Friday, March 04, 2005

NHS propaganda - adding insult to injury

Having asked, via the interweb during the Labour party conference, a question of Tony Blair (that being "Why don't you fuck off and apologise for Iraq, you twat?"), I seem to be getting propaganda direct to my inbox. All fine and dandy, but I must say that I object to be addressed as "Dear Labour Supporter". I have never been a Labour supporter, and don't particularly intend to be.

Apparently, according to the propaganda, the party of Foundation Hospitals and piss-poor Private Finance Initiatives which have cost the taxpayer millions is the party of the NHS. The fact the email has the audacity to imply that the Tories are the main party that wants to privatize the NHS after the PFI balls-up is just ridiculous.

I can not deny that the NHS has got increased funding under Labour. I will, however, deny that it has actually got any better.

My father, a conscientious NHS Dentist, earns - in real terms - less now than he did 25 years ago. Although this is not entirely due to Labour - the decline started under the Tories - Labour have done precisely fuck all to make working for the NHS an attractive prospect and, if my father and his colleagues are to be believed, are actually going to make the situation worse through their new payment plans.

If you can't get the staff, there's no hope in hell of the system being able to work. The fact that my father also lost several years' worth of pensions contributions in the Equitable Life shambles (which the government have singularly failed to do anything constructive about) and now, shortly being due for retirement, has no hope in hell of making this back only pisses me off further.

What also pisses me off is that I don't recall ever granting Labour permission to send me this crap.

The NHS is still a great service, but the recent years of wasting millions on administrative and management staff at the expense of the doctors, dentists, nurses and pharmacists that make the thing run is crippling what was once one of the finest examples of a "socialised" medical system in the world. To give a brief indication of how incredibly wasteful the thing is, Derek Smith, chief executive of Hammersmith Hospitals (covering just a tiny section of London), last year earned between £210 and £215,000. That's £30,000 a year more than the Prime Minister himself, for fuck's sake...

8 Comments:

Blogger DM Andy said...

I'm one of those admin staff that you think is wasting money. But if I wasn't there, then who would be doing the work that I'm not. £35,000/year Matrons and £100,000/year Clinical Directors, that's who.

Doesn't it make sense for the NHS to employ me at £20,000/year to do the work and leave them to actually treat patients?

3/04/2005 05:02:00 pm  
Blogger Nosemonkey said...

I certainly don't deny that admin staff are necessary, or that they can free up medical staff to do what they are there for. I'm simply saying that there are more admin and (especially) management staff in the NHS than is necessary. I haven't got the figures to hand, but I'm pretty certain that NHS admin and (especially) management staff levels have risen disproportionately over the last 10-15 years, while medical staff levels have been - at best - stagnating.

And - with all due respect - just as I find it simply wrong that a man running one small section of the NHS should earn more than the man who runs the entire country, I find it wrong that someone doing admin for the NHS should earn £6,000 a year more than a qualified nurse. (See here).

I don't deny that you do a good/useful job - it's simply the relative pay and proportions of staff devoted to support versus front-line treatment which gets me. Given the choice between three admin staff at £20k a year each or four nurses at £14k a year each, personally I'd go for the nurses. That doesn't necessarily mean that I think the admin staff aren't important, just that the nurses are more important.

3/04/2005 05:32:00 pm  
Blogger DM Andy said...

Ahh, the increase in admin/management staff is an interesting thing, that was driven by GPs. Do cut a long story first, I'll tell you what happened in Somerset.

What are now known as Primary Care Trusts started as Primary Care Groups, in order to give them management accounts support, Somerset Health Authority decided that they needed a junior accountant and an assistant for each of the four PCGs, 2 senior accountants covering 2 PCGs each both reporting to the Director of Finance of the PCG. All these staff were transferred from the Health Authority's existing staff (they were doing effectively the same job, just rebadged).

What happened then was that two of the PCGs were given their independence from the Health Authority (Somerset was a bit odd, 2 moved to PCT in 1999, the other two waited till 2000). Within a few months, the GPs that ran Mendip PCT decided that they weren't getting a good enough service from Taunton and decided to employ their own Director of Finance with a team of three management accountants (senior, junior and assistant) plus a clerical assistant beneath him. That must have tripled the wage bill for that small section immediately. Eventually all the other PCTs got their own teams. If similar happened across the country then it's no surprise that numbers have gone up.

