Letter i saw in the Telegraph sums things quite nicely.


SIR – There is a simple way of saving money in the NHS. In my field, we have more people directly or indirectly scrutinising cardiac surgeons than there are cardiac surgeons. We even have people scrutinising how we react to being scrutinised. Now, where’s my knife?

E. E. J. Smith FRCS
London SW20

Originally Posted by LadybeGood

Letter i saw in the Telegraph sums things quite nicely.


SIR – There is a simple way of saving money in the NHS. In my field, we have more people directly or indirectly scrutinising cardiac surgeons than there are cardiac surgeons. We even have people scrutinising how we react to being scrutinised. Now, where’s my knife?

E. E. J. Smith FRCS
London SW20

LadybeGood you get to the heart of the problem (if you’ll forgive the pun). :D

I understand 60% of NHS staff are bureaucrats, and there are now more managers in the NHS than beds - with many earning more than £100,000 per year.

“Marketisation,” and particularly the Conservative-created Private Finance Initiative (PFI) schemes imposed by Gordon Brown, has been a disaster that is saddling Trusts and the taxpayer with enormous debts. This attempt to turn the nation’s health service into a private profit centre for giant corporations should surely be rejected.

The figures released by the NHS Confederation show that the NHS budget for 2010/11 will be increased by £4.1 billion - just two thirds of the total foreign aid spend by the British government for 2009 (£6.02 billion).

It seems to me that Government should be wholly committed to a free, fully funded NHS for all British citizens and should amongst other things:
- Replace say 100,000 NHS bureaucrats with doctors, nurses and dentists;
- Invest sufficient money in the NHS to provide a decent service to the British people;
- Bring hospital cleaning back in-house and make high cleanliness a top priority;
- End the scandal of foreign health tourism that is currently costing £2billion per year;
- See to it that no money is given in foreign aid while our own hospitals are short of beds and the staff to run them.

Originally Posted by Markintime

The biggest trouble for the NHS is funding 'well medicine'. That is fertility, cosmetic surgery etc. If the NHS just treated illness and injury and pared down it's overstuffed (at managerial level) infrastructure then the finances would be a lot easier to manage.

I have to say this is only part of the problem, the main issue is treating those who are non entitled. Frequently in my little corner of the world I see non entitled patient with chronic illness fly in see the doctor who will often prescribe expensive treatments & they will fly back to their respective country.

The doctor & nurses all know they are non entitled however it is a HR responsibility to screen & check entitlement.

I myself have contact HR with concerns over entitlement, pass the information on only to see the same old faces 2 or 3 months later.

Health tourism is costing this country millions each year, a study in 2003 stated it may be as high as 200 million a year

Originally Posted by Pox_Dr

I have to say this is only part of the problem, the main issue is treating those who are non entitled. Frequently in my little corner of the world I see non entitled patient with chronic illness fly in see the doctor who will often prescribe expensive treatments & they will fly back to their respective country.

The doctor & nurses all know they are non entitled however it is a HR responsibility to screen & check entitlement.

I myself have contact HR with concerns over entitlement, pass the information on only to see the same old faces 2 or 3 months later.

Health tourism is costing this country millions each year, a study in 2003 stated it may be as high as 200 million a year

I'm surprised that is allowed to continue, especially by hard pressed trusts. Does it account for a large percentage of funding?

Originally Posted by Markintime

Originally Posted by Pox_Dr

I have to say this is only part of the problem, the main issue is treating those who are non entitled. Frequently in my little corner of the world I see non entitled patient with chronic illness fly in see the doctor who will often prescribe expensive treatments & they will fly back to their respective country.

The doctor & nurses all know they are non entitled however it is a HR responsibility to screen & check entitlement.

I myself have contact HR with concerns over entitlement, pass the information on only to see the same old faces 2 or 3 months later.

Health tourism is costing this country millions each year, a study in 2003 stated it may be as high as 200 million a year

I'm surprised that is allowed to continue, especially by hard pressed trusts. Does it account for a large percentage of funding?

I'm not certain about how high the percentage of funding is devoted to health tourism. However, the current costs are £2 billion per year.

Originally Posted by Ex-Grenadier

LadybeGood you get to the heart of the problem (if you’ll forgive the pun). :D

I understand 60% of NHS staff are bureaucrats, and there are now more managers in the NHS than beds - with many earning more than £100,000 per year.

