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The ailing NHS urgently needs a manager-ectomy


EVERY year we’re told that our NHS (which is supposedly the envy of the world) needs more money and more staff. And every year it gets ever more billions from us and thousands more staff.  

Yet the health service in England carried out 600,000 fewer procedures in the first nine months of 2022, compared to the same period in 2019. This was even though the total NHS budget grew by nearly £30billion – from £124billion in 2019/20 to £152billion in 2022/23.  

In the first nine months of 2019, the NHS completed 12.4million procedures. In 2022 this fell to 11.8million. Yet the NHS in England has 13 per cent more doctors – including ten per cent more consultants – as well as 11 per cent more nurses and ten per cent more clinical staff now compared to 2019. 

A cynic might conclude that the more billions we pour into the NHS and the more staff we pay for, the less work actually gets done. 

The latest wheeze our new Health Secretary, Steve Barclay, has come up with is to supposedly improve NHS efficiency (though I suspect the words ‘NHS efficiency’ are an oxymoron just like the words ‘Border Force’) by cutting down the number of pen-pushers to free up more money for patient care.  

Before making this empty promise, it’s a pity that the latest in a long line of ministers failing to run our health service didn’t look at a few current NHS recruitment ads. Had he bothered, he might have noticed these: 

1. Salisbury NHS Trust – Head of Diversity and Inclusion – £56,164 to £65,262 a year 

2. Cornwall Partnership NHS Foundation Trust – Inclusivity and Diversity Lead – £48,526 to £54,619 a year 

3. Nottingham University Hospitals NHS Trust – Director of Equality, Diversity and Inclusion – salary not posted yet 

4. North East Ambulance Service NHS Foundation Trust – Engagement, Diversity and Inclusion Advisor – £33,706 to £40,588 a year. 

5. Greater Manchester Mental Health NHS Foundation – Equality, Diversity and Inclusion Partner – £41,659 to £47,672 a year. 

6. Cumbria and Northumberland NHS Foundation Trust – Involvement and Lived Experience Diversity Officer – £33,706 to £40,588 a year. 

7. Gloucestershire Hospitals NHS Foundation – Equality, Diversity and Inclusion Officer – £23,949 to £26,282 a year. 

In case you were wondering what Cumberland and Northumberland NHS Trust’s Involvement and Lived Experience Diversity Officer will do, here’s the job description: ‘As the Involvement and Lived Experience Diversity Officer you will support colleagues and others to improve the diversity of the Peer Support workforce and the membership of the Involvement Bank of service users and carers.  

‘You will work with colleagues to reach good practice in involving and engaging people from all cultures. You will build strong relationships with diverse community groups and work with them to improve interest in involvement and working in the Trust.’  

No, me neither. 

I know a cancer surgeon in a hospital in a Scandinavian country. There, the cancer surgeons run their own department while the hospital’s administration department supports the clinical areas by handling such tasks as budgeting, payroll, paying invoices and so on. So decision-making power lies with the people who actually deal with patients rather than a professional, usually non-clinical management class.  

In such a hospital, it would be inconceivable that the cancer surgeons would decide that patient care would be hugely improved by spending a chunk of their budget hiring an Involvement and Lived Experience Diversity Officer, or even something as supposedly ‘useful’ as a Director of Equality, Diversity and Inclusion. 

But in our collapsing NHS, a new managerial class with little understanding of how hospitals work seems to have taken over. The number of managers in NHS England has shot up from around 25,000 to about 38,000 since 1997. Meanwhile the number of beds managed by these managers has decreased from around 200,000 to just 141,000. So we’ve gone from about eight beds per manager in 1997 to only around 3.7 beds per manager now. 

When we have about seven million people on hospital waiting lists, when ambulances are queuing up for hours at A&E, when people are dying while waiting for an ambulance, it seems beyond incredible that management teams at hospitals around the country are deciding that one of their urgent recruiting needs is for Directors of Equality, Diversity and Inclusion – or Involvement and Lived Experience Diversity Officers.  

Our hospital managers seem to be blissfully unaware of the massive waiting lists, the queues of ambulances at their A&E departments and the rates of excess deaths resulting mainly from people being unable to receive medical treatment.  

Instead, they appear to be caught up in their own world where they sit in endless meetings spouting meaningless management gobbledigook while spaffing billions of our money on rubbish that has absolutely nothing to do with patient care 

As for our political leaders, they seem to have given up trying to achieve anything. They promise everything and deliver nothing. They seem to only be interested in keeping their jobs for as long as possible so they can get rich at our expense. 

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David Craig
David Craig
David Craig's latest book THERE IS NO CLIMATE CRISIS is available as a paperback or ebook from Amazon

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