Okay, so I work for the National Health Service, an institution which - in the popular political imagination of the moment is financially inefficient, irresponsible and 'blundering'. That's the backdrop to my sorry tale.
I'm in the relatively comfortable position of being able to do on-call from home. An overnight on-call block typically involves an advice call or two from juniors, more rarely, an actual call-out. In practice, this is more restrictive than it might first appear: I'm technically responsible for decisions the juniors make, and if they can't get me on the 'phone and fuck up, it's my neck on the block. Which means the mobile becomes umbilical, and drinking a calculated risk. And one's sleep is fucked-up.
So. The admin assistant in charge of the on-call rota telephones and asks me if I want to do a 24-hour shift at a weekend, to cover someone who's gone off sick. It's a minor hassle, but I agree - on the grounds that covering in this way means I get paid locum rates and, for various reasons, extra cash is verrry useful right now.
Just before the weekend in question, she telephones to let me know I'm no longer needed to cover the shift. This isn't that unusual - because doing locum cover is lucrative, admin tries to offer everyone an equal share; they must've realised someone else was due their slot - so so I accept it.
Out on the Friday. Wake up to find my 'phone buzzing with messages from work: one of the juniors is trying to get hold of me. I 'phone up switchboard, who assure me that, according to their rota, I am on-call; they're not aware of any changes. Irritated (I'd got myself out of the 'being on-call' headspace, and had made plans), I 'phone the junior back.
After midnight, I get an actual call-out, meaning I have to find a cab and head across London to deal with the situation. I get back just after 2am, frazzled and unable to sleep.
At the start of the next week, I contact the admin assistant and explain what's happened - that I apparently was on-call. She can't understand this, as Dr X supposedly telephoned switchboard explaining he'd taken over. She goes off to sort out the situation.
Aaaand 'phones me back today, sounding extremely unhappy. Seems switchboard have decided they'll only accept rota changes in writing, not verbally, and the admin assistant was unaware of this. When Dr X told them he was on-call they therefore disregarded this (helpfully neglecting to advise him to fax them with a written alteration) and went with my name, the last change in writing. Effectively, both myself and Dr X were sitting by our 'phones for 24 hours.
Fair enough, I think, you'll have to pay us both, then. The admin manager, however, has come down on his assistant like a ton of shit: she's the one to blame - and she must therefore pay my on-call fee herself.
"You mean you've got to find the money from the rest of your department's budget?" I ask. No. She's got to pay it from her own pocket. It's a moderately sizeable sum, particularly compared to her own salary; she's no idea how she'll find the money. She cries on the 'phone.
I'm stunned. I've never come across this situation before, not within the NHS. We try to avoid human error, but we recognise that it's inevitable. A nurse drops a vial of streptokinase, she's not expected to pay for it herself. More extreme example: a surgeon removes the wrong kidney, he's not expected to stump up compensation himself.
Perhaps we should. We're not, though - not currently. This is, for me, a precedent.
And it stinks. It really stinks. I'm put in the position of either waiving my fee for a weekend inconvenienced or demanding remuneration from a crying woman who I know earns much less than I do. I'm pissed off with her mistake, sure, but I'm also pissed off with switchboard for failing to tell me about Dr X's call (if I'd known he was the one who was supposed to be on-call, I could've 'phoned him myself, straightened out the situation and got something in writing faxed over). Most of all, I'm pissed off with the manager, who's presumably decided to financially penalise his employees for simple human error.
What do you think? And what would you do? |
