Health officials are drawing up plans to draft in thousands of extra volunteers to help the NHS cope with ambulance delays and hospital pressures this winter, according to a leaked document that lays bare the scale of the crisis in Britain’s healthcare system.
People will work for nothing in the NHS. Therefore low pay in the NHS is not what ails the NHS, is it?
And now for some fairly basic finance, this isn’t even economics. The cost of employing someone in the NHS is high. It’s the wages, plus the working conditions, the maternity leaves, the diversity training and, the biggie, the pension. The pension costs are not the contributions made, they’re the net present value of the future pensions – a much higher number.
The complaint is that the cash component of that total compensation is too low. While the financing of the entire system is high already. So, change the composition of the total compensation. Lower the future pensions to pay more in wages now. Job done.
Finally, a posit. NHS pensions, as with the state one, are pay as you go pensions. There’s no investment fund there. “Contributions” this week get paid out as pensions next. Thus violates Spud³’s insistence that pensions savings should be put to work to build the necessary investments for the future. So, that needs to change as well then. How can we build that glorious future society if the public sector is not using pensions to invest in building it?
Change all public sector pensions from defined benefit paid out of current cashflow into defined contribution ones with investment funds backing them and there’d be plenty to pay for that Green New Deal, wouldn’t there? Job done.
Try making this point to NHS workers and they get very defensive all of a sudden 🙂
I’ve long argued for this. Most nurses (indeed most public sector workers) don’t value their defined benefit pension schemes as much as they cost to provide. This applies even more do to younger nurses, who would much rather have higher wages.
The solution is obvious – reduce the accrual rate of the DB schemes, and increase in salary instead. Very broad brush calculations would suggest that the pension ‘costs’ on average c. 45% of earnings, of which employees pay c. 10%?
So halve the accrual rate (keep the employee contribution the same) and increase salaries by 15%.
Everyone’s a winner!
The key point of providing additional benefits to employees is that they need to value those benefits more than they actually cost. When the reverse is true, when the benefits cost more to provide than they are valued by the recipient, it’s stupid to provide them.
Not directly the NHS, but the crisis within the ‘Care’ sector. Lots of people moaning on the radio and tv about about a lack of staff and the need to source carers from abroad. No mention that tens of thousands of UK care workers were effectively sacked by HM Gov. because they chose to refuse the jab.
“From 1 April 2022, people carrying out face-to-face, CQC-regulated social care activities will need to be fully vaccinated against COVID-19″…
Remove the requirement and problem solved?
Give them less pension and they’ll have more money today, but since the pensions aren’t actually paid today that means the govt has to shell out more cash today. That alone explains why it probably won’t happen.
This could be done without changing from DB to DC (probably worth doing at the same time, since change is hard; but not strictly necessary).
Getting volunteers for an organisation that is broken and where staff morale is rock bottom should be a piece of cake.
As usual this looks like they are solving the wrong problem. As far as I can tell the ambulance delays and pressure is down to them not being able to free up beds for patients who need social care once they are out of hospital. This backs up the entire system making it all horribly inefficient. We had a solution for this decades ago: it was convalescent homes. Whatever happened to them? If the government can requisition hotels to house the flood of immigrants they could also do so to use them as convalescent homes, with a lower level of care that hospitals provide. These could be “staffed” with the odd experienced NHS nurse, paid carers and those volunteers who want to help solve the problem.
It would also be necessary change the law to make it very very hard to sue the system, otherwise it would still be paralyzed by the fear of moving someone out of a hospital bed to a lower level of care convalescent home.
Not true, TMB, there’s always the creeps, budding thieves, ‘angels of mercy’ and fantasists to rely on!
You think they’ll be screened out? They can’t seem to do that for regular staff!
@AndyF: ’…with a lower level of care that hospitals provide…’
Is that even humanly possible?
Thousands volunteered to help with transport during the Covid nonsense and were never called upon.
@JuliaM Your comment brings one J. Savile Esq. to mind.
@Addolff – “Remove the requirement and problem solved?”
That’s not how people work. Once someone has decided to make a change to their lives as significant as changing jobs, they need a significant incentive to switch back. Merely removing the reason for the first switch is unlikely to be enough.
The problem with the NHS? It is a centrally planned marxist construction. Its not all of the NHS of course. Parts are privatised. The parts that work OK! I am fairly sure someone called Margaret solved the problem of the tyranical unions, and she had a good go at the worst excesses of the State. Still a way to go though. Starting with splitting up the NHS and privatising it. I wonder how many people really want to continue with this large failing healthcare system?
