When the NHS is struggling to make ends meet how can they justify this?

Yes GrannyTwice, the DM article did report a Chief Nurse on £700,000 - that's the point at which I stopped reading.

No I haven't missed the point at all and I said in my first post that I accepted there was an issue. Bu the DM is never a reliable source of information - they give a simplistic view when to discuss the matter properly requires much more detail. Cruns point shows exactly what happens when figures are not given their proper context - gp surgeries do have nearly all part time admin staff and so you need the FTE figures and no of patients before you can make any comment at all. They also have nurses and health care assistants. I believe the article says something about a Chief Nurse on £700, 000 - oh come on!

If the DM knows all about these salaries, how is it that politicians are apparently only just learning about them?
I have noticed today that without any great fanfare, the Audit Commission closed three weeks ago and its functions will be undertaken by a plethora of other bodies - or that's what it looks like to the uninformed (me). Perhaps someone with more knowledge of public finance might be able to tell us to whom these bodies will be accountable in future.

www.audit-commission.gov.uk/about-us/future-functions-at-a-glance/

GrannyTwice just in case you have missed the point because you can't bring yourself to look at a DM article , I think the gist of the thread is (although I haven't read the article either!!) that the bosses in the higher echelons of the NHS are wasting money on themselves; awarding themselves huge pay increases on already bloated salaries and going on jollies at the expense of the rest of the NHS which is struggling.

A bit like the Tesco fiasco in some ways - the suppliers/farmers being screwed down on price so that some can barely make a living and customers paying over the odds whilst those at the top were buying themselves private Gulfstream jets.

However, unlike Tesco and the greed at the top, this could be a matter of life and death for some people.

Perhaps gillybob has assessed it better than me and can help you.

Many, many articles have been written in the press, both local and national (not just the DM), over the last few years, of the excesses of those at the top of the NHS at the expense of nurses, patient services etc.

I am amazed, crun. Presumably some of them were part-timers, but I have never seen more than about 6 or 8 admin staff at our surgery and there were 6 GPs.

I've just had a look at the staff list for my surgery. It dates back to before all the doctors left, but when there were eight GPs, there were twenty three admin staff!!

Soon, the usual way for all organisations to save staffing costs ( private and public) is just not to fill vacancies . These figures would not be published and it's the remaining staff who are then affected

What is the debate about - the structure of the management of a hospital? The salaries paid? A hospital has to have a CEO - it has to have a Board. On the Board the various departments necessary to the running of the hospital have to be members - Nursing, Finance, Estates, IT, Pharmacy, doctors.

I googled my local hospital.
No, been no job cuts for years.
Job cuts, actually came up as job vacancies!

I don't think that booking clerks are the problem; it is the people in the upper echelons of the NHS whose posts, self-importance and subsquently their salaries seem to have taken on a life of their own.

They would be the people who would decide whether or not there should be 'cuts' - well, they are not going to cut their own posts are they!

It sounds like, at some hospitals, that low level admin has been cut enough, or too much.

Some of these supposedly highly paid managerial and admin staff who overloaded the system were actually secretarial staff working to clinicians, who now do their own admin, as iam says. Our local hospitals are impressively efficient but if the booking clerk for a group of doctors is on holiday, you can't make or change your appointment.

Gilly - yes I'm not doubting there is an issue - just the overall approach. If The DM was trustworthy, we could have a proper debate. For example, quoting a salary including pension contributions - that would need to be done across the board for true comparison purposes but DCs salary is always quoted without the pension contribution, the value of the free housing, transport to work costs etc etc. Re admin/management and clinical roles - the position is much more complex than some people think. There are some roles for which you need clinical qualifications in order to carry them out. Some of these positions have no management function as such ( although all will have some necessary admin eg a hospital pharmacist will have to record what drugs have been dispensed) . However, hospital pharmacy and team of pharmacists need managing and so there will be a Director of Pharmacy who will be a qualified pharmacist. There is much more to running the pharmacy department than just dispensing medicines so a manager ie the director would be responsible for a whole range of issues that would aim at improving medicine management and dispensing practices within the hospital. His/her position would count as management but only a clinician could do it. Similarly, a Trust board always has a Medical Director who is a consultant at the hospital. A proportion of his/her salary would count as management but the role would be fundemental to the proper use of the medical resources within the hospital. Then there are other roles which need no clinical qualification such as IT, HR, accountancy all which contribute to the management of the hospital and which a clinician clearly would not be carrying out. The DM simplifies the debate when it knows full well such simplification is deliberately misleading

