Today "The government has announced measures to clamp down on "rip-off" staffing agencies used by the NHS to plug gaps in nursing and doctor rotas."
The plan is to set a maximum hourly rate of pay. The government will also try to stop financially struggling NHS trusts from overspending to temporarily fill staffing gaps.
Sounds a plan on the surface but there is a great deal to consider.
Temp agencies have overheads and not all are ripping the NHS off. If an hourly rate cap is put in place will some agencies simply drop NHS contracts? There is nothing to say they have to supply temps permanently to the NHS.
As NHS contracts fixed or casual come under attack expect staffing issues inside the NHS to deepen.
Agencies that rely on the NHS to keep their business afloat may go to the wall. How many agencies are run by bosses with links to government we wonder? Will these numbers increase as the cap begins to bite? That is quite possible if you know or can anticipate the government's next moves.
When an hourly rate cap is put in place how will it be monitored? Is that going to increase bureaucracy in the NHS and introduce another tier of costly management?
How many agencies will simply reduce the fee paid to their temp rather than take a financial hit themselves? Employers of temps via agencies pay a fee which is made up of money for the worker and a fee for the agency. Shifting the pay to fee ratio may leave the temp out of pocket.
New temps may settle for less money but if you have been paid a particular rate of pay to cover nursing shifts on a temporary basis will you accept a drop in pay?
Agency nursing staff has been one of many thorns in the side of the NHS for some time.
There are situations when temps on wards are getting paid more than the permanent staff and this can cause resentment.
However a temp may work regularly or infrequently and miss out on perks. It is the usual case of 'swings and roundabouts'.
But when BBC News reports "NHS foundation trusts in England spent nearly £2bn last year on agency staff - more than twice the planned amount" you know something has to give. "Health Secretary Jeremy Hunt said the cost of agency and contract staff across the entire NHS in England last year was £3.3bn and staff costs had spiralled out of control. On one occasion, an agency nurse cost the NHS £2,200 for a 12-hour shift, and a doctor £3,700 for a 30-hour shift."
Expensive management consultants rip the NHS off big time. Created jobs under the vague term of 'project manager' pay over the odds to a favoured few.
But in the end if temps do not plug nursing gaps on NHS hospital wards who will suffer the most? The patient’s first and foremost but of course other staff suffer along the way.
Will the Tory government care if the NHS fails?
Why would they when most of them can easily afford private healthcare. They may use the NHS but in times of dire need they have other alternatives. The majority of the electorate do not.
NHS spending: how temporary staff keep the health service going
Fast forward to 2015 and some citizens call their GP or an ambulance for trivial or non-existent health emergencies straining the NHS to the extreme.
And if you have a real health emergency it is also very different in 2015
Luckily it is two years since we experienced a health emergency at night and put in a call to our GP. My husband was flat out and an emergency call was necessary.
I was put through to an out-of-hours service that initially asked that we go to a night surgery across the city. We have no transport but even without those issues the patient was not fit to travel even in a taxi.
The responder understood but it would take time to get a GP to our home with no guarantees as to when.
A decision was made to contact an ambulance and husband was taken to hospital and admitted for three days; in the end it was not a serious matter but he did need treatment.
Back to the past
The issue of night visits is not new. In 1972 when my mum suffered a life-changing and ultimately life-taking stroke she was let down by her GP. He failed to visit in time resulting in a night-call-out but a locum attended. The locum did his best but without mum's medical history and notes it was deadly.
But that was an exception rather than a rule.
Out of hours service 2015
A mixture of heavy patient demand and a commercial out of hour’s service is potentially lethal.
It adds pressure on hospitals and the ambulance service as desperate people bypass what they see as a failing service.
Most GP practises in the UK now use outside contractors to cover out-of-hours services; about half of the companies used are not-for-profit with around a quarter commercial private contractors.
New technology adds an extra dimension to healthcare and the access of patients notes in 2015 but a 'family doctor' with your best interests at heart remains hard to beat.
Patient satisfaction with private companies providing out of hours care is poor and although researchers say the reasons are not clear we could all form an opinion on that one and the following statement from the Mail Online report which says "NHS providers scored highest on timeliness, patient confidence in doctors, and overall care experience."