To think that one of the NHS’s biggest problems is that it’s almost impossible to sack anyone?

Very sad- this has not been my experience at all

And the re applying is across the board- so maybe a way of firing as the OP wants, but also very alienating to the very dedicated people who are also part of the NHS

Yes I think we agree in general.

Still it is very demoralising to have to re apply for your own job.

I think there is little thought given to the mental health of NHS workers (and probably other professionals like teachers etc) who are expected to be 'on' all the time

Sure, there are some terrible private sector gigs out there, and HR teams which don't have a clue about hiring, etc. I just mean, as a general principle, you can't use "but they are very stressed and have to jump through thousands of hoops every day" to imply "therefore, they are extremely highly skilled and well-qualified and producing amazing productive work". In my experience those kinds of people actively avoid places that have those kinds of hoops.

Definitely not the case in our department. We’re run off our feet.

I was reacting to the specific criticism of NHS - you seem to agree this can happen anywhere which was my point

I work in the public sector and we've sacked 2 members of staff in the last 6 months.

I've worked in the public sector for 20 years and have never worked with anyone who went off sick "for years". The longest I've known was a woman who took a year off when she had cancer. She got full pay for 6 months, then half pay for 6 months. I've never worked anywhere where it was possible to be off sick on full pay for longer than 6 months.

I think OP raises some valid points but the sweeping generalisations on this thread are ridiculous.

It can simultaneously be true that a selection/review process can be extremely onerous and also not reliably select for quality/performance. (In fact in my experience in the private sector they are loosely negatively correlated.)

I worked in the NHS as a GP for 13 years and yes, you are spot on....but true that all public services in the UK suffers from the same issue, whether that is civil service, teachers or local authority..

As an nhs manager this is so true. I spend hours with hr and occupational health talking about staff who find reason never to be in work and the gp signs them off without even seeing them face to face. It’s soul destroying. People play the system !

I work for an nhs trust. We employ a lot of graduates /under 25’s. (I’m in my mid 40’s). What I have noticed is that many of the younger staff whip their phones out at every available moment…. Waiting for a meeting to begin - facebooks/snapchat scrolling commences, a lull in work - phone out. The older generation would look for something quick to get done before the meeting begins - their mobile phones in handbags or lockers. We have so many staff that under perform and could be let go following a performance review if it were a private sector employment.

Also in 20+ years of working for more than one NhS trust I have only ever seen one person sacked, and one manager asked to take early retirement. I did witness a locum being let go with immediate effect when he flipped out and held a colleague to the wall by her throat. Sordid affairs, one colleague had a camera in the female lockers - he was given a managed move and a slap on the wrists. I’m also acutely aware that there are people who have slept their way to the top - and sit there on huge salaries entirely awful at their job. It is probably one of the most corrupt employers - apparently the police is similar.

I worked in an allied profession. All on call was overtime. Some months I doubled my pay.

Any extra hours worked(ie staying late) were either claimed as overtime 'calls' (over £20/hr when I first stated there 25yrs ago) or as TOIL rounded up to the next 15mins every time.

Oh yes the perfect journalists who can root out all of the corruption and solve all of the problems.
I have recently read articles which are poorly researched (about things which I know a lot about) and often just plain wrong or stuff about their daily lives of the standard of "I need to write 500 hundred words quickly"

Who would replace the people you would sack? Who are these angels willing to take on the job? Which is very hard and often thankless, as is clear here

I agree that there needs to be some change but there are on the most part very dedicated people working very hard in the NHS and trashing them is very sad

It does need reform but the problem is we can't pause the NHS while it's done. in order to reform it properly we'd have to run twin processes and funding where on the one hand for example we keep doing hip replacements on Older ppl who fall over and also fund the well evidenced preventative work that stops ppl falling in the first place which will take several years to work through the system but will eventually result in fewer hip replacements

I can't see how that can be done

Previous generations of GPs were not part of the commissioning process and required to attend a ton of meetings about what & how many services to commission from hospitals and community health providers

I have to attend a lot of these meetings and shake my head at GPs having to spend their time on them

This is just a civil service trope. There are lazy people everywhere. People in the NHS are actually under a lot of pressure. Have to reapply for thier own jobs etc.

Anyone remember when bright minds tried to get a grip of this by mandating annual reviews where the top 10% would be recognised by a management panel but the bottom 10% also had to be agreed by ‘moderation’ (horrible meeting deciding who to pick). The bottom 10% would then be put on mandatory PIP. If they didn’t improve in 6 months they would be managed out.

Those bright minds did not think this through or understand civil service culture and lack of HR support. We all complied. Morale tanked. Good people were targeted because they would be less trouble to target. The bottom 10% took out grievances and never improved or got sacked. The unions went crazy. The EDIA people showed there were more ethnic minorities put in the bottom 10%. The whole thing got dropped.