Perhaps I should add that middle and upper management were at least as affected, if not more than the more junior staff, at each round of cuts.

x post.

Not sure if Iam64 is saying the same as me or not.

I will use our local council as an example.
It used to be heavily overstaffed. Due to monetary restraints, they got rid of a lot of staff. Nobody really noticed.
Then they got rid of some more. Again not much difference.
Then some more.
Now some more again. And people are noticing, not least the staff that are left.

I dont think our local hospital was anywhere near as close off the mark.
Perhaps they are now? Not sure that they are.

Empire Building - good words.

clinicians - I looked up the word in case I was using the wrong word. But I wasnt. It mean doctor, nurses etc.

I dont see how having too many booking clerks frees up doctors?

soon - you're right, admin and managers don't do clinical work. Sadly, many clinicians now spend hours doing work that would have been done by admin historically. It's the same in nhs, social work, police, teaching - you name it, the demands of time spent inputting stuff into computers has taken on a life of its own. It's demoralising, time consuming and take practitioners/clinicians away from their key role.

I never get why a heavy staff load in big organisations is seen as necessary and a good thing.

But clinicians are often the best ones to know how to run hospitals, soon.

If it wasn't for the Daily Mail, then, would these stories never get out, would they be suppressed?

I remember when I went in for an operation about 10 years ago; I arrived but had to wait along with another patient in a little area because the day room was piled high with spare chairs (?) and unusable while the sister in charge of the ward had to wait for a 'bed manager' to let her know if we could be admitted.
The sister fumed and said she had always known exactly how many beds she had and whether or not people could be admitted; now she had to wait for an admin person in a newly created job to tell her what she could or couldn't do.

DH calls it 'Empire Building'.

admin and managers dont do clinical work.
The jobs are completely seperate.

There is an issue alright GrannyTwice !

There is a common practice called the "one day retirement" where someone retires for one day and is then re-hired to do the same job.

I agree with your sentiments re The Daily Mail GrannyTwice but the story of Lorraine Lambert (CEO South Tyneside NHS Trust) was covered by our own local newspaper recently. So I have no reason to disbelieve it.

If I remember rightly her husband has a similar position in North Tyneside.How cosy.

Tory not story - although story is a good description of manifestos in general

Well as we all know anything in the DM will be absolutely 100% true and not in the slightest misleading. I don't for one minute think there is nothing to discuss re NHS management and salaries but doing it on the back of a DM story is a waste of time. Will make two points however - there is an issue re consultants retiring, claiming their pensions and then being re-employed - and soontobe of course the proper use of admin/ managerial staff frees up clinical staff time - here are some examples - booking appointments, recruiting staff, managing theatre time - which is incredibly expensive. As for admin/management costs going up - some of this is down to the sheer complexity of modern medicine and some of it down to the fragmentation and privatisation of the NHS - how much do you think the most recent
shambles reorganisation of the NHS has cost and is costing in management time? And perhaps someone could tell me which page of the story Manifedto that was on in 2010? And have you seen the admin/ management costs for other healthcare systems?

My sister works in the NHS and she is constantly being drip fed (pardon the pathetic pun) information as to the desperate state the NHS . How they are having to cut back on front line staff, patients are suffering, moral is at an all time low etc.

I wonder if they ever mention the HUGE salaries, bonuses and pensions that these people are getting at the expense of all of us.

I doubt it.