The Pharmaceutical Journal
Vol 270 No 7248 p647
10 May 2003

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Letters to the Editor

Agenda for change

Will hospitals be able to operate effectively?

From Mrs Annette Morant, MRPharmS

I read the news feature on "Agenda for change" (PJ, 3 May, p611) and I wonder whether hospitals will be able to operate effectively in its wake.

Within "Agenda for change" there is the National Health Service job evaluation scheme, which it is claimed "is a means of fairly rewarding people by measuring their job-related skills, knowledge and responsibilities". It can be appreciated that there will always be winners and losers with any such scheme but one can only wonder whether the new pay structure for managers — of whom there are apparently a greater number than beds within NHS hospitals — will actually reflect their true worth to the NHS.

There was, by the way, no reference to supply and demand or market forces in the original document.

Nurses are among the winners so it is quite understandable why they voted overwhelmingly to accept the proposals. Their top basic pay (not including additional elements such as London Weighting) is to rise from the Whitley Scale figure of less than £27,000 to over £37,000. Lower grades are also expected to gain appreciably. This is the outcome of the job profiling already carried out.

There are already some known losers. These include radiographers, all types of therapists, as well as the front-line secretarial and clerical staff. However, Ron Pate, chairman of the staff side of the Pharmaceutical Whitley Council, commented in the news feature: "We aim to get newly qualified pharmacists into Band 6". Since this is £20,300 to £27,500, it will hardly be any more attractive a proposition than today.

However, health care is a complex issue and not just about doctors (who are an entirely separate case), nurses and pharmacists. It also relies on a whole range of people acting as a team.

Although there is much lip-service given to recruiting staff, there continues to be a shortage in areas involved in patient care even though administrative staff numbers appear to be growing in an uncontrolled manner. For example, in much the same way as there is a shortage of hospital pharmacists, there is a shortage of secretarial staff. If their downgrading (and effective devaluation) results in them voting with their feet the results will be catastrophic. If the work of front-line clerical and secretarial staff in patient care, for example, booking appointments, arranging follow-ups, getting test results and typing letters to GPs, is not carried out effectively then hospitals will grind to a halt — even if they have a full complement of pharmacists and nurses.

In order to cope, the trusts will have to take on even more agency staff at exorbitant fees if they are to continue to provide services. This will eat into their already overstretched budgets and could well bankrupt trusts.

Even with this Government's sleight of hand, giving with one hand and taking away by increasing national insurance rates with the other, I cannot believe that it is setting out to undermine the NHS deliberately. I suppose it can only be another hospital blunder.

Annette Morant
Edgware, Middlesex

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