July 2024

Another NHS fiasco? Too many consultants, too few consultants

Our wonderful NHS seems to stagger from crisis to disaster to chaos – mostly due to the incompetence, stupidity and dishonesty of politicians and senior NHS executives.

I’ve written before about how, under Blair and Brown’s New Labour, the NHS went from having about 200,000 hospital beds and 25,000 managers in 1997 (8 beds per manager) to just 140,000 hospital beds and 43,000 managers by 2010 (3.2 beds per manager)

Hospital beds per manager

This a truly staggering loss in managerial productivity.

At the same time, pay for NHS managers shot up, doubling for mid-management positions and tripling for hospital chief executives.

This was part of Brown’s bureaucratisation of Britain where throughout the public sector we got ever more managers being paid ever more for doing ever less.

To their credit, the Tory-led Coalition reduced the number of NHS managers from the 2010 high of 43,000 to nearer 38,000. Hooray! Progress! Or maybe not?

Here’s another figure readers might find relevant to assessing the Government’s claims to be improving our NHS.

The NHS spent £640 million on private-sector management consultants in 2014, up from £313 million in 2010. In 2010, when costs were less than half today’s at £313 million, Tory Health Secretary Andrew Lansley stated “I am staggered by the scale of the expenditure on management consultants in the NHS.” Lansley blamed Labour for the blooming costs and vowed then to “reduce management consultancy costs by 46% over the next four years” and promised “every penny saved will be reinvested in improving patient care”.

As with any promise by an incompetent, lying politician, we got the opposite – a massive increase in management consultancy costs and a reduction in the money available for idiot Lansley’s ‘improving patient care’.

So, in 2010 the NHS was spending £313 million on management consultants to help the NHS’s 43,000 overpaid, over-pensioned managers to do the jobs they were already being well paid to do. That’s about £7,300 per year per manager. By 2014, this had shot up to £640 million for 38,000 managers – a staggering £16,800 per NHS manager per year.

If we assume that a hospital consultant costs about £100,000 per year, then for just the £327 million increase in management consultancy costs from £313 million to £640 million would have been enough to pay for another £3,270 real medical consultants. Or perhaps 10,000 nurses.

Maybe our politicians fail to understand the difference between (generally useless) management consultants and (generally useful) hospital consultants? (click on image to see more clearly)

nhs management consultants

Commenting on NHS leaders’ ever-increasing reliance on management consultants to do their jobs for them, a senior medical figure remarked “If these well-paid individuals lack the skills to solve most local problems in-house, or by learning from other NHS colleagues, perhaps they shouldn’t be leading at all.”

I don’t think any of us would disagree with that.

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