But my point here is that it wasn't government diktat that got us to that situation, it's because decision-making was devolved down to doctors, it's them that decided that they needed better information and hired the people that could do the work.

3/04/2005 07:07:00 pm  
Blogger DM Andy said...

By the way, I missed your attack on the money I earn. It's an appalling cheap shot to compare what a starting nurse with no experience earned in 1999 to what an admin person with similar training earns after 8 years in the NHS in 2005.

I don't believe I'm over or underpaid (though it is true that when I'm in meetings with clinical staff I'm the lowest paid person there). Although I have no need to defend myself to you here goes.

I'm an Admin & Clerical Grade 5, on the top of my scale, that's £20,876/year. Under Agenda for Change, that should translate to Band 5, on £21,044. When I'd graduated and started with the NHS, an equivalent position would be bottom of Band 4, £15,504.

A newly qualified nurse (bear in mind that's the same university education I had) will start at the bottom of Band 5, that's £18,114. That's before any additional payments for nights and weekends, I doubt there's any full-time hospital qualified nurse in the country that actually earns less than £20,000.

None of this should be taken to say that nurses are paid too much, they do a very difficult job that should be more rewarded.

So Nosemonkey, next time you want to take a cheap shot at what someone earns, get your facts right.

3/04/2005 07:45:00 pm  
Blogger Nosemonkey said...

I think you misunderstood me, which is probably fair enough, given the circumstances. The main thrust was meant to be anti-management, where the really wasteful salaries are. It wasn't meant to be a personal attack by any means. The point about relative levels of medical / management / admin staff does, however, remain. The government has the ability to override local NHS trusts to cut back on wastage. Considering how much the thing costs, I think they should do - it's dying on its feet.

3/05/2005 12:19:00 am  
Blogger DM Andy said...

Nosemonkey, you said

"And - with all due respect - just as I find it simply wrong that a man running one small section of the NHS should earn more than the man who runs the entire country, I find it wrong that someone doing admin for the NHS should earn £6,000 a year more than a qualified nurse. (See here)."There were two things wrong with that, firstly the BBC News article you were linking to was a story about the 1999/2000 pay negotiations when a newly-qualified Grade D Nurse was earning £14,000 basic. So I pointed out that now, a newly-qualified Band 5 Nurse (the pay structures are in the process of changing) is on £18,114 basic, with the enhancements for nights and weekends bringing that comfortably up to £20,000. So the facts you were arguing were wrong.

Secondly, you weren't comparing like with like. If you want to talk about the wages of a newly-qualified nurse and compare to an admin person, you have to compare it to a similar job, ie a graduate entry level post, something like the NHS Graduate Scheme, which pays a salary of £18,114, exactly the same as that newly qualified nurse.

That's why I'm upset.

3/05/2005 08:10:00 am  
Blogger Nosemonkey said...

I'm not sure how I was supposed to know what level you are at - but again, no personal offence was intended. The point about the lack of medical compared to clerical staff nonetheless stands. It's this sort of thing which I was largely complaining about. We simply don't have enough medics (or cleaners to cut back on superbugs for that matter), but we do have plenty of managers and admin staff in the NHS.

The point was merely meant to be that for the thing to work more efficiently, more medical staff are required - and I'd say it makes sense to divert more of the limited funds to medical staff and training. In an ideal world, we'd have plenty of admin AND plenty of medical staff - but there simply isn't the money.

3/05/2005 12:10:00 pm  
Anonymous Anonymous said...

As a recently retired consultant I am amazed by the manager's comments. Perhaps he really does not realise how much the new management structures have used up the NHS funds. Doctors and nurses have always done the majority of the real management in the hospitals. The extra managers have been grafted in to check up on the clinical staff and to run all the wasteful PFI schemes. I suggest that he reads Pollock's book NHS plc.

12/15/2005 10:09:00 pm  

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