Those overpaid NHS managers

Jeez! I left the health service ten years ago and I still read the same boring old crap.

Also known as misinformed information, or however you want to describe it.

Let’s get this straight.

A so-called overpaid manager earned between £30-50K a year. I’m using old figures here.

A medic earned £50-100K a year, or more if they were on bonus.

We have got this haven’t we? These people are trained to treat patients and you want them to waste their time on management?

Get out of it.

Can you not do the cost benefit analysis?

If anyone can find one good reason why someone on twice my salary should spend their time on managerial issues instead of treating patients, then go ahead. I am really interested.

About roughseasinthemed

I write about my life as an English person living in Spain and Gibraltar, on Roughseas, subjects range from politics and current developments in Gib to book reviews, cooking and getting on with life. My views and thoughts on a variety of topics - depending on my mood of the day - can be found over on Clouds. A few pix are over on Everypic - although it is not a photoblog. And of course my dog had his own blog, but most of you knew that anyway. Pippadogblog etc
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37 Responses to Those overpaid NHS managers

  1. Perpetua says:

    I used to work in local government and am familiar with all the ill-informed criticisms of managers. Do people really believe that organisations run themselves once they’ve been set up? Sigh….


  2. bluonthemove says:

    My father was deputy medical superintendent at the local asylum. He did some admin but mainly saw patients. The medical superintendent decided to retire which posed my father a dilema, he didn’t want the top job as that would mean no longer seeing patients, but didn’t want someone else to have it either.

    His solution was to suggest doing away with the superintendents job, give himself the title of senior consultant i/c clinical decisions, and bring managers in to run the non clinical aspects of the hospital. This had been tried in one or two general hospitals, but I believe this was the first time this was done in an asylum, this would be well over 40 years ago.



    • I got on extremely well with my clinical colleagues. We both got paid commensurately for different jobs. There is no logic in asking a medic to do a manager’s job that they aren’t paid to do, and don’t know how to do, when their skills are elsewhere, and there never will be.


  3. Journalists are to blame! The newspapers are full of misinformed rubbish written by people who want to provoke a public v. private sector divide. The power of the popular press is determined to make an issue of public sector performance, pay and pensions whilst failing to understand how it works – or not wanting to!


    • Journalists are not to blame at all!! Stupid people are to blame who consider that doctors should spend their valuable time running health services instead of letting managers on half the salary run them.

      Politicians endlessly want to point the finger at overpaid managers, People do too though. Everyone thinks managers are a waste of space.

      Every hour I spent in the health service would have been double the cost had it been done by a medic. The first medic who stood in for me at one meeting didn’t know his elbow from whereever. I am sick of manager bashing but it isn’t just coming from journalism. It also comes from stupid soppy public perspectives that think ‘professionals know better’. Really? Because I can give an awful lot of examples ……


  4. Vicky says:

    If the medics are tied up with managerial issues instead of treating the patients, that could explain why there are waiting lists for ops.


    • I would have thought that was fairly obvious to anyone with half a brain. Medics should be doing medicky things and leaving boring old stuff to boring old people.

      There are waiting lists/times for ops because there always have been and will be. There is a psychological aspect to not going for an op too soon as well.

      Waiting lists for ops are selective. But this post is about saying why is a doctor earning twice the money of a manager to do a manager’s job when they should be better employed doctoring.

      The concept that doctors know how to diagnose/cut people up so therefore can run services is so seriously flawed it is laughable.

      But hey, if the Brit public wants to spend £100K plus on a medic wasting time on paperwork, who am I to argue?


  5. EllaDee says:

    I’m not sure how many people [who should] understand the term “cost benefit analysis” or “economy of scale”… even though they’re basic high school economic principles.


    • Bashing public sector managers – central government civil servants, local government officers, and especially NHS managers is quite the fun sport. It’s also always irrational based on pure emotion and totally ill-informed. I’ve worked in all three as well as the private sector.

      There are lots of ways all three could be improved, and indeed the private sector too, but cutting back on hard-working, efficient and effective managers and replacing them with a more expensive ‘professional’ (of whatever type) who has no managerial skills or qualifications is not one of them.


  6. pendantry says:

    To compensate for my flippancy above, here’s what I think about this:

    There are several intermingled issues here. Clinicians have enough on their plates making sure they’re up to date with medicine: expecting them to also be expert information technologists as well is asking for trouble. While I take on board the problem that some administrators are too ready to implement change for its own sake, information technology moves on, and to take advantage of the advances in that field requires change.

    The single most important issue here, to my mind, and one that too often seems ignored when the rants against cuts start (and believe me, I too can rant against ‘em like a good’un), is the simple fact that we’re expecting ever more from a service that as we all know is hard-pressed to service its current workload. We’re living longer; the age profile of the UK is changing, upwards. More ways of dealing with diseases and infirmities are constantly being introduced (and Big Pharma never fails to get its massive payback for each one). We’re expecting more from the NHS, while at the same time throttling its resources right back.

