NHS staff - 50% higher rate of sickies

[MrBen]

I was really interested to read this in yesterdays Times.

The majority of arguments put forward to improve the NHS focus on government funding and the key external factors but always I think, way too little on improving current, internal efficiency and specifically people.

The report above shows that NHS staff have high levels of obesity, smoke more and throw 50% more sickies than their private sector counterparts. If the rate of sickness was to fall in line with non public sector workers they would save a massive ?555 million a year.

So (and I realise this is at a very base and simplistic level) why should I, as a tax payer, be funding these skivers and why do we have a system that lets people get away with it?

I feel I'm qualified to comment having spent a year working for an NHS Trust Headquarters and a hospital early in my career before embarking on 10 years in the private sector. At the time of leaving the NHS a senior manager tried to persuade me to stay by saying that whilst lower paid, it was much shorter hours with good benefits and "lifestyle". In other words "stay here if you want to take it easy". And I don't buy the argument that 50% more sick days is down to long hours and stress (you'll find both in abundance in the square mile)

So what can the NHS learn from the leanest most efficient models of private enterprise without compromising its socialist core values? And how do you feel about funding these lazy people who know they can't be fired easily?

[bignumber5]

So (and I realise this is at a very base and simplistic level) why should I, as a tax payer, be funding these skivers and why do we have a system that lets people get away with it?

And well done for uttering the phrase that instantly makes all NHS staff think you're a dick - we pay tax as well, you know. We also work hours that would make you (as a self-confessed desk pilot) shudder, with responsibilities that are overwhelming on a daily basis, and (as your post is pudding-eating proof) are still largely unappreciated by people who direct any intellect they have at picking up on the perceived shortcomings. The work in healthcare in the private sector is (at a very base and simplistic level) not as hard. The sickness rates are better. Yes, that is the arguement, yes it's valid, and no, being a manager obviously does not qualify you to comment intelligently since you have apparently spent that time with your eyes closed. Similarly increased rates of obesity and smoking do not point towards a workforce that eats and smokes instead of going to work, it points to a workforce that is in declining health itself. The tone of the article you have cited is attempting to highlight that. Maybe you could consider the implications of these factors rather than waving your misinterpreted copy of the Times under the metophorical noses of public sector healthcare workers, citing your status as a tax payer as an excuse to make an entire industry feel like shit.

[Huguenot]

Why is working in the private healthcare sector not as hard?

What are the hours that make people shuddder? My understanding is that the working time directive is followed by all NHS employees apart from junior doctors. That's 48 hours, which is kind of standard. My last full time job I averaged around 60.

Incidentally, you didn't really address the question about what the NHS could learn from these results?

[Canning]

Interesting discussion. I am not sure, however, that I trust the Times' statistical analysis. How can a comparison between the NHS, which is huge and a major employer in the British economy and the tiny, specialised private healthcare sector be valid? I believe it is well known that the NHS overperforms in terms of GDP consumed, this judgement has been calculated whilst comparing GDP consumed by other countries with similar levels of economic development.Obviously if staff sickness were addressed within the parts of the NHS where it is problematic the NHS would overperform even more.I am a little wary also about the political motivation of the Times ownership, the Tory party have made some false steps recently as regards the NHS. If they are to win the next election they need to create the impression in the public domain that there is some sort of case for the NHS to address, or they need to convince voters that those in the Tory party who want to attack the NHS are random nutters!

[Peckhamgatecrasher]

This may be simplistic, but doesn't working in that environment mean you have a higher chance of picking up bugs, etc?

[Jeremy]

PGC - that's exactly what I was thinking. Also, it seems reasonable that if you work in a hosptial, you should stay away from work if ill, to avoid spreading viruses and stuff (it's not always the case in the private sector).

[macroban]

The Times article does NOT say NHS staff "throw 50% more sickies".

[bignumber5]

Huguenot Wrote:

-------------------------------------------------------

> Why is working in the private healthcare sector

> not as hard?

>

> What are the hours that make people shuddder? My

> understanding is that the working time directive

> is followed by all NHS employees apart from junior

> doctors. That's 48 hours, which is kind of

> standard. My last full time job I averaged around

> 60.

>

> Incidentally, you didn't really address the

> question about what the NHS could learn from these

> results?

The work is easier, the hours are what they are (you don't have to stick around for hours after your shift has officially finish sorting stuff out), and the money is significantly better.

I haven't offered an answer to the question because it's a bollocks question being asked in a snide, presumptious way with apparently no understanding of the industry. That PGC has had to gently raise the issue of hospital acquired infection shows how far from the mark the OP has started. Jeremy, you are correct that there are regulations in place regarding return to work after illness for the purposes of infection control, and they are more stringent in the public sector. As Macroban points out, the article doesn't suggest skiving, it suggests declining health. The OP has reinterpreted rather differently to fit the point he seems to be trying to make.

