Public vs private employment

Issues related to pay, contracts, Agenda for Change, the NHS, the BPS, unions, etc.

Public vs private employment

Postby persephone56 » Sun Apr 23, 2017 7:32 pm

I just wanted to open up a discussion about working in the public service as a psychologist (i.e. NHS or similar) versus private work. I have spoken to a few clinical psychologists who have seemed pretty vehemently against working in private practice, but it wasn't appropriately to explore too deeply at the time.

I'm wondering what the opinions of folk here are? Are you an NHS for life psychologist? What are your views of private practice?

I'm only a first year trainee, so I have no experience of private work, but I certainly like the idea of being my own boss. I spent two years in British Columbia, working in the equivalent of the NHS. Nearly all psychologists that I worked with worked part time in the public service (for the benefits and stability, mostly) and a day or two a week in private practice (for the money). That seems to be less common over here though?
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Re: Public vs private employment

Postby miriam » Sun Apr 23, 2017 11:36 pm

I was an "NHS for life" psychologist until the NHS stopped being a single public sector organisation and started being a lot of separate Trusts run like businesses dependent on contracts, many of which have been awarded to private sector organisations.

But I'd have still stuck with it, if my own trust hadn't treated me so badly. They broke all the rules about maternity leave, and made promises they couldn't fulfil before telling me that if I didn't income generate to a certain target staff in my team would be made redundant. They then made it impossible for me to income generate by telling me I couldn't quote or invoice - and by not invoicing the work I did that was agreed without a written quote. At the point I walked away, I'd have gone with nothing, except that they panicked and offered a redundancy settlement in return for me not making a claim against them and signing a gagging contract (and not being able to tell anyone I was leaving for any reason other than to have a career break after having twins).

Thankfully for me I'd been doing expert witness work for a decade by then, and therefore had a safety net of pre-existing contacts and income to cushion my departure from the NHS. Since then I've tried various things - trying to tender for public sector work, winning a research award, helping to start a parenting charity, building up a social enterprise - and whilst it hasn't all been easy (and in fact has been very hard at times) I can't see myself going back. In fact at a point I wavered I was offered a psychology lead for a district's CAMHS and declined it, and also declined interviews for two other equivalent posts, and an offer of employment as clinical director post in a private organisation.

I know myself, and just as I have strengths and weaknesses in my clinical work* I know that I am only comfortable in certain roles within an organisation. I used to be fine on the bottom rung doing the legwork, and I'm still fine as an independent professional doing my own thing alone or with an assistant, and at the other end of the scale I'm good at running projects and services. However, I hate being a middle manager with people above me making decisions, whilst I'm responsible for their delivery. So, whilst I could go back to being a sole trader if I didn't want to run a business any more, I would never go back to being an employee without a really high level of autonomy whether in the NHS or private sector.

Having said all that, my ethics are still the same as they were when I was "NHS for life". I'd much rather have a truly publicly owned NHS that works as a single organisation according to the need and the evidence base without any funds being diverted into profit. I've always done a lot of pro-bono work to help the psychological agenda at a national scale, such as being on committees and writing best practise documentation. Likewise, I've never been the kind of person to want to charge individuals in distress for services, so I've only ever done work that is free at the point of access to service recipients (like court expert witness work and work with LAC that is funded by local authorities) and whilst we have at times provided a small therapy service we predominantly took third party funded clients (eg insurance, local authority, school or employer funded work) and on the rare occasions we did charge individuals we ensured that this was always proportionate to their means.

*for example, I recognise that I'm great at complex assessments and formulations, and pretty good at service design and evaluation, but I am a mediocre and impatient therapist
Miriam

See my blog at http://clinpsyeye.wordpress.com
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Re: Public vs private employment

Postby persephone56 » Wed Apr 26, 2017 3:23 pm

Thank you for that thoughtful and interesting reply, Miriam. I find your description of disliking "middle management" interesting, and it seems to fit with my experience of working with several other clinical psychologists.
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