Agenda for Change (AfC) is another effort by the government to improve the perennial problem of recruitment and retention in the NHS. Any cynic will observe that the government never undergoes any programme of reform unless there is a significant money-saving element to it.
That same cynic will throw their heads into their hands to see the lack of joined-up thinking illustrated by the government’s support for NHS employers who want to alter the NHS pension. The NHS pension (in particular the final salary scheme) has always been a great attraction to (or a consolation for) working in the NHS; so it looks bad for employers to move the goalposts now. Health Unions argue that the NHS pension changes will even undermine the AfC changes.
But despite the prospect of more pay there are still reports of NHS staff shortages and warnings of a tighter squeeze on recruitment created by overspent NHS trusts. If the BMA and health unions' disenchantment with changes to their pensions continues and consultants continue to face long waits to see the cash benefits of their new contract coming through - 18 months after settlement - the Department of Health is going to have to work even harder just to persuade existing staff that a career in the NHS is still worthwhile.
The point is, as colleagues have coolly observed, instead of all these proposed improvements to recruitment and retention, why not spend the money on increasing our salary? But that would be too obvious.
When I hear about Agenda for Change I keep hearing the word assimilation mentioned. I am not a Trekkie, but this reminds me of the universal declaration of the Borg: “You will be assimilated. Resistance is futile.” In the case of Agenda for Change, resistance is indeed futile because it’s going to happen anyway no matter how much the health unions prevaricate, and the entire process just seems relentless. Is the government’s intention to turn us into half-robots like the Borg whose assimilation is to the collective (the NHS)?
Is this the hidden subtext of Agenda for Change? Are Department of Health bureaucrats secret fans of Star Trek: The Next Generation – and is this where they got the idea from?
