NHS chief warns 'no more jobs for life'

THE NHS can no longer be relied upon as a job for life nor can it guarantee the traditional professional career that doctors, nurses and others have enjoyed, Sir Duncan Nichol, the retiring chief executive of the NHS said yesterday, writes Nicholas Timmins.

He warned that 'the very nature of NHS employment is at a watershed' in the search for efficiency and improved care. And important power shifts between groups of staff are still to come as managers insist on flexibility in matching work to skills people have.

Boundaries between the work of nurses and occupational therapists would dissolve, Sir Duncan said, as would those between types of laboratory staff, while it was essential that doctors become involved in contracting 'if we are to achieve the benefits of the reforms'. In a paper for the European Policy Forum, Sir Duncan said 'the willingness of clinicians to accept responsibility for costs as well as quality' remained 'a key issue'.

The reaction of professional bodies to attempts to reshape the NHS workforce has been 'predictable, with considerable formal resistance by the professional bodies themselves and localised resistance from those staff whose work, skill and competencies is under review'. Yet greater flexibility remained the key to success and job security.

'There is now a growing realisation that the health service cannot be relied upon as a job for life.'