to recognise that the point of the NHS is to pay doctors and nurses as little as possible

[yubgummy]

The whole point of the NHS is to have all healthcare purchases go through a single system, so that we can negotiate harder with vendors/suppliers due to being a single big buyer with control over the whole market - or so I hear a lot.

So why are we surprised that nurses don't get paid much - they are the "suppliers" who don't have any other options!

Please remember that AHPs are paid the sane wage as nurses, it's not just nurses who are affected or provide care.

That is not the point of the NHS, and in some ways the single unionised workforce should give immense bargaining power.

We are just a nation not much used to striking.

What is your understanding of nurses pay scales?

You say that they "don't get paid much" but you don't quantify that

Actually you are wrong, we buy things for our department from suppliers, there is no nationwide agreement

The point of the NHS is to provide free at point of use health care

I’m not sure what you’re banging on about and I’ve read your post three times.

The other option that nurses do have, is to leave, which is what a lot are doing.

That is not the point of the NHS.

You are also very misinformed if you think that the NHS (or any public sector) is any good at negotiating procurement on any scale. Most suppliers charge far more than on the open market.

The whole point of the NHS is to have all healthcare purchases go through a single system, so that we can negotiate harder with vendors/suppliers due to being a single big buyer with control over the whole market

Rewriting history much? That’s possibly the opposite of the ‘whole point’ of the nhs.

The whole point of the NHS is to provide a healthcare service for the people who live here. They are not obliged to be shit employers.

They're also not obliged to pay over the odds for staff just for the sake of being nice...

@yubgummy - the healthcare workers are suppliers who have plenty of alternative options - hence the very large number of vacancies (work for private sector, agency, pharma).

I personally think the point of the nhs is to reduce the bureaucracy of running an insurance/payments system. Let’s say you have compulsory health insurance - you now need to employ more admin staff to log patient insurance info (which company, which level of insurance), chase payment (eg if procedure not covered by insurance) or put in details of reimbursements (if patient pays then claims back). Insurance companies also have to employ actuaries, IT staff, accountants etc.

i don’t know about nhs procurement, but I’m pretty sure they don’t make the most of their bargaining power - because each foundation trust does it’s own thing. I think they independently commission their own IT systems and payroll. Why don’t they have a national nhs payroll system?

I would say that vaccine procurement seemed quite well managed. I wonder if they could do something similar in other areas?

@yubgummy

Why do you think nurses and doctors being paid a decent wage is over the odds?

What do you think they should be paid and what is you opinion based on?

Why don’t they have a national nhs payroll system?
They do, it's called ESR

No, the point of the NHS was to provide universal, comprehensive and free health care.

@RichardMarxisinnocent - when I worked for nhs a few years back I’m pretty sure I had to contact a private company to get the correct payslip. Didn’t realise it was part of nhs

It is not about being nice, it is about having a functioning service. The pay award criteria are down the to government, not the NHS anyway.

Nurses are leaving in droves to work privately doing fillers and pretty much every psychiatrist does private work on the side. If they were paid the same as in other countries e.g. the US, Australia or Canada retention would be much higher. It's like the opposite to the answer to every "why isn't my house selling?" thread. Everyone wants fair pay. I would say this wasn't the founding reason for the NHS but it has become a side effect of the way it is being run into the ground by underfunding.

Didn't someone suggest 12 admin per surgical staff.

I don't think they have always had a single payroll system, but they have some for a while. There are a small number of NHS organisations who don't use ESR but 99% do.