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Our bloated NHS - it’s beyond ridiculous now.

(520 Posts)

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Urmstongran Mon 16-May-22 10:07:56

At the moment, only about one third of NHS staff are doctors or nurses (roughly 450,000 out of 1.4million employees).

The new analysis shows that the number of officials working in the Department of Health and NHS England has more than doubled in two years, with even sharper rises seen at the most senior levels. Meanwhile the number of nurses rose by just seven per cent, thinktank the Policy Exchange found.

Its experts said the trends showed an “astonishing” explosion in central bureaucracy, calling for an urgent review and action to slim down and streamline its workings.

The findings come ahead of a review of leadership in the NHS by a former army general.

Sir Gordon Messenger has been sent in by Sajid Javid, the Health Secretary, amid concern over the quality of management in the NHS as the service faces the biggest backlogs in its history.

volver Mon 16-May-22 10:09:39

Somehow, I just knew who had started this thread.

No pictures Urmstongran?

BTW - Telegraph.

Lido Mon 16-May-22 10:09:54

The NHS has experienced a decade of underfunding since 2010, despite cash boosts in 2018 and 2019. Between 2009-2019 the NHS budgets rose on average just 1.4% per year, compared to 3.7% average rises since the NHS was established.

Lido Mon 16-May-22 10:19:00

NHS managers make up circa 2 per cent of the workforce compared to 9.5 cent of the UK workforce.

In recent years the number of managers has been cut, at a time when the NHS is facing its biggest challenge.

The NHS as a whole is under, not over, managed. However, persistent and misleading media headlines continue to claim that the NHS is overmanaged.

kittylester Mon 16-May-22 10:21:05

Good post, urms.

I don't see that there was a need post in that manner volver.

Are you disputing the facts?

Urmstongran Mon 16-May-22 10:24:27

Too many managers. Too many chiefs and not enough Indians. I don’t suppose our doctors and nurses are happy but I bet the administrators are delighted. Big fat salaries. Huge index linked pensions. So many ‘tick boxes’ - diversity, inclusion, well-being courses - plus ‘targets’ whereby the top managers get a bonus for delivering them (on top of their well remunerative posts). Surely that’s part & parcel of their remit anyway?

Urmstongran Mon 16-May-22 10:25:42

She can’t help herself kitty. She lies in wait for me I think!
No matter.

Urmstongran Mon 16-May-22 10:26:44

Are you an NHS manager Lido??

AGAA4 Mon 16-May-22 10:27:54

This will turn into a blame game. It will be the management's fault and has nothing to do with the underfunding by government of the NHS.

Lido Mon 16-May-22 10:28:03

This is a dated chart (sorry, I can't find a more current one quickly to illustrate the point).

The staff make-up of the NHS is not a binary nurses/doctors or admin/management choice.

Anyone got any idea why the NHS could need more admin and management staff over the last couple of years? It's not as though they've been facing any kind of crisis is it??

Lido Mon 16-May-22 10:29:00

No Urmstongran I'm a retired gardener with an interest in facts.

Urmstongran Mon 16-May-22 10:31:45

Amanda Pritchard took over as CEO of NHS England from Simon Stevens last August. Yet she was paid a third more!
How come?

Urmstongran Mon 16-May-22 10:32:43

The NHS is permanently in ‘some kind of crisis’.

GrannyGravy13 Mon 16-May-22 10:33:15

What is desperately needed is for GPs to revert back to their pre-Covid appointments.

A & E’s are overwhelmed by people who cannot for multiple reasons get to see their GP. By the time they get to A & E they need admitting.

We have had experience of this recently, an AC went to A & E at 7.30am and got talking to an elderly lady. AC was seen treated and discharged with a caveat to ring 111 if their symptoms persisted or worsened. We rang 111 and were told that we would be holding on for approximately 90-120 minutes, so DH returned AC to A & E. AC returned to A & E at 6.30pm the same lady was sitting in the same seat still waiting to be seen, AC had to sit on the floor for over four hours before being seen, then they could find no record of their earlier visit, it was only when they showed the bruise/cannula entry site that they believed them. The registrar discharged them with a prescription to be taken to pharmacy when opened, because in his words we would under normal circumstances admit you, but we have no available beds anywhere

I am an admirer of the NHS but it does need a radical makeover, throwing money at it is not the solution, yet to see a Political Party to come up with anything or the balls

NotSpaghetti Mon 16-May-22 10:34:22

I'm sure there are loads of managers urmstongran but how do they count the technical roles? The sonographer, IT workers, radiologists, phlebotomists - and the porters, people on the switchboard, personal assistants to the consultants?

