Overpriced, but undervalued

The role of third party agencies in the delivery of health care has recently generated plenty of publicity, with much of the debate focusing on whether agencies represent good value for taxpayers’ money. We are paying what appears to be an extraordinary amount of money for interim staff, with an article recently published in The Telegraph highlighting the £3.3 billion bill for temporary workers.

News that revenues at Britain’s ten largest agencies have increased by 40% over the last three years has provoked minor outrage, with many British people generally seeing profiteering in the health sector as being at odds with the spirit and values of the NHS. However, this rise does not necessarily mean that the pockets of chief executives are being shamelessly lined by the public purse; rising revenues for third party agencies are simply a symptom of a lack of available healthcare workers. The vast majority of care agencies work under strict price controls from the NHS, and overpricing is a result of the NHS’ demand extending beyond these agreements.

Among the payments made by the agencies to the NHS, some naturally arouse significant amounts of attention. A prime example is one payment of over £3,200 to one doctor for a twelve hour shift. Finding a highly skilled professional available at a specific time in a specific location is very difficult, and will incur a high cost in any industry. Whether we like it or not, the healthcare system in Britain is not immune to market forces.

The NHS itself is also guilty of overpaying for staff, with the £47,000 monthly pay for a temporary trust finance director being a primary example. While overpaying for vital frontline staff when urgently required is sometimes an unfortunate necessity, such outlandish fees for executives are less forgivable.

Thankfully, instances like these are anomalies. The large majority of agency staff are extremely hard working and provide the health service with vital support for nowhere near this expense. Using specific examples of payments to highly qualified senior professionals to draw wider conclusions about the use of agencies is not productive, and should not feature in any debate.

Instead of examining a small minority of providers’ balance sheets, thinking about how the NHS’ structural resourcing problems can be addressed would be a far more effective use of policymakers’ time. The NHS would not function without third party staffing agencies, and until endemic issues are fixed, they will remain a fundamental part of it

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