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Thousands in NHS face axe in war on wasteful bureaucracy
Nicholas Cecil, Deputy Political Editor5 Oct 2009
Thousands of NHS employees could face the axe after the Tories promised a purge of bureaucracy in the health service.
The Conservatives say they have identified £4.4 billion of annual administrative costs which they would aim to slash by a third by 2014/15 if they win power.
Shadow health secretary Andrew Lansley believes the savings, which would total £4 billion over four years, can be found by reducing bureaucracy in primary care trusts, strategic health authorities, the Department for Health and quangos.
Calling for “lean and good-quality management,” he said: “Labour has allowed wasteful spending on bureaucracy to spiral; a Conservative government would cut it right back.
“We are determined to shift NHS funds from the back office to doctors and nurses on the front line.
“Our tough new approach will shift £1.5 billion a year out to where it's needed most.”
Senior Tory sources also stressed that across the wider health service, efficiency savings could be made in excess of the £15 billion to £20 billion over four years already being proposed by the Government.
“We agree that savings on this scale are necessary and we support them, but we want to go much further in slashing wasteful bureaucracy in the NHS hierarchy,” one said.
Mr Lansley also highlighted a 12-point plan to improve services to patients including letting them choose their consultant, easier access to speak to a GP out-of-hours and ward-level information on MRSA rates.
Other promises include more single rooms in hospitals, giving a million more people access to an NHS dentist, free dental checks in schools, health screening and blood-pressure monitoring in pharmacies, and speeding up the drug-approval process.
Patients with long-term conditions and the terminally ill would be given more control over their care.
The Conservatives stressed that the running costs of primary care trusts had jumped 50 per cent from £1.43 billion in 2003/04 to £2.14 billion in 2007/08, with spending on administrative and clerical staff soaring 81 per cent, on managers and senior managers by 43 per cent, and on management consultants by 162 per cent.
They added that the running cost of quangos had risen £140 million over this period to £1.94 billion, while the number of staff they employed had fallen by 10 per cent compared with a goal of 25 per cent set five years ago to save £500 million a year.
Reader views (29)
The current management is just so wasteful. The joke that is the email system is a case in point, it would have been cheaper to buy Hotmail, yes the entire company.
- Threaded, Roskilde, Denmark, 07/10/2009 07:03
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Biggest waste of money in the NHS is the funds wasted on all these 'management consultants' who come in charging a fortune and whose aim is to slash the existing workforce and it's no surprise that the fees charged are not a million miles from the claimed savings made.
These people often have no experience of healthcare, and their primary aim is headcount reduction. Usually the headcount reduction leaves the organisation too 'lean' and unable to cope with holiday periods and times when a bug does the rounds.
I worked for a while as a management consultant and got out as I found it ethically impossible to work for organisations which ignore key aspects of clients' businesses and whose reason for being there is to increase their own fee income.
Having had experience on bopth sides of the fence, ,as it were, I'd advise cost saving measures to be aimed at this area. Get the 'management consultants' out and you will have sorted out a load of problems and reduced expenditure by a handsome amount.
- Anti Tory, London, UK, 06/10/2009 16:18
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Michael, London: the NHS is not just the biggest employer in Europe - it is the THIRD BIGGEST EMPLOYER IN THE WORLD - after the Chinese Army and the Indian State Railway. This may surprise anyone with a relative in hospital who is hanging around trying to catch the eye of a time-oppressed nurse or doctor.
- Roz, France, 06/10/2009 11:19
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great britain was once great britain but not anymore because we have lost our ways but with david cameron and nick clegg we will lose all the more. because if you look and what tony blair and gordon brown has done they have done they have helped families with working families tax credits help the elderly people to travel for free in most areas but not before 9.30am help them with cold weather payments help with ordering on line there medication and increases with there pensions but not a lot but under the conseratives and lib dems they would loose it all and that now what we are seeing cuts in all services including the nhs because they are not bothered about i.e ( the young who cannot get jobs the middle class who also cannot get jos and dont forget the older people because of out of all them its the elderly who need it the most because what they dont understand they will be bloody old them selves one day so mr cameron and mr clegg dont do what you say your your going to do and dont deliver becuse we all know what happens when you dont deliver you get KICKED OUT so dont forget that because the people of this country know what happens if you cut public services ( SO DONT FORGET BECAUSE WE DONT FORGET AT THE POLLS )
- Peter Fradley, crewe cheshire, 06/10/2009 05:23
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You take out the admin and then you will have chaos. There is not such things as an admin free organisation and those jobs are just as important as the rest in the NHS....
Cameron lives in fantasy land, what he really intends doing is not just trimming the admin but nurses, Drs and just about anyone who makes the NHS what it is...
Why does he want more single rooms? well it makes it easier to privatise....?
I would not trust Cameron to run a tuck shop let alone the NHS...he is a faux in how he pretends to care. I would not vote for him if you paid me a million pound. He will destroy the NHS just like his idol Maggie did, only he will be even more callous..
