What will the NHS look like in 2020? The impact of IR35 on NHS workers

I can’t answer that. Not sure anyone can, but it looks dire at this moment in time March 31st 2017.

I started as a Student Nurse at the age of 17 in 1975. I started my Orthopaedic nurse training working on the wards and having 6 weeks block in nursing school and got a wage at the end of the month. I completed my State Registered Nurse Training, and 3 years later I went on to train as a Midwife.

I had four children and was fortunate to be able to work part-time to keep my skills up to date until the children were at school and I then increased my hours first to 30 hours a week and then full time.  After 15 years I went into Patient Safety as a risk manager. During that time the enrolled nurses were phased out, Project 2000 had come in and then every nurse had to have a degree to practice.  And students went to university and a bursary was introduced.

After 16 years of being a risk manager at various Hospitals I went on to be an independent contractor using my skills and knowledge to support Patient Safety in many different organisations. For the past 4 years this has been the best time of my career, enabling organisations to use a system for recording patient safety, complaints and risks to organisations.  This makes it easy for staff to report when care has not gone as planned or staff are under pressure due to shortages of staff or equipment.

 I have never been out of work since 1975, but I am now . Why? Because of the IR35 changes that have been brought in by the Conservative Government’s Budget 2016 all my contracts have been terminated. This was to show the public that the Conservatives are strong on cutting down on Tax evasions by Public Sector Contractors (PSC).

But actually what this change will do is decimate the NHS and other public sector organisations even further. There is confusion about how to implement it so contracts are just being terminated, like mine. It is deeply unfair, as it requires contractors to pay tax at source on all their earnings despite the fact we are not employees and so have none of the benefits of an employee. No sick pay, pension, holiday pay, no protection. Everyone is allowed to earn £11,500 before they pay tax, but not contractors. We must pay tax on every penny of earnings, and then claim back any overpaid at the end of the year. That would reduces our pay by 20% assuming new contracts are signed.

This is what I have found being a Public Sector Contractor. I had to set up a limited company. As a limited company I have to pay VAT quarterly, Corporation Tax yearly, Income Tax yearly, Pensions and Tax on the majority of my dividends. I have been doing this for 3 years and each year I have a turnover less that what I was paid as a Risk manager.  This rule hits everyone working independently, and probably won’t really bother the really big earners it was targeting in the first place.

I have heard I am not the only one whose contracts have already been terminated in the panic of bringing in this rule next week. There are many in posts similar to mine, and in  IT, and even care givers who are leaving or who have had their contracts terminated with the NHS because of this.

At the same time as this is happening it is reported that nurses are no longer able to register with an agency if they have a substantive post, preventing them working additional hours to top their wages up. And the Conservatives have given Nurses a 1% pay rise while awarding themselves 11% pay rise. The Public sector has been hit so hard by the pay freeze during the coalition years and now only 1%.  Could it be that some nurses will leave the NHS jobs and do the more lucrative agency work?

With reports of the European nurses leaving because they don’t feel welcome, bursaries being taken away, student nurse places not being filled, who is going to be left to care in the NHS when many older more experienced  nurses are retiring because the situation is no longer tenable.

I know from experience that all NHS Acute and Community Trusts work as a team, clinical staff and support staff to try and make the patient’s journey safe and a good experience, It is so very sad for this be dismantled in such a vicious way.

I just hope and pray that 2020 is not too late to put it back together again by a Labour Government led by Jeremy Corbyn.



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