The NHS and the ‘resource intensity of wellbeing’

It is almost beyond belief. In just two decades or so, the National Health Service has gone from having virtually no formal management structure, just administrative staff, to this week’s announcement that out of a total staff of 1.36 million, 39,900 are managers. Let me put that in context: there are 5,000 more people now employed to tend to organisation than there are consultants – a mere 34,900 – tending to the sick. And if that were not enough to savour, new figures from the Incomes Data Services show that chief executives of NHS foundation trusts now earn an average of £158,000. Across the board at executive level within the NHS, salaries rose by 7.6 per cent in foundation trusts, and 5.7 per cent in non-foundation bodies. It is the starkest of all illustrations of just how far the pendulum has swung from medicinal to managerial.

Not that I am against management, nor high salaries – far from it. I am a passionate believer in management. In my career, as a former chairman of Granada, Allied Domecq, and the Arts Council, I spent much time analysing, writing about and teaching management skills. But in the case of the NHS, what we need are far fewer – albeit far better – managers…………………….

………………..The experience was both salutary and shocking; the hospital staff, including management and consultants, was eager to make it a better, more efficient place. There was enormous goodwill and huge pools of talent. But there was simply no process to pull it all together in a cohesive, sensible way.

When I meet people in the health service now who saw the BBC series, they say the same thing: how typical my experience was of their own hospital – and how the problems I identified persist throughout the NHS today. …………………..

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