UK: Firms linked to tax havens profit from NHS recruitment crisis
By Joe Lo From The Ferret
Firms profiting from NHS Scotland’s recruitment crisis have links to tax havens and pay their directors up to £184,000, a Ferret analysis has revealed.
When NHS boards struggle to find doctors, nurses and other medical staff they use private recruitment agencies. But recruiting this way can cost up to twice as much as the budget for a vacant post, according to NHS Ayrshire and Arran’sannual accounts.
Some of the recruitment firms are ultimately owned by companies in tax havens like the Cayman Islands and Hong Kong – and their directors are highly paid.
Campaigners said the revelations were “depressing” and “appalling” and that agency fees were “sucking the blood out of the NHS” to the ultimate detriment of patients.
NHS boards say they are trying to reduce their spending on agency staff but are struggling to recruit, while the Scottish Government said agency staff should only be used as a last resort.
Overall Scotland’s NHS boards spent £152 million recruiting private agency staff in 2017-18. In total the Scottish NHS spends over £6.5 billion a year on all staffing, more than half its budget.
NHS spending on agency staff 2017-18
| Health board | 2017-18 agency spending | Agency spending as a proportion of salary and wage bill |
|---|---|---|
| Shetland | £3,506,000 | 15% |
| Dumfries and Galloway | £11,646,000 | 9% |
| Orkney | £1,570,000 | 7.3% |
| Highland | £16,202,000 | 5.5% |
| Grampian | £21,498,000 | 4.6% |
| Lanarkshire | £16,219,000 | 4% |
| Ayrshire and Arran | £11,208,000 | 3.4% |
| Fife | £8,469,000 | 3.3% |
| Borders | £2,785,000 | 2.9% |
| Lothian | £20,518,000 | 2.6% |
| Tayside | £10,074,000 | 2.4% |
| Forth Valley | £4,471,000 | 2% |
| Greater Glasgow and the Clyde | £23,822,000 | 1.8% |
Source: Health board annual reports
The biggest spenders on agency staff in absolute terms were the largest health boards covering Scotland’s major cities. NHS Greater Glasgow and Clyde spent£24m, NHS Grampian £21.5m and NHS Lothian £20.5m.
As a proportion of their total wage bill though, rural trusts tended to rely more on agency workers. Around 15 per cent of NHS Shetland’s staff spending went through agencies as did nine per cent of NHS Dumfries and Galloway’s and seven per cent of NHS Orkney’s.
In its annual accounts NHS Shetland said that retaining and recruiting staff “is the most significant risk to both the delivery of quality services and sustainable recurring financial balances.”
It added: “The use of agency and locum staff to fill essential clinical posts continues to be a financial cost pressure and (presents) challenges in maintaining continuity in a patient’s pathway.”
Most health boards, including NHS Shetland, are trying to reduce spending on agency staff through measures like recruitment drives, building up their in-house bank of staff and requiring senior management and clinicians to approve the use of agencies.
However, at several boards agency spending increased between 2016-17 and 2017-18. At NHS Lothian, it went up from £19m to £20.5m; at NHS Lanarkshire it went from £15m to £16.2m and at NHS Dumfries and Galloway it rose from £10.7m to £11.6m.
Most of this money goes to recruitment firms approved by NHS Scotland’s procurement body NHS National Services Scotland (NSS). These companies are paid when they fill a vacancy.
For more on this story go to; https://theferret.scot/tax-havens-firms-profit-nhs-recruitment/