- Gary Hills, Hitchin, Stevenage, 06/10/2009 00:34
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You take out the admin and then you will have chaos. There is not such things as an admin free organisation and those jobs are just as important as the rest in the NHS....
Cameron lives in fantasy land, what he really intends doing is not just trimming the admin but nurses, Drs and just about anyone who makes the NHS what it is...
Why does he want more single rooms? well it makes it easier to privatise....?
I would not trust Cameron to run a tuck shop let alone the NHS...he is a faux in how he pretends to care. I would not vote for him if you paid me a million pound. He will destroy the NHS just like his idol Maggie did, only he will be even more callous..
- Gary Hills, Hitchin, Stevenage, 06/10/2009 00:34
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The NHS needs pen pushers. They provide healthcare, they have to keep records of everything and doctors and nurses are too busy treating patients to deal with the necessary paperwork. In some cases they don't have enough administrators - the GP surgery where I used to work had an enormous backlog of filing that had to be done to keep patients' records up to date, I was brought in as a temp to deal with it and barely managed to make a dent in the huge piles in my time there. Now it has gone electronic which should help everything stay up to date but you can't axe people that are necessary to keep the thing ticking over.
- Lily, London, UK, 06/10/2009 00:09
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Same old tories,putting people lives at risk like they did in the 80's,90's
- Andy, London, 05/10/2009 22:02
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If the beaurocrats and other non-useful staff are going to be reduced all well and good for the medical staff.
Our NHS are the biggest employers in Europe.
- Michael, London, UK, 05/10/2009 19:59
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David, London
Maybe a spelling lesson or two would help, or is it a typing lesson you need? If middle management can't spell or type, or at least check what they have written before sending it, what hope is there for managing the needs of hundreds of staff and patients within the NHS framework?
- Val, London, UK, 05/10/2009 16:43
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@ David, London
Well if you stopped surfing the web and did some work you might hit your targets! ;o)
Seeing as the NHS is second biggest employer in the world, I think we can easily trim the fat.
- Frank, Home Counties, England., 05/10/2009 14:25
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Excellent, now lets see the axe fall in central government offices, local government offices and education.
In fact lets cut out all of the unnecessary jobs that have been created in the last 15 or so years. Yes that will put loads of people out of work, but until we face the fact that we cannot support the people that are already in this country will we understand that UK PLC doors are closed to all immigrants that cannot support themselves and additionally create wealth for this nation.
We must also revise our economic strategy to become a significant net exporter rather than an importer, if that means protectionism from the products of former friends, so be it. It is only by understanding that we are able to support ourselves will we understand how to thrive in an economically declining world. We must produce things that others want and we must consider owning or own means of production.
How brutal does the axe have to fall before people wake up and realise that we must support ourselves before we support anybody else.
- James, City of London, 05/10/2009 13:41
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Bureaucracy cannot add anything to patient care. It can at best only leach money out of the system and ensure that the remaining service is equally inadequate everywhere. The NHS now has more paper-pushers than medical staff, and that's getting worse by the day.
It's high time that resources were redirected to providing more doctors and nurses and other necessary people who directly benefit patients. If the redundant paper-pushers can't find jobs elsewhere, then re-train them as hospital cleaners (and bring back matron to make sure that the floors are clean enough to eat off!)
- Nigel, London, 05/10/2009 13:05
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The trouble is the Rich and Powerful Tax Dodgers are funding the Tories and are wining and dining David Camoron and Gideon Osborne while they discuss their proposed policies. I don't think that fair taxation or action on bonuses are likely policies for the new Tory Government. The backers will want a return on their investment.
- S Jones, Kennington England, 05/10/2009 13:03
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Let's look at the case of the 500,000 "scroungers".
It is a doctor who decides if a person is incapable of work and therefore able to claim benefit - and I think a doctor would sign someone off without good reason.
So the Tory plan will have to pan out in one of two ways;
1) They will find "tame" doctors who will sigh people back to work just to get the numbers right thus putting sick people back into work.
2) Doctors who are so incompetent that they can't spot a lead swinger will have to be sacked. Either way the plan stinks.
And by the way - which jobs is Cameron going to put these peopleback into? Most employers wouldn't toch a long term sick worker with a barge pole.
- Barry, Welwyn England, 05/10/2009 12:37
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I am a middle manager with the NHS. Some of these comments are totally wrong. I have seen the number of my level of managers in my trust cut from 6 to 2. The problem is targets. The trust functions of the ability to meet targets. No target reached=no money. Nurses and doctors dont acknowledge this. We now run as a business. I welcome these cuts as there is wastefulness but we also need to change our mentality. Middle mangers ensure that there isnt the sick levels there were before and that targets are met. Get rid of all these targets and then look at reducing middle mangers
- David, London, 05/10/2009 12:28
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Fact is they created the massive increase in bodies involved in the NHS. Before Thatcher came to power England had just 90 Health Authorities that ran the NHS with only small Community Health Councils to act at a local level.
Thatcher introduced all these NHS Trusts on top of Health Authorities under her puchaser/provider scheme which some saw as a step towards privatisation of NHS Services. While the 90 H.As became over 190 H.As!!!
