Because thats how many staff it takes. You may think its a stupid number but without them you would get no healthcare 1/2 a million of them are nurses. Then there are doctors, Operating department staff, receptionists, cleaners, laundry staff, porters, catering staff, drivers, procurement and supplies staff, payroll staff, maintenance staff, medical physic engineers, lab staff. researchers, training and teaching staff, admn and support staff etc etc. IIRC managerial staff are about 5% ot the total.

500,000 nurses, to take care of how many people?

500,000 people at 20k minimum, plus pensions etc.. how much money is that..

TJ: “Lanesra – no matter how you wish it the position is we have that many staff because that is what is needed. “

That is simply not the case.

Productivity has fallen in the NHS pretty much every year since 2000 – this effectively means that the more staff the NHS has employed, the less it has produced per FTE.

Take a trip round many PCTs and SHAs and you’ll find a mixture of impactful roles that are undertaken by passionate, committed people, and other roles that don’t really seem necessary and are quite often filled by staff that should have been managed out for underperforming but instead have been sidelined into roles that don’t really need doing.

Another example. Do we really need 10 SHAs and 151 PCTs, all with seperate Boards / Directors? Do we really need all 500+ NHS Trusts to each have their own IT director and individual model for service delivery? Is this really an efficient model for running a complex, distributed organisation? The answer is clearly no – the NHS needs to be run more efficiently with more of its resources going to front line services / staff.

Get into the clinical professions and you’ll find that in some parts of the country, nurse to patient ratios are 15% higher but standards / care is worse.

Put all of these things together and you have a picture of a system that has struggled to use its rapidly increasing resources (£37B in 1997 to £110B next year). As with any system, there’s waste, and due to the scale of the NHS, this all adds up. Adopting widely used standards already established elsewhere in Whitehall functions e.g. Online Procurement would also save somewhere between 5-10% of purchasing NHS spend.

Juan, none of this girlyman stuff- proper manlove; Steam tractor engine pistons.

I do not deny there is some waste and innefficiency. However it is very small in comparison to the size of the organisation. To reduce waste and innefficiency the NHS needs more and better quality management.

What people fail to realise is that some of the extra money has gone into improved quality of outcome that cannot be measured in easy ways.

The “budget tripled” thing is bogus as well. Inflation in medical world runs roughly double to inflation in the general economy. Saleries have also increased. Hence there is not 3X the resources available to treat patients. More like 30% more.

“I do not deny there is some waste and innefficiency. However it is very small in comparison to the size of the organisation”

That’s precisely the point. Because it’s the world’s 4th largest organisation, waste and inefficiency adds up. Take discretionary spend on areas excluding estates and staff. NHS procurement accounts for c£15B of annual spend. The office for government commerce reckons that a 10% spend could be achieved by procuring through electronic marketplaces – representing a saving of £1.5B / year. The NHS doesn’t do this, despite the saving representing the equivalent of running 10-12 district general hospitals for a whole year.

FarmerJ – are you the forum member formerly known as ex-yorkshire-truck-whore ? 😀

FarmerJohn – from working in the NHS I am certain that is simply not the case. If you go for a “one size fits all” procurement that in itself has waste. You end up with anomalies where equipment that suits one area is not available and then needs special measures to obtain this equipment.

Efficiency savings could be made but would be a tiny % of the overall cost. Insignificant and most likely swallowed up by the increased management to administer the megalithic set up you envisage

Meanwhile, back at the Tube Strike, London vaguely resembles the Serengeti during Wildebeest migration time. Pouring out of Waterloo station this morning and over the bridges, a vast, jostling crowd of people who normally make their journeys underground were surging along in a great mass of pinstripes and briefcases, slurping on frappamappachinos. The mood was good-natured, with a bit of light eye-rolling and that amazing avoidance of embarrassment that Londoners can manage when you squeeze several hundred of them into a very tight space, someone has a raging boner and everybody catches it. Bicycles throng the streets, London Cycling Campaign actually manages to get positive press for its well-executed and useful “bike tube” initiative, taxis from the terminals are running on fixed fare bands, the buses waddle along, bursting at the seams and the sun shines.

Crow’s lot are supposed to be back on this evening by the time we’re going home, but presumably many of them won’t be able to get to work because the tubes aren’t running.

All good fun.

🙂

Andywhit: I beg your pardon?

Not quite so good natured coming into the City from the North BigDummy, lots of irate van drivers trying to squeeze their Sprinters through gaps that even the most determined Lewis Day bike courier couldn’t get through

lots of dangers for us cyclists too with scooters and bikers weaving in and out of the gridlock without even a cursory glance; the tube rats forced to the surface, spilling off the footpath
though some stretches of road were bizarrely clear where someone had blocked the turn at the last junction allowing the cyclists to practice their Cavend-ish sprints

FarmerJ – are you the forum member formerly known as ex-yorkshire-truck-whore ?

😀

That took me back… Where are you now, oh scourge of the unions?

Speaking of dangerous delivery drivers. Large truck this morning had me into the kerb, 100m’s on- girl had to jump off her bike onto the kerb to avoid him pushing her over it. I followed him- and got alongside (black sunglasses on a grey morning. Had a rant- took down his reg/employer and a Beemer driver gave me her business card saying he had also cut her up and she’d be a witness.

Is it worth complaining to his employer? (City Link) or would they get soo many complaints a day and probably use agency drivers anyway?!

Do it Hora. I don’t know about Citylink, but I do know that UPS directly employ their drivers, so it may well not be an agency. The company will be keen to protect its reputation, and will most likely give the driver a warning if only because they don’t want the hassle of dealing with complaints.

Phone them up and ask to speak to their fleet manager, if they get lippy say that you’d like to speak to the MD. I usually say its either one of them or I’ll just phone the police instead.
I particularly like it when they have “how’s my driving” stickers on the back. I phonbed one and held the phone up so’s the operator could record the threats and foul language coming out of the cab window.

😮 I emailed through- contact over another matter’. Woman just called me, checked some details then said she would be speaking to the Depot Manager (do you want him to call you as well?)- I said no need. Wow. So I would say a circa 40mins response time for a general email/through a companies site.

Inflation in medical world runs roughly double to inflation in the general economy

We’re doomed then. At that rate, how long before the cost of the NHS is more than the entire country earns? Or will we have to make harsh decisions about costly treatments and accept that some aspects of healthcare might not actually improve?

I think that that’s what’s happening now already.