Money and the NHS

We are forever being told that the NHS needs more money to cope with its ever increasing workload and that all possible economies have been made.

Is this true? Economies may have been made, but the waste appears to continue.

A typical response to any comment about the high salaries of senior administrative staff is that they have to be paid to attract the necessary talents. But is this so? This report from yesterday's Daily Mail surely says it all.

A builder who built his life on 'staggering lies' has been jailed for two years after making more than £1 million over the course of a decade by pretending to have a PhD to become chairman of two NHS Trusts.

Read the full story at "'Walter Mitty' former builder is jailed for two years"

The Walter Mitty style health chief fudged his CV in 2004, adding a doctorate which he did not have, and became the chief executive of St Margaret's Hospice in Taunton, earning nearly £100,000 a year.

He chaired the Torbay NHS Care Trust for nearly ten years, from 2007 to 2015, before becoming the chairman of the Royal Cornwall Hospital Trust in April 2015. 

But more interesting is the statement that he was said  to have beaten "117 rivals to become chair of Royal Cornwall Hospital Trust."

Surely all this demonstrates the poor quality of the people at the top. With 117 candidates for the post, he was deemed to be the best by the selection committee! Surely this says as much about those who chose him than the man himself. Then perhaps we should also ask about the qualifications of the staff working under him; if he is the best (as no doubt some of the senior staff would have applied for the posts), how good are they?

There are some 200 or more NHS Trusts in the UK, it would be interesting to know about the qualifications of those holding the senior management posts in all of these. How many more totally unqualified people are at the top of some of these trusts? How many got their jobs because of "The Old Pals Act"? How many more hold the posts because they submitted a false CV, or were promoted to a post for which they were not qualified?

I suppose of more concern from a prospective patient's point of view, a relevant question is "How many doctors within the NHS are not really doctors and totally unqualified to treat patients?" If a trust can't be bothered to check up on  a candidate for appointment as chairman, how well does it check candidates for medical roles?

Surely a wide-ranging enquiry is called for into the NHS recruitment procedures and their effectiveness.

Yet Another NHS "Study"

The Mail informs us that
"Study finds link between the thousands that die and wards with too few doctors"

I wouldn't have thought that it needed much "Study" to produce this amazing piece of information! It would appear that 14 NHS Trusts which which have been identified as having higher death rates have about 17% less doctors than average. They also have five per cent fewer nurses and 22 per cent fewer cleaners. These hospitals have on average only 50 doctors per hundred beds. By contrast, the best staffed hospital,  Guy’s and St Thomas’ in London, has 125 doctors per hundred beds, two and a half times more than the worst hospital and, as a result, has a death rate 22% below average.

To me, it is common sense; the more medical care that a patient has, the better are his chances of survival, why the NHS had to commission a study to prove this escapes me. Hopefully, the research will come up with recommended staffing levels for hospitals, making allowance, of course, for any specialist departments which might need above average staffing.

More to the point would be a study, by independent auditors and business experts, aided by the police if necessary, to find just where the money has gone, as my understanding is that funds are allocated to hospitals broadly on a per capita basis dependent upon the numbers of patients being treated. We need to know  among other things how the money has been spent, whether there has been any fraud, whether there are excessive administrative staffing levels and whether the salaries being paid to such staff are appropriate when compared with other Trusts and the private sector. In simple terms, is the management incompetent?

I must admit to a vested interest; the Buckinghamshire Healthcare NHS Trust, in whose area I live, is one of the 14 Trusts included in the study. Statistically, there should have been some 1553 deaths per year when in fact there were 1788, some 15% above average, and considerably more than achieved in the best hospitals. Personally, I don't believe that these figures will be helped by the recent closure of our nearest A&E at High Wycombe forcing emergency patients to travel longer distances to the already very busy Stoke Mandeville Hospital for treatment.