Then it was a push to improve the managers. Get them to be proper leaders. Just ended up with a load of expensive training that made little difference (although some was good).
I generally think natural leaders and good managers aren’t that prevalent in the public sector as they’re not a good fit. Too frustrating and not paid enough.

We do have some great managers but they struggle against the culture.

I have worked in the NHS and seen how it wastes money. If it was run efficiently there would be no need for more funding.

The whole thing needs complete reform. The model no longer works. It won't happen though because any attempt to improve it is politically toxic.

Unfortunately, we are expected to worship the NHS like a religion and never criticise it. We are told it's the envy of the world, but it obviously isn't, because no other country has ever tried to copy it.

We are supposed to believe that all the staff are selfless, hardworking angels living on cold baked beans and economy sausages. It is true that many are dedicated and good at their jobs, but a significant number are not.

What we need is a government with the courage to overhaul the whole thing and not be dissuaded by the howls of "They're destroying/privatising the NHS", or wicked attempts to scare people into thinking they wouldn't be able to have treatment if they couldn't afford to pay for it.

The fact is, most of us already pay for a "service" that often isn't available to us when we need it.

While the issue is live I agree wholeheartedly with your last line. That’s the trouble with these threads isn’t it, we all get defined by the problematic stories when for so many of us these types are very much in the minority.

It’s really grinding me down, I get told weekly how shit I am by members of the public, stakeholders, elected members who believe these stories apply to all of us. I like my work, it’s important, I’m good it and a busy day flies by. I’ve had jobs (in private sector) where there wasn’t enough to do and the tedium did my head in. The bullying, incompetence and general shitarsery by Peter Principle managers in the private sector was also worse, in my experience.

Well, I hate to remind everyone, but if Angela Raynor gets her way with the Employment Rights Bill, then things are going to get a lot worse in terms of sickness and absence and the legal handcuffing of managers.

Useful summary here: https://www.davidsonmorris.com/employment-rights-bill/ but the bill is well-documented online.

I am a GP partner and therefore run a practice. I have been a GP for 30 years and the job has changed massively. But none of my staff underperform.
My salaried GPs work 3 days a week. This is probably 30-36 hours a week with unfortunately many of them logging on from home on non work days to complete paperwork. I'd like to reduce this but would mean reducing available appointments. My nurses work all day. The only time they are not seeing patients is when the patients fail to turn up. But at least it gives them a bit more admin time. My receptionist's don't stop. My practice manager works her socks off and will stay late. And yes we have a robust probationary period, and I have sacked staff for underperformance. When I haven't they have left because they can't keep up.
And yes we make a profit - but that's my only income. We are not in deficit like hospitals because if we were I would personally be in deficit.

All (non big corp) GP practices are run like this. There is so little funding, there's no room for poor performance or slacking. But i don't disagree that bigger public sector organisations including hospitals will not work like this.

As a hospital consultant of 30 years, I could not agree more.

A minority of staff ruining it for everyone. It is very hard to get rid of them and HR processes are slow and cumbersome. The difficult staff just get moved sideways from team to team, and the problem continues as they are the one raising grievances and accusing others of bullying. It is extremely stressful working with these people on the team.

And the main issue is that the patients lose out. We can’t recruit better staff whilst the toxic members are in post. And if these kind of workers are unpleasant to colleagues, I worry how they are with patients.

I once heard a group of staff discussing amongst themselves how much annual leave and how much sick leave they had left to take. Of course there is genuine sickness, but I promise there are people taking the piss.

On reading this thread I question whether, in fact, as we are always hearing, the NHS is underfunded or woefully managed?

@StinkyCheeseMoose
This always raises a rye smile from me ....Private good/public bad is the kind of reductionist drivel you'd get from a teenage wannabe economist.
There are a great many examples of corruption and failures in private companies and the market...Water companies, Carillion, TSB (and most of the majority banks nearly bankrupting the country). The VW group diesel scandal....My particular favourite is the capture of the children's social care "market" by private equity firms which allow companies to go bust leaving vulnerable abuse children in unsuitable settings.
Equally scandals and incompetence in the NHS, the top of government (partygate was hardly the civil services finest moment) etc are also alarmingly common.
There are examples across the board in both the private and public sector of poor performance and a lack of accountability. If anything the commonality is a British thing (although see VW).
We have poor structures and systems for accountability in the UK in my opinion. Scrutiny via journalistic investigation or legal cases has diminished and we are still over reliant on leaders who come from a certain private school background that privileges over confidence and chutzpah over analytical skills and long term strategic thinking.....