NHS Agenda for Change

The story is that the NHS (National Health Service) is the world's third largest employer - behind the Indian railway and the Chinese army. That's quite a feat.

Agenda for Change is a national programme of workplace reform, designed to ensure that everybody gets paid the same amount for equivalent jobs, to make things fairer. And hopefully save a bit of money in the process. There are a staggering number of different salary scales, and it must surely reduce bureaucracy and overheads to simplify this. A laudable principle.

However, Agenda for Change is not the way to achieve it. Firstly, it had to be funded - but it must have cost hundreds of millions of pounds to carry out - money which is then not available to spend on anything else. Every aspect of every job has to be analysed, and the rewards that should attach to everything - qualifications, emotional and physical stress, antisocial hours, unpleasant working environments, responsibility - had to be quantified. This was used to produce a baseline of salary scales. Then every single post had to be matched against this list, to determine the amount of money that the person should be entitled to. This is a process that involved every person reviewing their own job description, and then meetings to match each job to bands. This process has overrun in many places.

Also, people's remuneration is to be protected for 5 years anyway. That's important - you can't simply take people's salary away. But what this means is that assessed salary increases are going to cost the NHS more, but there won't be any savings in salary for years. So ... unsurprisingly, hospitals can't afford it. The process has been carried out in at least one place, and the hospital management has then said, "We can't afford it. Do it again, but cheaper." So is there any way in which this can possibly be an objective measurement across the whole NHS?