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National Health Service Staff (Reporting and Registration)

Volume 615: debated on Tuesday 18 October 2016

Motion for leave to bring in a Bill (Standing Order No. 23)

I beg to move,

That leave be given to bring in a bill to make provision for the central reporting and registration of agency staff employed by National Health Service trusts, facilities and services; to make provision for the central reporting and recording of absence from work of permanent NHS employees; and for connected purposes.

The NHS has a budget of £116.4 billion for 2015-16. It is distributed among NHS providers, including 11 NHS trusts in England, one of which is the Wye Valley NHS Trust, which administers my constituency of North Herefordshire. In 2014-15, the Wye Valley NHS Trust budget was £183.637 million. Most of the trust’s expenditure is on staffing, which last year cost it £115.4 million—63%—of its total expenditure. That includes all staff—permanent, bank and agency.

Agency staff cost more than permanent staff directly employed by the NHS, because private companies dictate what our public NHS pays for them. The Government are working to limit that cost to the NHS by introducing a cap on fees paid to agency workers. I support and congratulate the Government on their work to limit the increasing privatisation of the NHS, because I am against the principle that private agencies can control NHS spending and I do not want the NHS open to abuse, which can be the case under our current system.

I propose the creation of a database of all workers in the NHS—agency and direct employees—and that it takes note of when they are working or claiming sick pay. Those data already exist in NHS bodies, and I would like them to be pooled to benefit the whole of the NHS.

There is too much reliance on locums and agency workers. We all know that our NHS staff are some of the most hard-working individuals, as they strive to keep our communities healthy and safe, but there is a struggle to fill certain gaps in staff owing to a lack either of individuals or of specific skills. That is a particular problem in rural areas, where there are simply fewer people with the specific skills that some NHS bodies require. That is compounded by the fact that those who are qualified can become agency workers and do the same job for more money. That, in turn, leads to the NHS employing more agency staff.

Between February and April, the Wye Valley NHS Trust used agency workers in the posts of band 2 healthcare assistants and band 5-plus registered nurses for an average of 1,966 shifts a month, at an average cost of £746,000 a month. That equates to £8.9 million a year for agency staff in those two categories alone.

That is why the Government’s work to cap the amount paid to agencies for their staff in NHS organisations is so important. Agency work cost £3.3 billion last year. So far this year, the price cap has saved £300 million, as the Minister of State, Department of Health, my hon. Friend the hon. Member for Ludlow (Mr Dunne), said in response to a question on 12 September, although I have heard that the figure is now much closer to £650 million. In order to support the excellent work that the Government are doing, we should accordingly require agency staff—and, in particular, information about their sick days—to be centrally registered on the NHS. Because information about agency workers is not detailed centrally on the NHS, staff may be employed directly with an NHS trust and also registered with an agency. These two employers do not share information about their workers, even though agency workers are based in NHS organisations. People may say that there are not enough staff in the NHS, but it is clear that there are if we count them properly. A register like the one I am proposing will also demonstrate the areas in which we need to focus our training resources, to make sure that we train the right people.

The vast majority of workers who are employed by both organisations are hard-working, honest people, but there are always some who seek to abuse the system. In 2015, a nurse who worked for an NHS hospital trust was struck off after making £10,000 by working agency shifts while on sick leave, and that is not an isolated case. Such cases cost the NHS not only through fraudulent sick pay but more generally as a cost to the public purse, and we also lose the individuals involved.

The NHS is aware of the risk of payroll abuse and sick leave fraud, and it has sent leaflets to members to make them aware of it. However, without a central system of data sharing between these bodies, organisations have to rely on hearsay to report abuse of the system. This is a good starting point, but it does not eliminate the risk of fraudulent activities , and we need the money to be saved for patients.

The lack of communication between the bodies needs to be rectified. We need to combat those who take advantage of the system by making information about employees more accessible to employers, to make sure that employees are paid fairly and the NHS does not suffer unnecessarily. The Bill would support the Government’s hard work to reduce unnecessary costs to the NHS by making it harder for those who take advantage of the system to do so. The Bill would create a centrally kept register of all the agency staff used across the NHS. The register would indicate when those staff were off sick and claiming sick pay. If those data were pooled, abuse could be spotted. The small cost that would be involved in pooling agency data is far outweighed by the risk of abuse and lack of control. All the data already exist, after all; it is simply a case of sharing them.

Information about the sick pay of NHS employees is already stored and reported on. For Wye Valley NHS Trust last year, the figure was just 4.33%. By the same yardstick, agency workers are paid by a public body, so their sick pay data should be stored and shared. There is no better way of managing the enormous agency bill than by ensuring that the data are used wisely.

People speak against the privatisation of the NHS, but that is exactly what will happen if the NHS loses control of its staff requirements. Agencies provide the staff our patients need for their safety. That must be controlled; otherwise, we will never be able to achieve the worthy target of getting the right pay for the right people, doing the right jobs. Our NHS staff deserve no less.

Question put and agreed to.


That Bill Wiggin present the Bill.

Bill Wiggin accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 24 March 2017, and to be printed (Bill 76).