permanent staff there, as I know from experience that they already work dangerously short staffed, without driving their agency staff away.
Wishing you good luck and best wishes Amy.

[KitKat1985]

I completely get where you are coming from with this post Amy, and I write this as a nurse myself. However I think the core issue is that so many staff are now being driven away from NHS jobs into agency ones for the reasons you describe, whereas the NHS should be looking into hiring more permanent (or at least bank) staff, and making this a more attractive option instead of driving all their permanent staff away. [For non-NHS staff readers to this post 'bank' contract staff in the NHS basically work on a 'as and when' basis much like agency staff do, but unfortunately get paid considerably less and have less benefits, which is why many workers who want flexibility / better pay like Amy go to agencies instead]. I can understand the desire to go to an agency. I've thought of it myself. I could probably work half my current hours for pretty much the same level of pay, and have the flexibility to pick and choose when I worked around my DD. And it's not an option I've ruled out yet .

When I was at work last week I'd say about half the staff on our ward were agency staff. However, the agency nurses are a mixed blessing. Yes they provide staffing and prevent wards from being dangerously understaffed; but they are also expensive (on average I'd say they cost a ward double what a permanent member of staff does on an hourly basis once the agencies have taken their cut), they don't provide continuity of care (and for many patients it adds to their anxiety of being in hospital having staff who don't know them or the ward looking after them), and the quality of them is variable (though I should say I've worked with some brilliant ones - and I am sure you are one of them Amy).

I guess what I'm trying to say in a rather rambling manner is that the cuts to agency staff pay concern me less right now than the fact that the pay for NHS staff is being cut so badly in the first place that so many staff are leaving the NHS to work in agencies. The NHS needs to start to address this issue so they don't keep leaving in droves.