    My mum has had both knees and both hips replaced. She has had to wait, from one point of view, a ridiculously long time for these operations: from another point of view, twenty years ago she would have been bedbound by now — or worse. When it’s my turn to get into the queues for knees and hips (… and shoulders? elbows? eyes? ears?), I’m going to be sharing the queue with far more people than she has had to.

    The bottom line, as I see it, is: the only way we can possibly get an ‘NHS service’ that repairs all our ills when we need it and doesn’t charge us a bean at the point of care is if we, each and every last one of us, stump up more to fund it, in tax (it would be a good idea to start with those who play the system to avoid paying tax altogether). And that is something that nobody (bar me, it seems) is prepared to even consider.


    • I did see your reply on DOPs 🙂 but thanks for adding it here too as we have a different readership. Or should that be just readers?

      Totally agree with what you say. As I recall, in MORI type surveys people always claim they will pay more for health (and education) and when it comes down to voting, they always go for tax cuts. Ah the fickleness of human nature. Your link to the company scam is just so depressing. Yet another example of big money avoiding contributing to the system. I’m glad I avoid anything to do with GlaxoSmithKline or whatever they are called these days (that’s based on their animal testing rather than their financial lack of ethics).

      We also overuse our health service in the UK. I fell a few years ago – dog chasing cat scenario – and my right arm was useless for four months. Having seen enough of hospitals, and to be truthful that also included clinical incompetence, I didn’t go to hospital. Had I been working, I would have not had that option, but I let it sort itself out. That was four months of no lifting, writing, brushing hair/teeth, putting in contact lenses – and I am right-handed. Little by little, movement came back and less painfully. Keyboard activity was actually good for the fingers, although my writing is still bad (never was good once I started typing). But that is an appointment in casualty, a few X-rays, either a cast, or an operation to mend anything broken (almost certainly bones in fingers) sprained wrist, upper arm, a couple of pins in. Taking everything out a bit later. Physical therapy. Blunt truth – unnecessary.

      That’s not to compare it with hip/knee replacements. That’s a different issue, and your comment about being bedbound being worse than a long waiting list is a good one. Our expectations are too high, and yet we abuse a ‘free at point of care service’ by going to the GP with every sniffle under the sun.

      I think the other point that people outside the service don’t appreciate is how much our hands are/were tied by politicians. I do think, as a public service, the NHS should provide statistics. But it is seriously complicated collecting and providing them accurately. Do people really want doctors to be doing that? And yet they want to know what is going on. Someone has to do it, and that person is invariably a manager. Someone has to interpret them too, and make sure they are accurate.

      I knew very few, if any managers who implemented change for the sake of it. We reluctantly had to implement political changes – or we would have been out of a job. Simple. What we tried to do, when we weren’t busy doing all the silly political stuff, was work with our clinical colleagues to make changes that improved services so that patients got a better deal. That to me, was what change was about. It also needed someone with good co-ordination and communication skills to bring together different clinical skills, take an overview, and motivate people to make that change. The NHS is another world on the inside, and sadly ever more centralised 😦


  7. free penny press says:

    Being an American I am out of the loop here but in reading all the comments I’d say That’s another fine mess someone has created..


    • It’s not actually a mess at all. It is portrayed as one. Big difference. I would hate to have your (lack of) health care 😦 really feel for Americans when I read about yet another way of taking away contraception. It is basically a great service, which needs some improvements in clinical quality and admin.

      It does not need political intervention and wasting money, which is where your point is spot on.


  8. bluonthemove says:

    I remember reading some very impressive statistics for Cancer outcomes from the USA. On delving deeper it turns out that these really good outcomes were only those of the 55% of the American popualtion who have health insurance, as they’d been gathered by the health insurance industry, leaving out the outcomes of the 45% of people who didn’t have health insurance.
    Can’t help thinking if one compared like with like, the UK results would be atleast as good if not better than the US ones, and would deflate some of the arguments against universal health care.


    • Basic but extremely essential and great point about who is collecting the stats/making the study. I tended to read Mayo Clinic and anything published in New England Journal.

      The only arguments against universal health care are political and financial ones ie those looking to make money out of sickness and those who erroneously believe that a tax-based health care system is wasteful. (And who love everything American)

      I cringe reading about American health care experiences. Someone paid thousands, maybe 32K$ ? for an RTA recently that wasn’t even major.

      I doubt outcomes are about a system. Maybe about the amount of money invested in expensive technology? maybe about times of presentation (but again, not relevant in some cases), and so often about five-year survival (so-called) rates.

      It’s a long time since I read much on cancer outcomes, but the one thing that stuck in my mind was a population-based comparison which said Med Spain, specifically Murcia, had a great survival rate/low incidence.

      From which, I took the simple message, eat more vegetables and less garbage. Prevention being better than cure. I’m summarising and simplifying hugely there, but I don’t think there is that much difference in clinical knowledge or care worldwide – in theory. In terms of auditing individual clinicians, that’s a different matter, but for cancer that is about infection rates and margins of excision, for example.

      But don’t smoke, eat well, exercise to some extent, drink in moderation, and avoid obnoxious chemicals seems like a great start to me for any health regime. Here endeth my health lecture of the day.


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