Thursday, December 07, 2006

(Temporary) Nurses On The Job

You have a problem with Nurse Klench?

The NHS spends an extrordinary amount on temporary nurses: according to the recent National Audit Office Report (blogged here), it's running at £800m pa, or 10% of the nursing paybill.

As we noted previously, this reflects the shocking lack of staff planning and management endemic to the public sector. Which is why the public sector uses temps around four times as much as the private sector.

It's been a problem for years, and at yesterday's Public Accounts Committee grilling of the NHS mandarins responsible, we got more of an insight into why.

The Chairman quoted from a twenty year old PAC report which highlighted exactly the same problem we still have. Had the NHS learned nothing?

NHS Chief Executive David Nicholson pleaded Not Me Guv: he was a mere hospital administrator at the time, and clearly the organistaion itself could not be expected to learn.

Labour MP Sadiq Kahn was concerned about the low quality of temps and their frequent lack of proper supervision. He said he was besieged by constituents complaining that temp nurses at St George's Hospital Tooting were unable to speak English, were too posh to wash, were not up to date with vital stuff like infection control, and changed all the time. Who was in charge?

Nicholson's pained response was that he did not recognise that picture of temp nurses., adding later "personally I've never come across language skills being a problem". You wonder if he ever visits the hospitals the rest of us go to.

Kahn also asked how many temp nurses were employed by the NHS. The extraodinary reply was that the Department doesn't know. At which point, fellow MP Richard Bacon nipped out of the meeting returning ten minutes later with a spreadsheet where he'd calculated an estimate based on the data in the NAO Report. The flustered mandarins asked if they could take it away with them to give a pointer to their thousands of admin gremlins who've been unable to crack it.

The mandarins' defence was that this was not an issue for them- it was the responsibility of NHS managers on the ground. Committee members were unimpressed. What's the point of you lot then, one asked.

The reality is that the top brass make their high level plans and set all those targets, but haven't a clue how it will be executed at ground level, and can't even monitor the impact once it's happened.

Anyone who ever for a moment thinks the guargantuan NHS can be fixed should sit through one of these meetings.

Sadiq Kahn is becoming more and more disenchanted. "Can you imagine," he asked, "how depressed some of us are, who not long ago argued for putting up taxes to fund the NHS?"

Sadiq, welcome to the real world of Big Government. Now do us all a favour and start arguing for breaking up the NHS into managable competing units.

PS Is it me or are the mandarins going to the dogs? Back in the days of Sir Humphry, surely the top brass used to be Oxbridge double-firsts, smooth as silk, and answering tricky questions with Latin aphorisms. Yes I realise they also used to fly us into mountainside regularly, but at least the cabin announcements were polished and reassuring. The new CEO of the NHS- the largest employer in the Western Hemisphere... I'm sorry, no offence... but he comes across as a senior clerk from a local building society somewhere up North. And the lady who runs NHS Professionals... umm how should we put this... possibly used to work at Nails4U in Basildon.

PPS This PAC meeting was attended by visiting parliamentary budget watchdogs from Slovenia and Kenya, both there to see how we do it. An interesting contrast. The Kenyans looked bored stiff and left after half an hour. The Slovenians looked riveted throughout, stayed til the end, and were talking about it excitedly outside... well, they were talking excitedly about something anyway. Now, where are you going to put your overseas investment?


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