Fewer hospital beds, fewer doctors, many more managers
An Independent Audit of the NHS under Labour (1997 to 2005) has just been published by the King's Fund. I looked straight for what the audit found in relation to staffing, both clinical and non-clinical:
(a) Compared with 1987-88, the number of acute and general hospital beds have fallen from 180,889 to 136,123 in 2004-05 (a reduction of almost 25%).
(b) The number of doctors has supposedly increased from 86,580 in 1996 to 108,990 in 2003 (an increase of just over 25%). BUT, a significant proportion are only work part time, and because of the European Time Directive, all the junior doctors are doing far shorter hours; in reality, the "doctor hours" has actually decreased.
(c) Despite this, between 1997 and 2003, the number of managers and senior managers working in the NHS rose by 12,376 (from 21,434 to 33,810), representing an increase of 58%.
What the hell is going on?
Comparison with other developed countries also makes interesting reading. For instance, while the number of nurses within the NHS has increased, England still lags behind every country except Italy in terms of the number of nurses per 1,000 population. England also has the lowest number of practising doctors for every 1,000 people in the population of all developed countries.
So, if many hospitals are running at a deficit (because they are underfunded), and it is nurses and doctors who treat patients, and there are too few of them, why aren't we spending limited funds on increasing the clinical staff working in the NHS rather than on bureaucrats? Why not have a genuine 50% increase in the number of medical staff (doctors and nurses) who are available to look after and treat patients (forget about "head counts" which are completely misleading as many are part time, and those who are full time are working far fewer hours), and if we have to (and I am sure we don't, there are too many of the them already), 25% more managers rather than the other way round?
(a) Compared with 1987-88, the number of acute and general hospital beds have fallen from 180,889 to 136,123 in 2004-05 (a reduction of almost 25%).
(b) The number of doctors has supposedly increased from 86,580 in 1996 to 108,990 in 2003 (an increase of just over 25%). BUT, a significant proportion are only work part time, and because of the European Time Directive, all the junior doctors are doing far shorter hours; in reality, the "doctor hours" has actually decreased.
(c) Despite this, between 1997 and 2003, the number of managers and senior managers working in the NHS rose by 12,376 (from 21,434 to 33,810), representing an increase of 58%.
What the hell is going on?
Comparison with other developed countries also makes interesting reading. For instance, while the number of nurses within the NHS has increased, England still lags behind every country except Italy in terms of the number of nurses per 1,000 population. England also has the lowest number of practising doctors for every 1,000 people in the population of all developed countries.
So, if many hospitals are running at a deficit (because they are underfunded), and it is nurses and doctors who treat patients, and there are too few of them, why aren't we spending limited funds on increasing the clinical staff working in the NHS rather than on bureaucrats? Why not have a genuine 50% increase in the number of medical staff (doctors and nurses) who are available to look after and treat patients (forget about "head counts" which are completely misleading as many are part time, and those who are full time are working far fewer hours), and if we have to (and I am sure we don't, there are too many of the them already), 25% more managers rather than the other way round?
posted by Adam at Thursday, February 09, 2006
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