I was invited to appear on Radio 5 Live last night in a discussion about the decision of the NHS in East Suffolk that GPs and consultants will not refer anyone classed as obese for hip and knee replacements.
I argued that this level of rationing of healthcare was the inevitable result of having the NHS which, like most state monopolies, wastes its money and staff on an enormous scale. I referred to the study by Maurice Slevin which indicated that the managerial, administrative and support staff in the NHS per nurse runs at four times the level of a private hospital. In the NHS there are eight management, admin and support staff per ten nurses compared to only 1.8 in a private hospital.
Unfortunately I did not have the opportunity to counter an argument put forward by Roy Lilley (please excuse me if I have mispelled his name) a former NHS Trust chairman. He asserted that only 2.8 per cent of the staff in the NHS were senior management.
That is the sort of statistic that the NHS loves to trot out on such occasions. It gives the impression that there is no overmanning. But that impression is utterly misleading.
One needs to note the precise phrase being used. He did not say 'Management, administrative and support staff' he defined it very narrowly by saying 'senior management'. That really does not address the argument at all. The assertion is that the NHS is inefficient and wasteful in its employment of all these managerial and back-up staff as a whole - not that it is merely wasteful with the numbers of 'senior management'.
Incidentally, I don't know how the word 'senior' is defined. But it is obviously very easy to define that word as one likes. If one defines it very narrowly, then even this figure could indicate wasteful use of resources. Think of this parallel: if one said, 'only 2.8 per cent of the employees of the army are generals' it would indicate massive over-employment of generals.
Posted by James Bartholomew • Indexed in NHS • Waste in public services
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To be fair to Roy Lilley, he is no unthinking defender of the NHS. In fact he is frequently very critical of it.
Take a look at this article from the Guardian, for example:
http://society.guardian.co.uk/publicmanager/comment/0,13002,926566,00.html
Posted by: HJHJ at November 24, 2005 09:29 PM
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'Tis true, political debates are awash with spurious statistics that obscure clean lines of argument. It is sometimes difficult to find a newspaper article which does not base it's entire case on irrelevant statistics.
At the moment I keep reading that "aviation emissions are the fastest growing source of greenhouse gas emissions". That is mostly irrelevant in terms of policy recommendations if they are nevertheless small compared to other sources.
It's not a rational world out there ...
Posted by: Tory Convert at November 24, 2005 06:22 PM