Department of Health statistics showed the health service spent pounds 25m on general managers' pay in 1987 compared with pounds 251m last year. The number of NHS general and senior managers had risen from 700 in 1987 to 13,200 in 1991.
David Blunkett, Labour's health spokesman, said: 'It is an absolute disgrace that the commercialisation of the health service is resulting in public money being spent on increased salaries for senior managers instead of prevention measures and the care of patients. These figures show increased bureaucracy being created by the Government's reforms. Patient care is not being given the priority it needs.'
Hector MacKenzie, general secretary of the health union Cohse, said the figures proved the imposition of a managed market on the NHS had been an expensive mistake. He pointed out that over the same period the total pay bill for nurses and midwives rose by only 60 per cent. 'Instead of staff at bedsides we have managers in offices.'
The Department of Health insisted the figures reflected a planned increase in managers to cope with health reforms. Few new staff had been taken on from outside the service, it said.
Virginia Bottomley, Secretary of State for Health, insisted that the appointment of more managers had helped cut waiting lists, and increased hospital activity. She added: 'I shall be weeding out unnecessary bureaucracy like everyone else.'
The Institute of Health Services Management argued that expenditure on general managers was still only 2.2 per cent of the total NHS salaries and wages bill, which compared favourably with other health services around the world.
It said: 'Demands on managers have increased significantly. There is far greater responsibility to ensure the requirements of successive governments are delivered, and there are higher risks to job security.'
The Department of Health statistics also showed a fall of 44 per cent in NHS ancillary staff to 95,000 over the last decade largely through competitive tendering for laundry, catering and domestic services.
Health and Personal Social Services Statistics for England. 1992 edition; HMSO; pounds 11.50.Reuse content