Well said Optimistic1!
The difference between Wealth Tax, Inheritance Tax and Income Tax
Gransnet forums
Health
NHS problems from the horses mouth
(111 Posts)Why is nobody listening to the experts.
This is a letter published in the Telegraph today
SIR – I’m a retired consultant, and I know that so-called managers have multiplied dramatically over the past quarter of a century.
Hospitals used to be run by the consultants, who are the only people with the knowledge to appreciate what is necessary in healthcare. The medical executive committee consisted of one consultant from each specialty, and it discussed what was necessary for the proper functioning of the hospital. Its decisions were communicated to the hospital secretary, who implemented them.
Now, the hospital secretary has been replaced with a CEO, who is in charge of countless other managers. This grotesque experiment in managerialism has resulted in huge increases in expenditure without any improvement in patient care, as these managers are not medically qualified. They are appointed in order to prevent doctors spending too much money.
Unless this is reversed, with consultants put in charge of all medical decisions, the NHS will collapse. The health service exists to diagnose and treat. Doctors do this with the help of nurses, physiotherapists and others. They do not need managers, whatever politicians might imagine.
Gosh.
As a recently retired senior director in the NHS I am pretty shocked by this retired consultants comments. I worked very very closely with all my consultant colleagues and there was plenty of mutual respect both ways. The majority of consultants don’t want to do ‘management’ as they would rather be clinical. The ones that do in my experience rely on good managers to support them and do a lot of the day to day stuff.
I get pretty sick of reading /listening to people who have never worked in the NHS going on about how there are too many highly paid managers in the NHS and that is the root of all the problems as it is just not true.
Like in any work environment there will be good and bad managers - like there are good and bad doctors and nurses but the vast majority of any person working in the NS are caring, hard working and there for one thing - treating and caring for patients. We did this by working together which sounds something the consultant who wrote that letter did not do.
“For years senior clinicians/physicians have been sent on managerial and administrative courses. “
They are doctors and nurses and yet you are expecting them to be managers and administrators as well, it’s this overloading of front line staff that is crippling the NHS.
Teachers have the same problem, overloaded with administration and meeting targets
volver
The letter writer literally wrote, they don't need managers. They do need managers, because however good their training is as a surgeon (for instance), they probably don't know much about GDPR implementation (for instance).
How do you know they have no idea of GDPR implementation? Do you know a surgeon or physician or are you just surmising?
For years senior clinicians/physicians have been sent on managerial and administrative courses. They have meetings out of hours with other departments to see how things can be managed more efficiently. They also have their own independent review bodies hence the B.M.A and others.
You have little faith in consultants growstuff
It's not surprising surely that the NHS has a lot of managers. It is the largest civilian employer in Western Europe. Harking back to the days of Matron is unlikely to be helpful: hospitals are far more complex organisations than depicted in Emergency Ward 10. They deliver a very large volume of operations, treatments, laboratory results, etc., far beyond those of Matron's day and employ a much wider group of professionals supplementary and complementary to medicine as well as specialist support staff such as engineers and need to buy in other services it would be uneconomic to retain in house.
volver
^They do not need managers, whatever politicians might imagine.^
Ah, the "horse's mouth."
We're doomed.
The term "We're doomed"'is a bit too light-hearted for me, sounds too much like "Dad's Army".Especially on such an important matter.
The whole system needs an overall it is no joke.
Some of the clinical staff count as managers too of course!
From the same report:
"According to the Office for National Statistics, the proportion of managers in the UK workforce as a whole in June 2010 was 15.4 per cent. These statistics also show that there were 77,000 hospital and health service managers across the United Kingdom, or 4.8 per cent of the NHS workforce. In other words, the NHS has a managerial workforce that is one-third the size of that across the economy as a whole."
Sorry I got the figure wrong. :-(
From the 2012 study:
"Best estimates suggest that the NHS spends roughly £8 billion of its £100 billion budget on management and administration."
Katie59
growstuff
Katie59
Work expands to fill the time available, the amount of red tape is just unimaginable, it would not surprise me if half the NHS budget is spent on admin.
No, it's not. It's about 3.4%.
Believe that if you want, the total cost of management administration is 15% plus, but that does not include the time taken to carry out the administration at clinical level.
Recent studies show nurses only spend around 1/3 of their time caring for patients because there is so much management and admin that has to be done.
My own experience of 30 plus years nursing bears this out, you never have time to do the nursing properly, friends tell me the care sector is even worse.
