Is the NHS really over-managed?

Managers There are over 35,000 managers in the NHS in England

It has become fashionable to bash NHS managers.

In fact, it is a common joke within the profession that you are better off saying you are an estate agent than health manager.

It is easy to understand why.

Ministers have been quick to criticise the "pen-pushing culture" in the NHS with both current Health Secretary Jeremy Hunt and his predecessor Andrew Lansley promising to reduce bureaucracy in the NHS.

The number of managers in the health service has already been cut by nearly 7,000 in the last three years and now stands at 35,650 in England.

But in the rush to tackle the "problem" has it been properly considered whether management and leadership in the NHS actually needs sorting out?

Research to be published later this summer by the Chartered Management Institute shines an interesting light on the issue.

The work has found the NHS has a poor record in investing in its managers.

Compared to other parts of the public sector, it spends nearly 30% less on training its leaders, the research suggests.

The CMI goes on to argue that this is misguided as good management leads to an engaged workforce that is more productive and provides better care.

Ian Reynolds, the chairman of Kingston Hospital, who has been crunching the figures for the CMI, is clear.

"It may be unfashionable to say so, but overall the NHS is under-managed."

Dean Royles, director of NHS Employers, agrees managers have been unfairly targeted.

While acknowledging the failure in management over the Stafford Hospital scandal had been "deeply embarrassing", he also believes good managers are a force for good.

"We know if we have engaging managers we have an engaged workforce. These staff are more likely to be committed, work well as a team and go that extra mile for patients," he says.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 272.

    @James Allen, you could not be more wrong if you tried. How will your medical sciences degree qualify you to be a professional manager? There is an essential place in NHS management for experienced medical professionals, in partnership with professional managers and provided they are well-trained in management. But a wet-behind-the-ears graduate with "passion for medicine"? No thanks.

  • rate this

    Comment number 271.

    @laughingman - with you right there, I am at the end of a medical sciences degree and wish to manage within the NHS, as I know that I could apply my interest in medicine (and my back ground in care) effectively within the NHS. I know that someone with a degree in management won't have the same passion for medicine, and as a result will be worse...

  • rate this

    Comment number 270.

    Just what do many of the responders below fail to comprehend? The NHS has always been controlled (aka 'managed') by doctors and nurses, but they are expert in blending into the background when things go wrong (with care that they and only they are actually delivering). Doctors and nurses are only managed by their own...guess who investigates and exonerates?

  • rate this

    Comment number 269.

    Sometimes it's necessary to cut costs, meaning wages. Now who decides the redundancies? Managers. Whom do they make redundant? Nurses. They are not going to sack themselves yet the saving from sacking 10 nurses = the same as from sacking one manager. Fewer nurses = patients waiting sometimes hours in pain and discomfort. Fewer managers = fewer pie charts, tick boxes and meetings. Ask patients.

  • rate this

    Comment number 268.

    If the NHS seriously reckons it needs more managers, maybe the real issue is that too many of the current managers were almost certainly recruited from generic backgrounds with no prior experience of working in the NHS.

    Sadly, the issue of managers with little 'hands on' knowledge of the Industries they control seems all too common in the UK, as I am sure most people have experienced first hand.


Comments 5 of 272



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