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You would be forgiven for thinking that there will be little remaining of the NHS by the time the next general election comes around in 2014. However, despite analysts suggesting that between now and then some 53,000¹ jobs will be lost in the drive to achieve £20bn efficiency savings in the health service, there is a danger of getting carried away with the ‘bloodbath’ rhetoric dominating the headlines.
The NHS is undergoing arguably the single greatest cultural shift since Aneurin Bevan’s vision of a state-funded health service became a reality back in 1948 – cultural in the sense that the job for life ethos now appears moribund having been replaced by the new buzzword “flexibility”.
Liz Eddy, head of skills and employment at health trust representative body NHS Employers, recently commented that if you were to take a job in the NHS today, it might not look the same in 18 months’ time. She said: “It’s really about your ability to work with the organisation and adapt and develop your skills as things change.” And she appears to be right.
Indeed, the shift in the nature of demand for healthcare professionals over the last 12 months has been significant. Locums, for instance, are increasingly being used by the NHS to bolster existing staffing levels on either a short or long term basis without the on-going costs of employing permanent staff. While this approach may have its critics, the increased dependence on locums is not only providing a cost effective solution to employers who may have lost highly skilled medical professionals due to the cuts, but also ensures the continued provision of quality patient care.
Admittedly, many people have suggested that employing locum staff to cover full time NHS posts is both detrimental to patient care and diminishes the skill set of an otherwise permanently employed doctor. But this would be a poor assumption to make.
The reality is that agency staff employed through the Buying Solutions Framework of approved companies are often vetted more thoroughly than permanent staff. Locums are required to be licensed to practice and invariably have a broader range of skills, often having worked at different hospitals and in roles that may not have been available had they remained in one location. As such, the increased dependency on employing locums need not be at the detriment to either patient care or those working within the NHS itself.
Cast your mind back to when David Cameron’s election pledge was to “cut the deficit, not the NHS”. The then Health Secretary of the incumbent Labour government warned that should the Tories come into power, they “will cut the number of nurses, the number of doctors and the number of hospital beds. It does not get more frontline than that”. But whilst the scale of job losses originally forecast has proven to have been grossly underestimated from initial predictions of 27,000², it is not all doom and gloom. Far from it.
Most of the cuts are likely to be achieved through natural wastage rather than compulsory redundancies. And as an employer of 1.4 million people, the NHS remains the single largest employer in Europe. So even if the number of jobs lost reaches the number anticipated over the next few years, more than 30,000³ people retire from the health service every year where posts will need to be filled.
Yes the purse strings may be tightening and the job for life culture within the public sector in general has already seemingly consigned to the history books, there are jobs within the NHS – and plenty of them.
At the time of writing, the number of live vacancies on the NHS jobs website stood at over 6,3004 – almost 80 per cent of which were for non-clinical posts, ranging from administrative to IT positions. BritishMedicalJobs.com alone has seen a 118 per cent increase in the number of vacancies being recruited for the year-on-year period April 2010 v April 2011, combined with a 55 per cent increase in demand for locum vacancies and a comparative 55 per cent boost in the number of online applications.
While it was expected that the loss of many permanent jobs would cause an increase in new candidate registrations and applications for locum positions in particular, no one could have quite anticipated the speed at which these changes would start to take effect. And should the government succeed in shedding the 53,000 jobs it currently predicts, employment within the health service will still be 1.34 million – some 341,000 more than when Tony Blair took office in 19975.
1. Health & Social Care Bill
2. November 2010: Royal College of Nursing estimated the number of jobs cut would be 27,000.
3. Health Business
4. NHS Jobs
5. NHS Information Centre