The University of Nottingham

Britain is facing the prospect of an NHS staff migration to the private sector and urgently needs to smooth the mass transfer of workers, new research has warned.

Hundreds of thousands of employees are set to make the transition in the next few years as the UK continues to witness its biggest cull of public sector jobs in half a century.

But at present not enough is being done to support workers as they struggle to adapt to their new environments, says a study by Nottingham University Business School. As a result, many are displaying the classic responses of people forced to abandon their ‘homeland’ — including a failure to integrate and a burning desire to ‘go home.’

Study author Professor Justin Waring said: “When we talk about a diaspora we usually mean a dispersion of people from a smaller to a much greater geographical area.

“We also expect basic attributes such as the hope of return, the wish to preserve links with one’s origins and the enduring difficulty of achieving full assimilation.

“Bearing all of this in mind, it’s not hard to discern obvious parallels in the growing mass movement of workers from the public sector to its private counterpart.

“As our research shows, the public sector diaspora is now a very real phenomenon — and we need a much greater understanding of the significant problems it poses.”

The findings, due to be published in the journal Public Administration, emerged from a major study of NHS workers relocated to private healthcare providers.

Researchers began observing and interviewing staff two months before their transfer and continued to do so until a year after their arrival in the private sector.

Professor Waring, a Professor of Organisational Sociology, said: “What we found during months of interviews and observations was the public sector diaspora in full effect.

“Some employees clearly viewed their new environments as offering a chance for fresh beginnings and revitalisation — whereas others just wanted to go back.”

Doctors generally saw transfer to the private sector as a valuable opportunity to restore their professionalism and autonomy and take part in leadership and planning.

Many were delighted to be freed from what they regarded as the excessive bureaucracy of the NHS, with one remarking: “You can’t be a proper doctor in the NHS anymore.”

By contrast, many nurses and clinical practitioners complained they were never fully consulted about being relocated and felt genuinely ‘exiled’ as a result.

Some responded by trying to recreate familiar NHS practices and reporting channels, prompting managers to set about changing these ‘outdated’ attitudes.

Healthcare assistants struggled most of all, with many unhappy with their new surroundings but afraid to complain in case management replaced them with new staff.

Claiming they were treated ‘like second-class citizens’, some feigned acceptance of the new regime while actually continuing to harbour distrust and bitterness.

Professor Waring said: “These same responses are occurring throughout the public sector diaspora — largely because of inequalities in position, assistance and guidance.”

Recent shifts from public to private sector include the part-privatisation of Royal Mail and the controversial proposal that child protection services should be outsourced.

Professor Waring added: “History tells us that for most diasporas some form of adaption — even assimilation — is not only possible but sometimes beneficial.

“But we won’t achieve that here until we fully appreciate quite how difficult it is for public sector workers to reconcile change with their traditional ways of working.

“We hear an awful lot about what they should do to acclimatise, but maybe it’s time to think more about what the private sector should do to accommodate them.

“We need commitment and understanding from all sides and at all levels, otherwise we’ll only erect more barriers for those who have to make the transition.”

Professor Justin Waring

Justin Waring is a Professor of Organisational Sociology at Nottingham University Business School and Director of CHILL, the School’s Centre for Health Innovation, Leadership and Learning. The study discussed here, Mapping the Public Sector Diaspora, is due to be published in the Journal of Public Administration