NHS workers who take sick leave are claiming tens of millions of pounds a year in overtime and anti-social hours allowances while off work, the Daily Telegraph can disclose.
By Rebecca Smith, Medical Editor
Published: 10:00PM BST 21 Aug 2009
More than one million NHS staff are paid well above their basic salary when they are ill under a contract which guarantees them a far better deal than those working in the private sector.
The generous terms mean that when they are on sick leave they receive full pay, plus a selection of benefits. These include supplements for unsocial hours and overtime for six months, with half pay for a further six.
The deal means when an NHS worker - such as an ambulance worker, nurse, porter, or midwife - goes off sick they are paid according to an average of their total pay for the previous three months, rather than just their basic salary.
In many cases, workers have boosted their income by working nights or extra hours, or are paid a ‘recruitment and retention’ bonus, which can add tens of thousands of pounds to the basic salary of a middle grade worker living in London.
The NHS has higher sickness rates than the rest of the public sector and enjoys the most generous terms and conditions while off work. The service loses 10.3 million working days annually due to sickness absence alone, costing £1.7 billion per year.
Critics have said the scheme is "morally and ethically wrong" and should be reviewed.
However, supporters said NHS workers are exposed to unique pressures, with 56,000 physically attacked each year, and they deserve to be looked after.
The news comes after a report this week found that, of the 1.4 million workers in the NHS, 4.5 per cent or 45,000 call in sick per day.
Stephen Alambritis, of the Federation of Small Businesses, said the sick pay terms should be reviewed, especially in light of the recession when all workers are being asked to make sacrifices.
He said the organisation has been 'caught out': "To have sick pay going for six months and include overtime and extra payments does seem to be overly generous; an employee in the private sector would not expect that.
“NHS staff do a sterling job and there is huge stress involved in the work but the pensions are good, the sick leave is good, it is not brilliantly paid, but there is security of tenure.
"In the private sector the stress comes with the fact the job may not be there the next day."
The average NHS worker takes 10.7 days off sick a year, compared with 9.7 days for the public sector as a whole and 6.4 days in the private sector.
The Telegraph has received allegations of NHS workers asking managers when their six months on full pay expires so they know when to return to work, people booking holidays and then taking sick leave to cover the time off, and posting photographs on Facebook of themselves out with their children while off sick.
The terms and conditions on sickness absence are included in the Agenda for Change contract which covers nurses, midwives, hospital porters, paramedics, ambulance workers and administration staff, but not doctors. The wage bill for the contract in England was more than £28bn in 2007/8, according to the National Audit Office.
Under the contract, full pay is paid for the first six months off sick and then a further six months at half pay after five years’ service. Before then, the length of paid time off is on a sliding scale.
Overtime, over the standard 37.5 hours a week, and unsocial hours, for working nights or weekends, is payable at time and a half with public holidays paid at double time, or lieu time can be requested instead.
Staff can also receive around £3,205 in 'recruitment and retention premia' where employers find it difficult to fill posts, while those in inner London are paid a 'high cost area supplement' worth 20 per cent of basic salary, to a maximum of £6,080.
In the private sector, standard sick leave normally includes a short period on full pay, around one month or six weeks, followed by statutory sick pay paid at £79.15 per week for people earning £95 or more. In many cases employees are automatically put on statutory sick pay, once they qualify - which is when they have been off sick for four days.
Dr John O'Sullivan, an occupational health consultant in the private sector, said the NHS terms were 'morally and ethically wrong' and there was little incentive for staff to return to work.
"This is taxpayers’ money. The NHS has the expertise to get people back to work but they just do not use it on their own staff."
The Health Service terms and conditions also eclipse other areas of the public sector: police receive full pay for six months and then half pay for a further six, but do not receive any overtime. Teachers get full pay for 25 days off sick then half pay for 75 days in their first year, rising to 20 weeks’ full pay and 20 weeks on half pay after four years working.
Neil Carberry, Head of Employment Policy at employers’ group, the Confederation of British Industry, said: “The inclusion of overtime and other extras makes this a more generous scheme than the private sector norm, and the overall approach in the NHS to the management of absence and long-term sickness is a real concern.
“Firms use occupational health provision to ensure all absence is genuine, and innovative rehabilitation policies that get people back to work sooner. The NHS should do the same.”
However, Sian Thomas, director of NHS Employers, said: “There is no evidence that withholding pay leads to increased efficiency and improved staff morale. In fact, it can be counter productive because it leads to feelings of resentment and de-motivation among all staff.
“In order to successfully tackle sickness employers need to address the long-term problem. In the NHS this includes preventing injury from lifting and handling, helping staff build up their emotional resilience and reducing physical and mental abuse from patients.”
A spokesman for Unison, the union, said overtime was “very much a thing of the past” : "We have to look after our NHS staff. If they are not fit and safe they cannot look after patients. If you go to any A&E department at night at weekends you can see the levels of violence and abuse staff face. Paramedics in particular are at risk of attack."
A spokesman for the Department of Health said: "Agenda for Change provides a fair pay system that recognises the dedicated work that over 1.1 million NHS staff do every day to help us deliver high quality patient care to all.
"We take the health of NHS staff seriously. The ongoing NHS Health and Wellbeing review is crucial to achieving our ambition to develop world class health and wellbeing services for all NHS staff.”
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