I'm off to work now (I also don't smoke and I'm a good weight for my height, if you can believe such a thing). I'm aware that I've come into this all guns blazing but it's exactly the kind of tripe that makes my blood boil. Approach it in an intelligent way and I'll engage intelligently. Call my colleagues and I skivers who are lazy because they can't be easily fired, and "don't buy" any of the reasons that we try to use to explain ourselves, and expect to meet hostility.

NOT a good thread. Potentially a good thread, but started with a ridiculous, confrontational style and I'm seeing to it that it meets a response of the same. Rephrase the original post as a question for discussion rather than an accusation of the world as you see it and I'll come back calmer.

[Huguenot]

I don't think it was a Times survey, it was an independent audit of NHS staff and surveys were only a part of it. You can't deny the message because you don't like the messenger. Poor form. You'll find it in the other press also.

The audit actually assumed that NHS staff were genuinely ill. It said they were 50% more ill than the general population.

That was a generous assumption when you considered that the audit also revealed that results were inconsistent between hospitals (rather negating the 'made sick by patients' argument), and that the inconsistency paralleled other performance measures.

You'd have to review your own experience as to what proportion of these days were genuine illness and what was skiving.

It would be an intersting thing to know if it was the 'NHS' factor, or the 'public sector' factor. Presumably we can compare with other public sector jobs.

It would still be nice to find out if the 'long working hours' is a myth. Do the NHS or don't they subscribe to the working time directive?

[Tony.London Suburbs]

Having worked in a Nationalised Industry ( Coal ) for 16 years and known many other Public Sector Workers in Local Government ( Southwark/Lewisham, in particular) and known many Employees of British Gas and British Steel, I know it was ( is???) considered very poor form, at grass root level, if the average worker did not take up their share of "sickies" per year.

For the first few years at The NCB I was one of the few white-colar workers who didn't have considerable time off and my colleagues were ( generally) not impressed.

I would like to see a comparison made over all Industries regarding levels of absence between the Public and Private Sectors both working in similar environments, in the same line of work.

[annaj]

There are lots of reasons that sickness is higher in the NHS, so of which have already been mentioned, some haven't.

Manual handling (ie lifting and moving patients) is a big factor and a lot of sick leave amongst nurses is due to back problems (don't have statistics and don't have time to get them right now, sorry, but they're out there). Exposure to infection and infection control measures governing return to work after potentially communicable diseases are also part of it.

Hours do play a big part as well, not just the number of hours but the proportion of anti-social hours. Just to clarify something about the European Working Time Directive, yes, doctors are now covered by it and it means that we work 48 a week on average. But it's the last two words of that sentence that are really important. The EWTD states that over an eight week period we have to work an average of 48 hours or less per week, but there is no limit on how many hours we can work in a single week (well, apart from the obvious that there are only a certain number of hours in a week) and there is no limit on how many hours can be outside of the normal working day. So, for example, last week I worked 62 hours all of them after 5pm and that's completely legal becuase once every eight weeks I have a week off. There is research that has shown that working in the evenings and at night is bad for your health, so it stands to reason that people who work some (or in my case most) of there hours during evenings, nights and weekends will have more sickness.

The stress question is always going to be difficult, because no-one wants to feel that their work, and their stresses, are being undervalued. Of course there are stresses in every field of work and I don't think many NHS workers believe that they are the only people experiencing stress, but there is a different (notice that I'm not saying worse) intensity to working in clincial fields. The volume of traffic on this forum during the day demonstrates that most office jobs have at least some downtime and the same really can't be said of clinical work. I work 8-12 hour shifts and usually get a single half hour break in that time. The rest of the time I'm mostly on my feet and I'm mostly in contact with the public. It is intense and it is tiring. There is also the mental stress of dealing with death, mental illness, aggresion and violence, which again is different to that encountered in otehr lines of work.

As for the smoking and obesity, well, I think all that the figures show is that NHS staff reflect the general population, which is getting fatter and smokes.

To be honest the Times article raises more questions than in answers. Firstly, and most importantly, it's not at all clear who or what the NHS figures are being compared to. It say "the private sector" but is that private health care or other private industry? If it's private health care it's not a great comparison, because the hours are shorter and better paid and there's less acute and emergency work. If it's other private industry it's an even less valid comparison. I would also be interested to know how the figures are broken down, is it predominently doctors, nurses or administrators calling in sick?