“Marketisation,” and particularly the Conservative-created Private Finance Initiative (PFI) schemes imposed by Gordon Brown, has been a disaster that is saddling Trusts and the taxpayer with enormous debts. This attempt to turn the nation’s health service into a private profit centre for giant corporations should surely be rejected.

The figures released by the NHS Confederation show that the NHS budget for 2010/11 will be increased by £4.1 billion - just two thirds of the total foreign aid spend by the British government for 2009 (£6.02 billion).

It seems to me that Government should be wholly committed to a free, fully funded NHS for all British citizens and should amongst other things:
- Replace say 100,000 NHS bureaucrats with doctors, nurses and dentists;
- Invest sufficient money in the NHS to provide a decent service to the British people;
- Bring hospital cleaning back in-house and make high cleanliness a top priority;
- End the scandal of foreign health tourism that is currently costing £2billion per year;
- See to it that no money is given in foreign aid while our own hospitals are short of beds and the staff to run them.

Whilst your ideals are spot on, your suggestions are way off.

Where do you get the figure that 60% of NHS staff are managers. On the proviso that the NHS employs around 500,000, that would mean there are around 300,000 managers in the NHS, leaving only 200,000 to be doctors, nurses, porters, administrators and associated health professionals.

As for many earning over £100,000pa, if you look at the payscales, most middle management are around the band 8a-8c scale, working out around £40-60k. The guys who get over £100k are the Chief execs, and directors, who make up a tiny proportion of the total number. Don't get me wrong, half of them don't bloody deserve it!

The NHS confederation project a budget fall (in real terms) over the next 5years, but that is after 10 years of ever increasing budgets, with little rel progress or improvement to show for it. Don't believe me? See the ONS report that shows that public sector productivity has declined over the period from 1997-2007 despite RECORD investments (almost 100% increase in investment over those 10yrs).

Public spending shoots up, productivity plummets...

We can't replace 100,000 beaurocrats with Nurses and Doctors. It's these very beaurocrats who run the bloody service. Doctors and Nurses do what they do best. Treat patients. Administrators and managers run the service so that Nurses and Doctors can do their jobs. Besides, there are more doctors and nurses coming out of Uni than we can give jobs to. Some of them have to apply for tens of jobs before they will even get an interview.

I do however agree that services should be brought back in to the health services. Have cleaners and janitors who are responsible (and accountable) for one area of the hospital, rather than imigrants (or chavs) on minimum wage, with little or no interest in doing a good job.

I would make an appeal to everyone who bashes the NHS to actually do some investigation into the headlines in the papers. Nine times out of ten, they don't add up. Yes, the service needs more front line staff, and yes it needs to re-focus itself on the patient, but without managers and administrators, the service would fall apart. It is now such a big and complex organisation that it needs a subculture of people to oil the machinery, and trust me, Doctors and Nurses are not those people...

Originally Posted by Pox_Dr

Originally Posted by Markintime

The biggest trouble for the NHS is funding 'well medicine'. That is fertility, cosmetic surgery etc. If the NHS just treated illness and injury and pared down it's overstuffed (at managerial level) infrastructure then the finances would be a lot easier to manage.

I have to say this is only part of the problem, the main issue is treating those who are non entitled. Frequently in my little corner of the world I see non entitled patient with chronic illness fly in see the doctor who will often prescribe expensive treatments & they will fly back to their respective country.

The doctor & nurses all know they are non entitled however it is a HR responsibility to screen & check entitlement.

I myself have contact HR with concerns over entitlement, pass the information on only to see the same old faces 2 or 3 months later.

Health tourism is costing this country millions each year, a study in 2003 stated it may be as high as 200 million a year

Simple solution, ask to see the passport, or a national insurance card.

If they can't present, make sure they are not in any immediate risk of death, then send them on their way.

Originally Posted by Agent_Smith

Simple solution, ask to see the passport, or a national insurance card.

If they can't present, make sure they are not in any immediate risk of death, then send them on their way.

Simple, as you say; so why doesn't that routinely happen?

The reason is simple.

Our politicians and our managers wont risk the sight of people in pain or other difficulty in front of our hospital doors getting to the press.

Well,MPs expenses have to be funded,somehow!