I would think there are lots of "back room" staff as well as researchers (my daughter is neither a doctor nor a nurse but is a researcher at major teaching hospital).

Just wondering where these figures are from?
Do you have a reference please?

kittylester Mon 16-May-22 10:37:50

I think we all love the NHS but we mustn't allow it never to be criticised.

MaizieD Mon 16-May-22 10:40:08

Oh look. Right wing Think Tank throws red meat to tory supporters who obligingly gobble it up.

It's not all that it claims to be...

growstuff Mon 16-May-22 10:44:19

So what jobs exactly do the NHS staff who aren't doctors or nurses do?

According to the Nuffield Trust, most of them are chiropodists/podiatrists, dieticians, occupational therapists, physiotherapists, radiographers, healthcare scientists, pharmacists, operating theatre technicians, phlebotomists, building maintenance staff, secretaries, receptionists, HR/payroll staff, paramedics, ambulance drivers and stock control staff.

The Health and Social Care Act 2012 and the internal markets resulted in thousands of staff being needed to administer commissioning, ie buying in services and awarding contracts.

Where do people think the axe should fall?

Lido Mon 16-May-22 10:47:28


She can’t help herself kitty. She lies in wait for me I think!
No matter.

On those who peddle propaganda rather than facts.

Lido Mon 16-May-22 10:48:08

Sorry, that was in answer to growstuff's question about where the axe should fall.

AGAA4 Mon 16-May-22 10:48:22

Firmly on the head of this government. The link MaizieD posted makes chilling reading.

Whitewavemark2 Mon 16-May-22 10:49:06

This government are past masters at blaming others.

One day the population will wake up and understand that everything has happened under the Tory watch.

Mismanagement and underfunding on an industrial scale.

When the took over in 2010 the NHS was in the best shape it had been in decades.

Now look at it.

MaizieD Mon 16-May-22 10:52:40

Perhaps an 110,000 shortfall in jobs might be skewing the figures somewhat.

Of which nearly 48,000 are medical staff.

The Kings Fund explainer on NHS staff and the distribution of tasks

BeEmerald Mon 16-May-22 10:55:13

Urmstongran you are absolutely right. The NHS is top heavy with too many chiefs and not enough Indians. It’s become a sacred cow that everyone pretends is too wonderful to criticise. The truth is it’s run by morons that couldn’t organise a social event in a brewery !
Sixty years ago it ran efficiently and then with modernisation it fell down the grid. For the last ten years every single winter our local hospital ( one replacing about eight that existed in the past ) has declared an emergency over either winter flu or the norovirus. Then came the pandemic which the NHS has and is using as an excuse for ineptitude and moronic decision making. Plus there’s the matter of privatisation - not a recent movement towards it as it was being planned over thirty years ago. How do I know this ? Because a family member was a manager in the NHS. Privatisation is a disgrace. The idea you can’t be seen for months by a consultant but if you pay you can see the same person within days is an abomination. Doctors and consultants/ surgeons who do private work should be made to repay the cost of their training/ bursaries and grants in my opinion.

volver Mon 16-May-22 10:55:42


Good post, urms.

I don't see that there was a need post in that manner volver.

Are you disputing the facts?

So this is what I'm disputing...

Right wing media will put a spin on things to appeal to their right wing audiences, some of who have no idea how society works. And many of whom have no idea how to interpret things.

I see that Lido and others have made some good points, so apologies to them if I repeat some:

No indication of how many "front line staff" who are not doctors or nurses are included in the million or so; physios, phlebotomists; medical secretaries, etc, etc.

What constitutes an official? Is my SiL who did the contact tracing an "official", what about the people who keep the IT systems going?

Is it a good thing that former marine who led the invasion of Iraq is going to review the NHS? Somebody who appears to have no medical experience whatsoever? It might be, maybe he has transferrable skills, we'll have to wait and see.

As for Good post urms, its a direct quote from the Telegraph. Verbatim. Cut and Paste. No analysis, no opinion, no critical appraisal.