Fortunately Labour won in 1997 and so was able to stop the plans. However Tony Blair did not do away with these extra NHS Organisations that the Tories had created.
- Melvyn Windebank, Canvey Island, Essex, 05/10/2009 12:00
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True to form,the Conservatives first target is to be the disabled.
- Charles Mayfield, Kensington, 05/10/2009 12:00
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Can we please have a breakdown as follows:
(a) total cost of NHS
(b) cost of non medical employees, e.g. managers, middle manages, under managers etc.
(c) cost of contract out cleaners
(d) cost of locum doctors
(e) cost of agency nurses
(f) total days lost through "sick leave" of all NHS staff.
- Patricia, LONDON, 05/10/2009 11:56
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K. Price
You must be the only person in Britain who believes Brown. Brown increased NHS admin, and I see more
adminstrators in the outpatients than doctors. My local hospitals has short of doctors but plenty administrators.
- Gary Smith, London, England, 05/10/2009 11:47
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I have recently been visiting a friend who is very ill in hospital and one thing has struck me each time - you will never walk down a corridor with seeing staff walking along carrying a file of papers or wearing their 'theatre' gowns (not sure how this stands-up on the hygiene front). I am not suggesting all these people actually have nothing to do and simply want to look busy/important - but it does cross my mind that all the while they're walking from A-B they can't possibly be involved in actual patient care.
Is there scope for greater efficiency?
- Peter, Surrey, 05/10/2009 11:29
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Quote: Keith Price, Luton England. Gordon Brown said that the Tories would start cutting front-line services and front-line jobs and this proves he was right.
If Gordon Brown was right, Keith; the Tories would not have to cut anything at all, it is only because Gordon was not right, that which either party that wins the next election, will still have to hammer us tax-payers very hard for the next ten years plus etc.
But I admire your resistance to reality, you are like a bull that is king of his field, but has no idea what the next field looks like at all, or even cares that there are other fields near his field.
One thing that is for sure; New Labour is not a Socialist Party in anyway, look at Tony Blair today, but he is not a bull like you, he is more a grinning Cheshire Cat.
Help Gordon next year Keith, he will need his friends if Tony doesn't fix him up as Vice President of Europe.
- Mickinlondon, london, 05/10/2009 11:28
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It's the middle managers in NHS that need to go. When I was a nurse the place ticked over just as well at the weekends without all the pen pushers wasting tax payers money and coming up with unworkable and rediculous ideas.
- Sue, Orpington , Kent, 05/10/2009 11:26
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Gordon Brown said that the Tories would start cutting front-line services and front-line jobs and this proves he was right.
- Keith Price, Luton England, 05/10/2009 10:19
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974 quangos costing over £171,000,000,000.00 to run in the UK.
Not difficult to see where savings can be made at a stroke.
- Reuben Camara, Morecambe Compound, EUSSR, 05/10/2009 10:14
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Quote: Steve,London, We all know who the half a million scroungers will be voting for next year.Their lives depend on it!
Quote: Mario Kempe, london. He is saying what most hardworking and taxpaying people are thinking. To many people are on benefits.
He is talking about the NHS, and the bureaucracy in the health service, run mostly by the middle class white collar workers etc. nothing mentioned in this article about the dole queues or work-shy spongers etc.
One day both of you might end up scroungers on the NHS, it happens to the best of us sooner or later.
Very few people go through life in perfect health, most need some kind of medical help or assistance sooner or later, it even happens to the elite among us, Margaret Thatcher and Terry Pratchett to mention just two people etc.
We need doctors and nurses; not over paid pen pushers, Chaps.
- Mickinlondon, london, 05/10/2009 10:10
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It's impossible: they all have their little fiefdoms and they sure as heck are not giving up power. We tried to save several million pounds for several NHS trusts by streamlining their logistics systems, as we had done for the Government in another country. You wouldn't believe how much money goes to waste in the stores and supply-chain - from drugs which are stored incorrectly, to theft, to inability to plan re-order times. The decision-making process alone takes months if not years, as everything is done by committee. Most do not work a normal working day as the rest of the populace would know it, many of them are poorly educated and do not understand what is actually going on and the general ethos is 'they can only sack me if I do something wrong - if I don't do much, I can't do something wrong, so they can't sack me!'. They have no interest in the 'bigger picture' of saving money for the over-all system, just that the money is saved in someone else's department and not their own. Operating as a lean private company meant that our team could no longer hang around unpaid waiting to start work month after month after month whilst the NHS Trusts faffed around procrastinating, so it broke up and is no longer available - and nothing was 'done' and so no-one was sacked for making a decison, and so they continue to waste millions of pounds: and so the cycle goes on!
- Roz, France, 05/10/2009 10:04
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He is saying what most hardworking and taxpaying people are thinking.
To many people are on benefits.
- Mario Kempe, london, 05/10/2009 08:52
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We all know who the half a million scroungers will be voting for next year.Their lives depend on it!
- Steve, London, 05/10/2009 08:20
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