NHS employs more managers but fewer nurses


Health Editor

The number of health service managers rose by 15 per cent between 1993 and 1994 as the number of nurses and mid-wives fell by four per cent, according to Government statistics published yesterday.

The figures appear to undermine repeated promises by ministers to cut red tape in the NHS which critics say is compromising patient care.

However, a Department of Health spokesman said the rise in the number of managers was due largely to changes in the way they are now counted. The fall in nurses and mid-wives did not allow for the increased appointment of nurses to GP surgeries and other sectors of care, he added.

The Royal College of Nurses immediately condemned the Government "smoke screen" over the figures. A spokesman said: "The harsh reality is that every year more qualified nurses are leaving the NHS while the number of managers increases in leaps and bounds." Last year there were "just 480" new practice nurses, he added.

Between1989 and 1994, the period including the introduction of the NHS internal market, the number of health service managers rose by 400 per cent. John Redwood, former Secretary of State for Wales, was the first senior Government figure to attack the growing army of "men in grey suits" in 1993.

Stephen Dorrell, Secretary of State for Health, in one of the most direct attacks yet on NHS bureaucracy, last month warned inefficient managers they should be "quaking in their boots" and threatened that hundreds of them faced the sack and would be replaced by front-line health service staff.

According to the Department's own figures published in its statistical bulletin, the number of senior and general managers rose from 20,010 to 22,950 in 1993-1994, while over the same period the number of nurses and midwives fell to around 348,000.

However, the departmentsaid that the rise in managers was due in part to a new classification system for NHS personnel which broadens the category to include lower tiers of staff.

The internal market which has been widely blamed for bureaucracy, accounts for only about five per cent of the increase, he added.

Gerald Malone, the health minister, last night reaffirmed the Government's determination to crack down on bureaucracy. He said general and senior managers accounted for only three per cent of the total NHS workforce.

He pointed out that savings of pounds 200m which would be achieved by1997-1998 through the re-organisation of health authorities.

"Although the statistics show a reduction in the number of nurses and midwives, the way they are collated does not take account of the near doubling of nurses in GP practices,"

The bulletin's main findings were that as of September 1994 there were about 940,000 people employed in the NHS hospital and community health services (HCHS) in England. This overall total is equivalent to about 760,000 wholetime equivalent staff, of which seven per cent were medical and dental staff, 58 per cent non- medical direct care staff and 35 per cent other non-medical staff;

t NHS Hospital and Community Health Service Non-Medical Staff in England: 1984-1994; Department of Health.