Ok, she was talking about ITV during its last proper franchise round in 1991, but she may as well have been talking about the NHS today, for it is sick. Militant junior doctors are holding tax paying patients and the Government to ransom with demands for premium pay at evenings and weekends and various other bonus payments when most of us are paid the same regardless of when and how long we work.
For a large variety of factors – predominantly time related, be it winter or weekend – demands on the NHS are notoriously variable, from the drunks who are glassed in a town centre at 2am on a Saturday to pensioners suffering from hypothermia on a snowy January evening, patients require the availability of professional care 24/7. Many recent studies have identified the very times when junior doctors want premium pay as the times when there is the highest demand for them. This would be fine if they were paid according to productivity – but they want the money because those times are “antisocial”, and if they don’t get what they want they’re threatening to take their £250,000 taxpayer funded training somewhere else, be it Scotland, Wales or sunny Australia. But you need only look at the definition of antisocial, which is “ontrary to the laws and customs of society, in a way that causes annoyance and disapproval in others.” It would seem that junior doctors’ interpretation of that is society might want an NHS that is there for them at Saturday teatime, and that rather annoys junior doctors who feel they should get an extra thirty per cent in their pay packet for just doing their job and if they don’t, we can all die.
It strikes me, if you’ll forgive the phrase, that two practices which I’ve experienced myself in my varying careers, would solve both problems.
In some workplaces, a system of annualised hours can be beneficial for both employers and employees. While I was working at an engineering firm in Sheffield work became scarce. The thing was, though, the forward order book was pretty healthy with large contracts in the pipeline, but in the short term there was little to do. This is typical in the manufacturing industry but highlights fluctuations in demand that can befall any organisation. In order to stave off redundancy a system of annualised hours was introduced.
Such a system sees employees work a certain number of hours over the whole year, but with a certain degree of flexibility about when those hours are worked. Normally, a period of regular hours or shifts forms the core of the arrangement, with the remaining time left unallocated and used on an “as needed” basis. Sometimes, the employee is paid in advance for the unallocated time, and may be called upon at short notice, perhaps to cover colleagues who are sick or on holiday, or according to a surge in demand.
Annualised hours are most often used for shift workers, but in theory they can be applied to any employee. They are most useful when dealing with big variations in demand throughout the year, and can help reduce overall working hours and overtime. ACAS, the arbitration service involved in the current junior doctors’ dispute suggests that “organisations that need to run twenty four hours a day all year, such as hospitals and the emergency services, can also find this arrangement beneficial.” Maybe they ought to have a nice word with the British Medical Association.
On the plus side, the system gives managers greater control over working patterns, with more potential to maximise efficiency. Employees may also benefit from longer and more regular breaks, and higher basic pay that’s received in even sums as a salary. But here’s the problem: when employees are currently enjoying high overtime earnings, annualised hours may be a disadvantage, which would have the effect of removing the cherry from the icing on the cake.
However, under most annual hours systems, overtime is removed and consolidated into basic pay. Employees may be required to work extra hours at short notice, which may disrupt planned leisure time, and be expected to work longer hours seasonally perhaps, in the case of the NHS, more so during the winter. But if the junior doctors decide they’re really not happy and do take their talents abroad, UK taxpayers – who have invested a quarter of a million pounds per junior doctor in training – will lose out. Happily, there is a solution.
When I first trained to become a bus driver – we are trained, unbelievably – I was trained by one of the largest multinationals that operate in the UK. I signed something called a training bond, and here’s how it worked:
The main concept – where employees either stay for an agreed amount of time, or the employer agrees to pay for a percentage of an employee’s training costs – seems reasonable, as since employees are the ones who will benefit in the long run, they should bear the cost of their own education. Doctors are funded by the taxpayer to get the skills that allow them to work in their chosen field. The training bond is an amount the employee agrees to pay back should they decide to leave the company before a specific time. Of course, the time an employee is required to stay with the company after training needs to be realistic as well. A ten year term might seem unrealistic, while anything up to five years minimum seems fair. Having the employee pay back costs on a pro-rata basis is also common practice in other industries. The cost of the training is divided by the number of months you require the employee to stay as a minimum, and therefore bond debt would be reduced by that amount or a percentage of that amount for each month of completed service.
Indeed, I myself signed a training bond with a company, was “tapped up” by an old friend who I went to work for, and duly repaid about 25% of the cost of my training. I understood that from the outset, and there were no hard feelings either way.
If employers use this type of formula, employees should not be reluctant to sign training bonds as these types of contracts are mutually beneficial: the employer has a trained workforce that they can count on for a minimum period, and the employee has an upgraded skill-set and an employment commitment from the NHS. This, combined with annualised hours, guarantees training, work and pay for junior doctors giving them real security.
Implementing these two simple and commonplace ideas would ensure that junior doctors are properly trained and can be called upon by their taxpaying patients whenever they’re needed. This is not about the Government having some ideological ccircle jerk over privatising the NHS. It is about security for junior doctors and patients alike, with the knowledge that fairly paid staff funded by equally hardworking taxpayers are available to treat them according to demand. In short, the NHS needs to grow up and behave as a service for the nation’s health, rather than a gravy train for junior doctors.