Response to SoS Health and Social Care

Office 4,
219 Kensington High Street,
Kensington, London,
W8 6BD.

15 October 2018


Statement to Matt Hancock:

The Independent Health Professionals Association notes with dismay the derogatory divisive and ill-informed comments of Health Secretary Matt Hancock in targeting its members as covered in the Health Service Journal.

If Hancock wishes to understand the reliance on locum staff he need look no further than his own department’s failures to adequately fund the service and the colossal underpayment of substantive staff drastically below what supply and demand forces would dictate. To put it succinctly healthworkers on the ground are under no doubt that the reason they feel demoralised is the failures of Matt Hancock ‘s predecessors and view plugging rota gaps as a vital safeguard against these problems and unfortunately Matt Hancock is showing every sign that he wishes to follow in their footsteps.

On behalf of the three thousand members of our Trade Association I am dismayed that the evidenceless smear that Hancock is attempting to place on the professionalism of our independent healthworker colleagues in claiming that they have less responsibility – they categorically do not have any less responsibility, they are as responsible as their substantive counterparts and are held to the same standards. I am confident that grassroots healthworkers will see through and reject Matt Hancock’s attempt to sew discontent in the workforce.

On the ground, far from resentment, substantive staff usually show gratitude for the assistance of locums in plugging the rota gaps that failures in recruitment and retention have caused, understanding that these doctors and nurses often leave their families, travelling hundred miles and taking flights, whilst putting themselves up in hotels and staff accommodation to fill rota gaps and protect patients. They also know what Matt Hancock often fails to mention – that many are also substantive workers driven to give up what little free time they have as the inadequately slim salary he offers them for their NHS work.

The complains we hear are usually more along the lines that NHS Improvement’s dangerous experiment with market manipulation and price fixing/caps is worsening rota gaps, leaving wards short staffed, and the staff working in such dangerous environments terrified these systems failures will result in their making an error and becoming the next high profile scapegoat.

Whilst we are outraged at the derision with which Matt Hancock has lashed out at our members, we do hope that he can reflect upon this and start to recognise that, far from the problem, our staff are the lie support system keeping the NHS going whilst he sorts out his recruitment and retention problems. He needs to start by bringing how much he pays substantive staff into line with free market rates – something, which given his political inclinations, he really ought not to need to have explained to him.


IHPA and new legal team reiterate mission

A new and powerful legal team

A new and a powerful legal team is being set up. This is due to new evidence that has come to us and are still coming in. This team will issue PAPLs to the trust within two weeks and a JR will follow. At our third general meeting on the 18/11/2017, Stephen and I will update you on the new strategies. I would advise you to attend the event. It’s best you don’t take any weekend shift on that day. There will also be an educational event with associated CPD points. We stand for you and by you.

Mission statement

The Locum Doctors’ Union (LDU) is an unincorporated association with the mission of supporting locum doctors to secure their rights by negotiation, mediation and litigation, as required. It does this by providing advice, assistance and a network for sharing relevant information and continued professional development. From an NHS Trust’s perspective, the LDU and HPU aims to facilitate a collaborative culture, to bring together the shared objective of ensuring the delivery of first-class patient care.

The benefits of membership

  1. Provide discounted CPD points
  2. Members will get discounted appraiser rates
  3. Medicolegal protection coming in the form of medic HR
  4. Indemnification of members at a rate cheaper than competitors
  5. Protecting members from unfair dismissal and claiming compensation for them
  6. Helping members to do audit using external audit companies
  7. Helping members who are being bullied in their trust
  8. Protecting against future HMRC investigation
  9. Help with MJR

The Healthcare Professionals Union (HPU) was formed on 11 May 2017. Its mission is to support nurses and allied health professionals throughout the United Kingdom by providing pastoral, legal and HR support networks.

LDU and IHPA main aims are:

(i) act to either injunct, halt or achieve an equitable resolution with regards to the latest IR35 guidance

(ii) stop the arbitrary blanketing of all Healthcare professionals into IR35 i.e. ensure that trusts follow guidance and take reasonable care when determining status

(iii) stop the imposition of double NICs i.e. payment of both employer and employee NICs

(iv) stop the “bullying or thinly veiled threats” in letters from trusts and/or agencies

(v) act on the interests of members on issues that are ascribed in the constitution, and/or other issues that might have a direct/indirect negative connotation on the aims and objectives of the union


(i) employ the services of a Public and Employment Law Barrister to consider the facts, and either write a non pre-action letter pending a pre- action letter, and/or legal action; and to look at the reliance and legality of an online tool to determine employment status; and to look at the derogation of powers from a public body (HMRC) to other public bodies and agencies that are neither qualified nor have the administrative resources to adequately carry out the task with reasonable care

(ii) employ the services of a Public and Employment Law Barrister to look at the facts, and write (on the unions behalf) legal representations asking NHSI, Trusts, and/or Agencies to take reasonable care when determining employment status

(iii) employ the services of a Public and Employment Law Barrister to look at the deduction of tax mechanisms of Trusts and/or Agencies at source, with a view to stopping unscrupulous corporate behaviour

(iv) employ the services of a Public and Employment Law Barrister to look at, and draft a legal response to correspondence of a “threatening or bullying” nature from Trusts and/or Agencies

(v) employ the services of a Public and Employment Law Barrister on retainer to provide legal services for the union on an ongoing basis

Healthcare workers who are directly employed by the NHS enjoy full employment rights.

  1. Job security
  2. Pension benefit
  3. Annual leave with pay
  4. Study leave with pay
  5. Stipends for Courses for CPD & ALS
  6. Maternity & Paternity leave
  7. Death in Service Benefits
  8. House purchase benefit / discount
  9. Discounted Appraisals


Locum Doctors and nurses under IR35

Locum doctors and independent healthcare workers are now determined as NHS employers only for tax purposes without full employers benefit as listed above.

  1. No job security; job could be terminated within 1hr
  2. No paid annual leave
  3. No pension or retirement plan
  4. No study leave with pay
  5. No Death in Service Benefits
  6. Must pay up to £900 to get appraised by independent appraisal body through agency
  7. Must pay for courses to get CPD points
  8. No paid Maternity & Paternity leave
  9. Not allowed to get NHS staff discount for house purchase
  10. Must work under IR35 as per NHSI
  11. Must pay PAYE tax, Personal NI, Employers NI.
  12. Cannot claim travel expenses
  13. Must pay for their temporary accommodation without reclaiming the expenses under IR35
  14. Will continue to travel long distance to cover for shift without claiming the travel expenses under IR35
  15. Will continue to travel long distances to work where they spend time away from their families in a temporary accommodation without extra income benefit under the new rule (IR35)
  16. Must work under NHS capped rate in most circumstances. This was introduced just about six months ago which has already slashed Locum Doctors income by 30%
  17. Further introduction of IR35 is aimed to completely remove any atom of extra pay benefit for being a Locum Doctor /nurse or a freelancer

We know that the disparity in benefits between the NHS’s permanent staff and its locums justify the higher pay rates that locums earn. But the new rules change everything. The imposition of IR35 treats locum doctors as ‘employed’ for tax purposes. They lose the tax benefits of being self-employed but don’t enjoy any of the benefits of permanently employed NHS staff.


Dr Ben Itsuokor
President IHPA/LDU