NHS

I'm sure that all the NHS management employees who have posted here are delighted to hear that random people off the Internet think they are a waste of money and don't deserve their salaries.

Alegrias1

I'm sure that all the NHS management employees who have posted here are delighted to hear that random people off the Internet think they are a waste of money and don't deserve their salaries.

Random people, do you mean those of us who have worked in the NHS and have seen the top heavy management layers. Sorry, but if the Trusts are happy , as was the case, to make Nursing staff redundant, then managerial wastage should be looked at too. Let me tell you a true story. In one round of vicious cuts, in the 80s, a friend, left in charge of a day Ward with one auxiliary nurse, that was how they were known then, was approached by a manager, at 19.30 in the evening, and told she was going to be made redundant, as her post was going to be disbanded. Very distressed, she still had patients to discharge, she carried on. Next day with all guns blazing went to see the chief exec, she was assured that should never have happened, and because of lack of due process her role was maintained. One excellent Nurse, still working, who was deemed not worthy of proper notice by a Manager. Who got rightly sent on training courses in how to manage redundancy.

No, I don't mean that at all Lincslass.

I mean people whose auntie's cousin's hairdresser once went into hospital and there was a person there called Doris who didn't seem to be very busy so obviously managers aren't worth anything.

The managers and admin staff are real people, they are posting here and trying to give their side of the story, and blanket statements about how they are worthless aren't fair. Are they?

Everyone I’ve ever known who’s worked for the NHS - from admin to surgeon - has complained about waste and too many managers.

IMO the other basic problem is the ‘free at the point of use’ bit.
People so often go on about how much better the care is in other European countries, while conveniently ignoring the fact that they so often pay something extra, over and above their usual taxation, and I include our national insurance in that.

In Sweden, for example (according to my Swedish friend) everybody (except perhaps children) pays a small amount for prescriptions, for visits to the GP and A&E, and for the ‘board’ element of hospital stays. All small amounts, but of course they add up.
There is an annual cap for anyone who needs a lot of prescriptions.

I doubt that any U.K. govt. of whatever colour would ever have the guts to introduce any such thing here, though. Better to have long waiting lists, never enough doctors or nurses, hospital beds, etc., rather than risk losing votes.

Free at the point of use is such a sacred cow here, regardless of whether it’s still fit for purpose, compared to the health service and the available treatments when the NHS was in its infancy.

Alegrias- well said!

I doubt only 14% is spent on management when you see the salaries some of them are on and as has been stated, assistants to assistants. It wouldn’t be a consideration in the private sector. Also it’s not the canteen staff that source the supplies for the hospital food, it is management.

QED

I worked in the private sector my entire working life.

If you want scare stories about dubious practices over redundancy, nepotism and wastage of funds, we'd better start another thread.

Except I might get sued

The bottom line here is that only those who have worked in the NHS see the mess it is in first hand and it is beyond belief.

I did work in the NHS!

I worked for a large county council, our department was the favourite one for cuts.
A whole layer of admin was removed, I promise you, it made no discernible difference at all to the level of service given. It saved a lot of money though.

14% is NOT spent on management in the NHS, 14% covers all administrative and managerial grades - ward clerks, medical records teams, salaries, procurement, departmental admin staff. 4.8% is spent on managers, of whom one third are clinical departmental managers. The cost of non clinical management is 3.2% of the NHS budget.
Shall we get rid of all administrative support for clinical teams and expect clinicians to do their own admin? Shall we get rid of all the non clinical managers and expect the clinicians to do that as well on top of their day jobs?
Or maybe the NHS, which is the biggest employer in Europe doesn’t need managing at all - or maybe Gransnetters would like to take on what has to be the most thankless job in the UK themselves. It’s time to get real.

Same in Education - too many chiefs and not enough indians.
My daughter works in the NHS and she says that some management have little or nothing to do. She had 3 top dogs observing her to see if she washed her hands properly.
It's criminal.

Oh... and I don't understand why you would find it difficult to talk to your sister. My sister spouts all sorts of rubbish but we still get together and have a laugh.

Here's this again.

I don’t know why we bother Alegrias1. People have to have somebody to blame to deflect from the real issues facing the NHS. Scapegoating is what people do when faced with the ‘too hard’ box.

Off topic...

People on the factory floor in the place I used to work didn't understand why we had HR as all they did was organise picnics and put up the Christmas decorations.

I was a Project Manager. God knows what they thought I did.

Alegrias1

Here's this again.

Watch yourself, you might end up in Casualty!

Casdon

I don’t know why we bother Alegrias1. People have to have somebody to blame to deflect from the real issues facing the NHS. Scapegoating is what people do when faced with the ‘too hard’ box.