Personally, I love my job and I think all the downsides are worth it. I also agree that the OP was aggresive, arrogant, accusatory and ill-informed, a year in an NHS office post early in your career doesn't make you an expert. The response to figures like these should surely be to see why this is happening and how it can be helped, not to shout "Lazy Skivers!" and start ranting about taxes.

Like BN5 I'm a non-smoker of a healthy weight and have only had two weeks sick leave in years, which was after an operation, so, I hope that's ok with you MrBen. Please keep paying my wages with your hard earned taxes and I'll do my best to keep treating the sick and injured and absorb the thankless criticism from every side.

[Canning]

Excellent post annaj! My partner works for NHS locally, she is too busy working to post .I am glad you have spoken up for her!. PS I said the same thing about the stats comparison by the way.

[Keef]

Good work PGC, if you're simplistic, then I'm right there with ya. First thing I thought was, "er, they work with germs".

[SeanMacGabhann]

top posting indeed annaj

I think I predicted something along these lines a few weeks ago

http://www.eastdulwichforum.co.uk/forum/read.php?27,326525,327755#msg-327755

and it is clear that the main purpose of the Times article is shite-stirring

As BN5 said in his post there are discussions to be had around this topic but when the question is so skewed to begin with..

To be slightly fair to the OP he is no desk-jockey and he works stupendously hard but where The City long hours culture is acknowledged to lead to burn-out after a few years, we hopefully want our NHS staff to be around a little longer than the average coke-sniffing trader

To be slightly less fair to the OP, the tone of the initial post was so self-rigtheous, unfair and indignant over something so petty it was a delight to read BN5's flounceatious reply

[MrBen]

This is the Drawing Room so I hope you don't mind my deliberately provocative Daily Mail style of question which was intentionally aimed to draw heated debate. And has done. Particularly where such an emotive subject as the NHS is concerned.

Firstly , by private sector I did not specifically mean the private healthcare sector nor, BN5, was I a faceless back room manager during my NHS stint. I was 22 and a lowly IT support guy but my work involved fixing critical front line systems on site which, as you'll know, were needed to save lives on a daily basis. Inefficiency in my work would slow the ability of doctors, nurses to respond quickly and I had to deal directly with those staff at all levels and yes, it could be very stressful at times.

But I think I need to be more specific before you all jump to conclude I'm having a pop at hard working doctors and nurses (who as it happens saved my life in 2006 at Kings - so I hope you'll understand my gratitude). They are fantastic public servants doing wonderful deeds but they should not be allowed to mask the deplorable inefficiencies and attitudes of lifestyle NHS staffers who are there for an easy ride.

The back office support and administrative functions take a massive chunk of NHS payroll and it was here that I saw a much higher proportion of people who thought nothing of treading water, milking the system and throwing countless unjustified sickies because they could. And they knew they could get away with it. Managers were often powerless to intervene, took a blind eye and many like mine, were themselves equally guilty. But it was the great unspoken and never addressed. A bit like an MP's expenses.

You're right AnnaJ, that my 1 year or so won't make me an expert - I was not claiming to be one - but I think it does allow me to draw some comparison with my time in the private sector where absence issues are mostly dealt with more efficiently. To be frank, dishonest workers throwing regular sickies without good reason would not last two months in most private sector companies. My point is that the NHS and the wider civil service allows this behaviour to thrive. Which equals inefficiency and a large part of the ?555 million loss to the NHS. Surely these are funds that could be used to recruit more doctors and reduce hours, stress levels, buy more heart bypass machines...whatever. There are dire funding issues at present having real impact on service and so I strongly disagree that this matter is a "petty" one.

The report found what many of us already knew (and in my case have witnessed) - that the rate of sickness in NHS staff is higher than the private sector, not just slightly, but a whole, whopping 1.5 times higher.

And I simply don't believe this is all attributable to the fact that "there are more bugs in hospitals" , stress and longer hours because other areas of the civil service are just as bad for absence problems. Whilst I'm not facing death on a daily basis, neither is your average NHS medical records clerk and at 60 odd hours a week myself to keep my business afloat, but I do know a bit about high stress, sleepless nights, fatigue and uncertainty. And I'm no coke sniffing trader. I care about where my taxes go and understandably don't see why I should fund someone's Monday in bed because they got caned the night before.

No question that The Times has some political motivation - look at their headline vs that of the Guardian for the same story. But the facts (i.e. a 1.5 x multiple) remain.

So....before I pile any more stress onto the genuinely hard working such as Anna and BN5 who would, I agree, take umbrage at my original post let me perhaps rephrase my question in a more specific and less provocative style:

Are there any learnings from the efficiencies of the private sector that could help deal with widespread dishonest absenteeism and help reduce the huge (1.5 times) differential in NHS absence rates thats currently costing taxpayers ?555 million each year and compromising NHS service?

