McTernan – on Politics

The furore over the recruitment of nurses from developing countries
to work in the NHS highlights one of the most pressing questions
for the public sector. Where is the future workforce going to come
from? This is not a short-term problem. It is the consequence of
long-term demographic change – an ageing population is matched by a
shrinking number of younger people.

Our traditional public sector employment model is based on
recruiting staff at age 18-21 and keeping them until retirement.
That is not going to work any longer because, even if there were
enough young people for the caring professions, business also wants
to employ them and will always be able to outbid public sector

What, then, is to be done? There are two possible futures. We can
see the outlines of one of these already. In many hospitals and
social services departments agency staff are in the majority in
many grades. The staff earn slightly more pay and are given more
flexibility than they would otherwise get – and the agencies make a
tidy profit.

Peering slightly into the future, one can envisage a point where
all staff realise that if they resigned en bloc and formed a
co-operative company they could sell themselves back to the NHS or
local authority at a premium and generate profits for themselves.

Apparently, this model is being considered by orthopaedic surgeons
in response to government plans to involve private providers in the
acute sector. The consultants realise that, by leaving the NHS and
selling back their specialist labour, they can name their price.
The truth is, though, that you can see how this could be done right
across public service organisations where there is a shortage of
skills – from child protection to maths departments. The challenge
for our organisations is that once you do this the glue that holds
the institution together vanishes and there are likely to be real
service costs.

The alternative is to re-engineer our mental map of public sector
careers. Can we imagine recruiting people not for their whole life,
but for a portion of their life – as little as 10 years? For
example, more than half the men in Britain who are over 55 are not
in full-time employment. How can we use them? Or, take women in
their thirties with young children at school. They need a job with
hours and holidays flexible enough to match school terms. Why
couldn’t they be teachers for the period their children are young
and return to their main profession after what would, in effect, be
a career break? In every part of the country there are
underemployed and excluded adults. Could we use their skills, and
by helping them help ourselves?

John McTernan is a political analyst

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