I work in the NHS in imaging (posts passim)
We are at a recruitment crisis - the baby boomers are leaving/left, next gen going early and there is a perverse incentive.
If I work 1* session (4 hours) in an NHS job, I get another 8 hours for supporting professional activities [SPA, look it up], including staying on the GMC register. I get 3/10ths of a salary (80-100k ish) *(might be 2 or 3)
I can then spend the whole of the rest of my time working for parasite external reading companies that do piece rate fees.
Strangely my colleagues that can barely manage 12 CT reports in 4 hours can do 15+/hour.
Outside of working time directive limits.
Of course there are (wink) controls in place - we are not allowed to do our own home work. Just everyone else's, who are doing the same for us.
For balance - the external firms are much better at quality control than the NHS (double "reads").
FFS they don't require eyesight tests for people whose job is looking at stuff.
Good luck increasing scanning in the NHS/high street - you can find people to take the pictures (maybe. really? - never).
Finding those that can look at them - not so much.
And there is a difference to non-UK trained as to their recommendations and reports - multiple additional tests rather than an opinion is clearly demonstrated across multiple trusts and organisations.
Outsourcing invariably recommends yet more scans/tests and fails to reference (available to them if they take time) previous. Fee/item doesn't seem to excite them to wait more time to recall older studies, which i don't understand </sarc>
For clarity : I have worked in the private sector in addition to a >full time NHS post. I have done a small amount of additional locally paid extra work in the past before "outsourcing" existed.
I currently refuse to do additional outsourcing as I see it as unethical.
And no, I've not been sitting on my arse. I'm one of few in my speciality in the UK that actually do invasive procedures, including biopsies to take diagnosis forward. Apparently in my speciality recruitment crisis you can deny any ability to do a biopsy (core requirement) and be put in post with that limitation on practice.