Has anyone else worked on both sides of the fence?

[Canning]

Still say NHS is overperforming and the theoretical ?555 million is a red herring. Compare it to the billions saved by the NHS set against other healthcare systems in other countries.

[SeanMacGabhann]

The report claims that absenteism is 1.5 times higher than the private sector - but not everyone is rushing to claim that a large part of that extra 50% is dishonest absenteeism

Largely focused on what the NHS can do for the staff (as the reports does) rather than accusing them of being dishonest strikes me as fair enough and a way forward. But some people are obsessed with how much they are being fleeced by and therefore see it everywhere

Nor am I condoning dishonest sickies - but by the same token, would I trust anyone who NEVER EVER had a Monday in bed??

[Keef]

Lets be honest, lots of staff in all public seats jobs take sickies, it is true. However, a lot of sickness absense is genuine, and I believe that management structures, and stupid targets set by a government, but not supported by them, are the main reasons.

[Tony.London Suburbs]

MrBen Wrote:

Has anyone else worked on both sides of the fence?

If you mean The NHS ( Public/Private) Fence, then No.

If you mean had many years if all kinds of different Sectors then, Yes since 1971 when I started in The glorious Civil Service and the highlight of each work period was the Tea and Cake Trolley (free, naturally).

There is no comparison whatsoever between the total absences through sickness of The Public and Private Sectors and in most Industries the Private Sector is much, much more stressful as the Employers want their "pound of flesh".

First day back at dear old Lewisham Council and I made the ridiculous mistake of trying to get back into the Office at exactly 5.00PM, I was almost knocked down in the scramble to leave the premises and not at 5.05PM either..lol

As expected, Mr.Ben notes it is NOT The Doctors and Nurses, who everyone agrees do a wonderful, sometimes thankless task, but the Administrators etc who are much more likely to abuse the system.

There is also no comparison between the average Public Sector and Private Sector employee, as well, when it comes to work ethic. Much of that has to do with the vulnerability of most private service employees compared to their public sector counterparts.

OBVIOUSLY, as we are talking about millions of workers there are MANY exceptions, either way to the general rule but I defy anyone with 40 years solid all-round experience of all work Sectors to disagree, that, in general, there is not a massive difference in attitude and performance.

btw: I am not being all moralistic about this as I always tried to do the least work humanly possible when working for someone else. Miraculously I have not had one minutes absence in the 15 years since I started my own Business.

Funny that...

[MrBen]

I think we are talking about consistent, systematic absenteeism here - not the odd cheeky Monday in a year. We may have overlooked TLS's earlier post but I think his public sector experience here is typical - there are areas of the NHS where if you don't take a certain number of sick days it's almost frowned upon.

Why should we keep paying for this? And can we not adopt some private sector practice to deal with it?

[Keef]

Perhaps the administrators, often very highly skilled people, should actually be paid a fairer rate, and they may feel more inclined not to take the p!ss a bit.

[Tony.London Suburbs]

Mr.Ben : A good friend has told me that there is a hugely disproportionate difference between abseenteeism on a Monday or Friday compared with the 3 Midweek days.

I'd like to see National Stats for that and if this is the case for someone to explain why there is a such a great disparity in the absences on a Mon/Fri as opposed to Tue/Wed/Thu. ( if my friend is correct).

I'll leave you to guess which way round the absences are...

[Keef]

Tony, it is obvious. The much much more important thing to be asking here, is why do people do it? Please don't just say "because public sector is soft", as that is a simplistic soundbite of an answer.

[Huguenot]

Canning, I'd be interested to see this data that compares the NHS so favourably with elsewhere in the world?

[Tony.London Suburbs]

Keef Wrote:

-------------------------------------------------------

> Tony, it is obvious. The much much more important

> thing to be asking here, is why do people do it?

> Please don't just say "because public sector is

> soft", as that is a simplistic soundbite of an

> answer.

For the same reason that people rarely return to a Supermarket and inform them that they have been overpaid.

For the same reason, on the Racecourse, that if we ask people how much they staked ( which is not because we don't know) then 99.9% will, at best, say the true amount and 25% of those will actually say more, purely because we have planted a seed of doubt in their minds that we don't know and they might be able to get away with more.

For the same reason that 99% of people do not go back to Betting Shops that have overpaid them.

Human Nature, I'm afraid ( in many cases).

The fact is that it is much more difficult to remove somebody in a Public Sector Job, who is supported by a strong Trade Union. (ask Bob Crow)...