Wonko, an overwhelming majority of people think that the NHS is a treasure that just needs a bit of a polish.
Huge numbers of people think that global warming is an immediate existential threat.
Many think that renewables / unreliables can cancel the threat of CO2 in the atmosphere.
and so on.
Mankind has an inexhaustible ability to believe in things that just aren’t true.
Its not all of the NHS of course. Parts are privatised. The parts that work OK!
GP surgeries?
Doesn’t say they’re unpaid, just says they’re not conscripts.
However, a conscript health service would be an interesting concept.
The pensions thing is something that irritates those in local government who have the nouse to work out what is happening. In local government the only option is a contributory pension – what you get is what you’ve paid in (plus growth, etc). Whereas in central government – which includes the NHS – there’s no pot, it’s a ponzie scheme.
Charles @ 1.30, You appear to imply that removing a ‘barrier’ to the entry of a supply into a particular market would not increase the amount of supply into that market. Really?
Some may choose not to return to the care sector if the mandatory jab requirement was lifted but you don’t take into account those who are presently barred from entering that sector who would choose to do so if said barrier was lifted.
‘I wonder why we aren’t getting enough peeps applying to join the Police Force now we mandate all applicants who wish to become Police Officers have a degree’…….
Give them less pension and they’ll have more money today, but since the pensions aren’t actually paid today that means the govt has to shell out more cash today. That alone explains why it probably won’t happen.
This could be done without changing from DB to DC (probably worth doing at the same time, since change is hard; but not strictly necessary).
There was a graphic going round Twitter that showed the breakdown of the package for nurses and assumed pension contribution was quite significant and too the package for an average nurse up to £50k.
This is all those chickens from wage bargaining in the past coming hoe to roost. Politicians thought they were being oh so clever by offering increases in non-contributory pension benefits knowing they wouldn’t need to find the money themselves and leaving the workers increasingly relatively worse off in take home cash terms.
There is a “community” paramedic and accompanying ambulance service in certain areas of North London, entirely staffed by volunteers, with the ambulances and other equipment paid for by charitable donations. It is entirely free of charge, and patients are taken to the nearest NHS hospital for treatment if required. It was set up because of the outrageous waiting times for NHS medics and ambulances which had led to numeorus preventable deaths.
I won’t tell you which community, but if I suggested that Steve would probably accuse them of stealing blood and limbs to satiate Zelensky’s cannibalism, and/or the secret genocide of white people, you might be able to guess.
@jgh
This is not really true. The LGPS is still a defined benefit Scheme and members receive their promised benefits, REGARDLESS of growth (otherwise) over the period. Yes in this case there is a fund, but where there is a shortfall it is the employer (taxpayer) that funds that shortfall, not the individual member. So this is nothing like the ‘normal’ private sector DC scheme.
So it doesn’t really solve the problem – benefits promised are large in relation to member contributions, hence massive taxpayer subsidies are required to make up the difference.
“You appear to imply that removing a ‘barrier’ to the entry of a supply into a particular market would not increase the amount of supply into that market. Really?”
When an employer starts to beat their employees, then stops and promises not to do it again because they are struggling to get employees, do you think many people will take them at their word?
Those who left care home work because of their anti (covid) vaccine stance and those who are still unvaccinated now are unlikely to put much faith in promises that ‘its different this time’. So no, dropping the vaccination requirement is unlikely to result in much of an increase in labour supply. People aren’t stupid and they can remember more than 5 minutes ago.
One thing I don’t know, and haven’t been able to find out, is whether the NHS budget includes the real cost of the pension, whether it has a nominal amount in it or whether it’s not included at a..
Cos if it’s not fully included the NHS budget, then surely the real cost of providing the pension should be added on top. Wonder if it would make much of a difference in those NHS spending as % of GDP stats.
@njc
I think there is a ‘notional’ cost of the pension included – from memory it is based on some prolific assumptions and thus was roughly half of the true cost yo the taxpayer.
Jim, it will be interesting to see if the US military has fewer leavers / more recruits over the next year or so now that the jab mandate has been dropped………
@Addolff – “hose who are presently barred from entering that sector who would choose to do”
Who are these people and why didn’t they enter the sector in 2019? We don’t produce enough people from our own education sector, and limit immigration so there is no pool of workers keen to sign up as soon as they can.