Expert claims “the loser is the NHS” when it comes to privatisation

David Hunter

Professor of Health Policy and Management dissects the current healthcare scene

With constant re-structures and changes hitting the NHS full force, healthcare services have been struggling with organisational adjustments as well as fighting a losing battle with target times as both A&E and surgery teams come under the spotlight. David J Hunter, a professor of Health Policy and Management at Durham University as well as a Director of the Centre for Public Policy and Health shares his experienced insights into the current NHS scene and how this could impact on healthcare recruitment…

  • How do you feel locum and temporary staff impact on the NHS?

“I appreciate that locum and temporary staff are often necessary and can’t be avoided in all circumstances and therefore contribute a great deal to the running of essential services on a daily basis.”  

  • What recent changes within the NHS do you feel will affect healthcare recruitment agencies?

“The recent structural changes within the NHS have resulted in a lot of churn with a resulting loss of talent, skills and experience partly through people taking early retirement and a belief that they do not want to face another major upheaval.   Many staff are suffering from ‘reform fatigue’ following almost continuous organisational change in the NHS since the 1990’s. The issue is compounded by the austerity policies pursued by the government which has resulted in an acute fiscal squeeze in public spending from which the NHS has not escaped.  ‘Doing more with less’ is the mantra and making cost efficiencies while at the same time raising quality of care requires a different mindset and skill set on the part of the NHS workforce, including temporary staff. 

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“Being able to cope with and lead change is a prerequisite.  The introduction of new digital and other technologies also places demands on staff in terms of their IT literacy and ability to function in the digital age.  Other pressures on the NHS are resulting from new challenges and external factors.  Some of these are arising from an increase in non-communicable diseases, many of them lifestyle driven (eg obesity, mental health, alcohol misuse etc); a rise in comorbidities among both younger and elderly patients; an increased focus on integrated care involving new ways of working between the NHS and social care; and growing health inequalities which affect both the state of health of the population in many communities but also the availability of staff with employable skills.  To meet some of these complex needs there is a need for more generalists working in clinical areas of care.   Arguably the NHS and medicine generally has been too successful at encouraging specialists with the result that general medicine has been neglected.   Those skills are urgently needed both in primary and secondary care.”  

  • Do you think NHS privatisation will influence healthcare recruitment agencies?

NHS staff strike threat

“Let me make my position clear at the outset. I am wholly opposed to notions of markets and competition in health care generally, including the NHS.  I don’t consider them to have a legitimate place in this sector and believe they result in greater fragmentation and an erosion of the public interest.  Whether the process of ‘hollowing out’ the NHS is called privatisation, outsourcing, or putting services out to open competition, or some other term, the loser is the NHS and its public service ethic. But if the government’s policy is to put services out to competition, and if the commissioners of services are obliged by law to do that, then it is bound to have implications for healthcare recruitment agencies.  The Labour Party have made clear their intention to repeal those sections of the Health and Social Care Act 2012 dealing with competition and moving away from the NHS as the preferred provider.  This can only mean a period of increased uncertainty and instability between now and May 2015 when the general election takes place.”

  • What challenges do you see healthcare recruitment facing over the next few months?

“The political uncertainty surrounding the future shape and direction of the NHS, the growing demands on it and on already hard-pressed staff, and the need for increased spending and more staff at the front end of care are key issues but it’s unlikely we will see much resolution of such issues or much honest public debate this side of the election.   A period of uncertainty with severe pressures on funding the only certainty must create pressures on recruitment, including the NHS being viewed as not an especially attractive place to work.  With the economy ostensibly recovering, this will mean growing competition for skilled or any staff and the NHS will find itself competing with a range of other service industries both public but increasingly private.  The South of England is likely to be most affected by these pressures. Issues around the minimum wage and its increase or moving to a living wage represent another area of uncertainty, as do concerns about the zero hours contract culture and flexible labour markets which, while having some advantages for some people, are also open to gross abuse and exploitation. We’ve seen all these dysfunctional aspects of the labour market arise in the staffing of care homes many of which are now in the private sector.  Undervalued and untrained as well as hard-pressed staff has to be a factor contributing to care abuse in homes.”

[testimonial name=”Healthcare Expert – David J Hunter” who=”Professor of Health Policy and Management” imagelinks=”” vertical=”no”]”Based at Durham University, Professor David Hunter is an esteemed expert in his field, writing about healthcare for publications such as the BBC. Also the Director of the Centre for Public Policy and Health, Professor Hunter knows the industry like the back of his hand.”[/testimonial]