So if nurses are spending so little time on caring, wouldn't it make sense to have more clerical staff? Oooops! But that would increase the money spent on admin.
Casdon
kittylester
No one is saying that we should do away with ALL admin staff and managers. Just that there are too many.
That would be fine if the government reduced the scrutiny and target management imposed on the NHS. For anybody who’s interested, here is the latest English one. Every one of the requirements requires people to make sure they are delivered, on top of the information required to ensure clinical standards are met and services are managed within budget.
assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1065712/revised-2021-to-2022-nhs-england-mandate.pdf
Ah! But if they reduced the scrutiny, consultants would order expensive tests because they wouldn't be accountable for the cost, value for money or efficacy. How would consultants know that their treatments were even working? How long would it be before the public started shouting about the trillions of pounds the NHS was costing?
Casdon
kittylester
No one is saying that we should do away with ALL admin staff and managers. Just that there are too many.
That would be fine if the government reduced the scrutiny and target management imposed on the NHS. For anybody who’s interested, here is the latest English one. Every one of the requirements requires people to make sure they are delivered, on top of the information required to ensure clinical standards are met and services are managed within budget.
assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1065712/revised-2021-to-2022-nhs-england-mandate.pdf
There is similar micro management imposed on the farming industry.
The difference is that the farmers and food industry have to pay for it the admin themselves.
growstuff
Katie59
Work expands to fill the time available, the amount of red tape is just unimaginable, it would not surprise me if half the NHS budget is spent on admin.
No, it's not. It's about 3.4%.
Believe that if you want, the total cost of management administration is 15% plus, but that does not include the time taken to carry out the administration at clinical level.
Recent studies show nurses only spend around 1/3 of their time caring for patients because there is so much management and admin that has to be done.
My own experience of 30 plus years nursing bears this out, you never have time to do the nursing properly, friends tell me the care sector is even worse.
The thing is that times have changed. The time when the consultant was king is over.It does seem like a call for the 'good ol' days ' when 21st century health care needs 21st century responses. There's a lot of inefficiency in the NHS, and it does need a reform but I don't think harkening back to the past will yield the answer.
More government micro-management - it helps no-one. Look what it is doing to education.
I am not suggesting no managers at all - I don't think anyone on here is; but the reason more managers get employed and the reason they are so busy is because of government interference - outsourcing, assorted edicts and targets.
It is a disjointed mess.
kittylester
No one is saying that we should do away with ALL admin staff and managers. Just that there are too many.
That would be fine if the government reduced the scrutiny and target management imposed on the NHS. For anybody who’s interested, here is the latest English one. Every one of the requirements requires people to make sure they are delivered, on top of the information required to ensure clinical standards are met and services are managed within budget.
assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1065712/revised-2021-to-2022-nhs-england-mandate.pdf
Agreed kittylester
No one is saying that we should do away with ALL admin staff and managers. Just that there are too many.
50 years ago I was Matron's secretary. Now there was a formidable lady.... And a delight to work for if you did your job properly. She did a ward round morning and afternoon. The ward sisters, who were themselves to be treated with respect, were very much on their toes.
She also knew every cleaner, every porter, the electrician, the joiners etc.
I loved it.
I don't see that because someone is an expert consultant in heart surgery or paediatrics or any other specialty they know much about how budgets should be allocated, staff managed, buildings maintained or complex organisations managed. Harking back to the days of Matron and Sir Lancelot Pratt isn't going to get us very far.
growstuff
LadyGracie
They obviously need managers but not to the detriment of medical staff. There are layer upon layer of managers, a total waste of money.
Maybe the government should stop issuing more and more targets.
This - ever changing edicts issued.
Also - my sis and BiL are retired consultants - they wanted to work as doctors, not admin/resources management ,
*So many medical staff are leaving because of stress due to overwork.
How many managers can say the same?*
My sister did. She was a manager of a large, under-resourced trust and was working six days a week and long hours. Her manager left and wasn't replaced, so she took on her work, as well as doing her own work and trying to fill gaps left by more junior staff who were leaving and not being replaced.
My sister left and found a job with a private healthcare company, was paid the same and had a fraction of the workload.
Kate1949
I posted on another thread that a close relative who works in the NHS said that there are an unbelievable amount of managers thinking up 'initiatives' which cost a fortune. Someone called it manager bashing.
It's actually the DfE in Whitehall which thinks up most of the "initiatives".
Join the conversation
Registering is free, easy, and means you can join the discussion, watch threads and lots more.
Register now »Already registered? Log in with:
Gransnet »