There is so much inefficiency, though, Casdon which is costing the NHS possibly billions.
Consultants we have spoken to recently are concerned at what is happening.

There is inefficiency, I’d agree Calistemon. Any huge and complex organisation with vested professional and staff side interests is going to be inefficient to some degree.
Clinical managers are run off their feet trying to keep their departments and services running, due to short staffing and the number of targets that have to be hit, they have so many balls in the air that it’s impossible to do their jobs as efficiently as they would like to. That doesn’t mean they aren’t hugely committed to doing the best they can. Being castigated by everybody for doing your best is a thankless position to be in, particularly when your own staff don’t want to know what you have to do. Staff themselves often won’t apply for managerial jobs because they don’t want the hassle, it’s easier to complain than it is to do the job yourself. That includes Consultants and GPs, those I’ve worked with who have made the leap into managing themselves all say how much more complex and political it is than they ever realised (and end up being cold-shouldered by their own teams when they have to make tough decisions).
At executive level there is a lot of political pressure, both from within the organisation and from above, which forces managers to work in ways which I’m sure none of them want to to achieve the targets- and balls do get dropped because the effort has to be put into issues that of choice would be less important.
There are no easy answers, but it’s the system that’s the problem, not the managers themselves. It’s got much worse in the last few years due to financial cuts, and many high quality managers have left, or been off sick due to the insurmountable pressure they are put under.
Pile ons like on this thread are demoralising, not least because most Gransnetters and many NHS staff themselves haven’t walked a mile in an NHS manager’s shoes so actually have no idea what they are talking about, and take the unthinking ‘this happened to somebody I know and it’s all management’s fault’ approach.

Fully agree Casdon. Another layer of trouble has been created by the need to cover all possibilities in order to avoid litigation. So many risk assessments and clinical governance measures to complete. All for the ultimate benefit of patients.

bobbydog24

I doubt only 14% is spent on management when you see the salaries some of them are on and as has been stated, assistants to assistants. It wouldn’t be a consideration in the private sector. Also it’s not the canteen staff that source the supplies for the hospital food, it is management.

Oh well you obviously know more than The Kings Fund, they obviously wasted their money doing a study.

I've worked in public sector, senior managers do not source food for the canteens. There will be lists of approved suppliers, that is because although someone will say they could nip down the road and buy 5lb of potatoes cheaper that is totally useless if you need 100lbs of potatoes.

Casdon

14% is NOT spent on management in the NHS, 14% covers all administrative and managerial grades - ward clerks, medical records teams, salaries, procurement, departmental admin staff. 4.8% is spent on managers, of whom one third are clinical departmental managers. The cost of non clinical management is 3.2% of the NHS budget.
Shall we get rid of all administrative support for clinical teams and expect clinicians to do their own admin? Shall we get rid of all the non clinical managers and expect the clinicians to do that as well on top of their day jobs?
Or maybe the NHS, which is the biggest employer in Europe doesn’t need managing at all - or maybe Gransnetters would like to take on what has to be the most thankless job in the UK themselves. It’s time to get real.

Exactly, 14% for management and admin is actually low.

Calistemon

^How are people supposed to recover from illness or surgery without proper nutrition?^
Just what we said recently.

When I was in hospital years ago, most of the food was inedible.
Nothing has changed, it seems.

I was in our local general hospital a couple of years ago. The ward had it's own kitchen. For breakfast we had a choice including cereal, toast, yogurts, eggs. For lunch we could choose sandwiches, freshly made, or jacket potatoes. The evening meal came from the main kitchen and suffered from mass catering as all mass catering does but we quickly learned that if you asked our lady in the kitchen you could get her to make you a nice sandwich and salad before she left and have a yogurt for afters and miss the mass catering if you wanted to although it wasn't that bad.

Calistemon

^I was in hospital a couple of months ago, and the food was great!^

Many years ago, DC1 was born in hospital - have you ever eaten a fried egg with thin greasy gravy on it, complete with globules of fat?
Me neither, I had to leave it!

When I was in a maternity home a couple of years later, the food was wonderful! Freshly cooked on site, however, that maternity home closed along with all the others.

What was that about nutrition aiding healing?
The nurses said they were embarrassed by the poor standard of nutrition offered to patients in our new hospital.

When I had my first baby in a busy inner city hospital you had to book for English or Asian menu. We quickly discovered that the Asian menu was great and we'd be waiting every evening for the Asian ladies to be served so that we could get a curry if there was any left, obviously as they'd booked Asian they got priority.

We were happy with English for a bacon and egg breakfast though.