December 29, 2002 

Latest figures reveal NHS has more bosses than beds
JONATHON CARR-BROWN AND LOIS ROGERS


THE National Health Service now has so many levels of bureaucracy that there are more administrators than hospital beds. 
Official figures reveal that for the 199,670 beds currently available there are now 211,650 staff classed as managers, administrators or clerks - an all-time high. Critics blame ministers' obsession with target- setting for the rise. 
The growth of administrators employed to monitor NHS performance and progress towards the government's 300 targets, has seen the bureaucracy grow by almost 12,000 in the past year alone. 
Figures released to Tim Loughton, the shadow health minister, show the number of senior NHS managers more than doubled in the past decade to 27,000, while the number of beds fell by almost 59,000. 
"It is ridiculous. You cannot get through a morning's work without being interrupted by someone with a clipboard asking silly questions," said a consultant at the Queen Elizabeth hospital in Birmingham which has more than 1,300 administrators for its 1,000 beds. 
Another specialist, in London, said: "We have people called patient pathway managers - uneducated individuals being paid £35,000-40,000, and trying to work out what they are meant to be doing." 
Management journals are packed with advertisements for NHS "information analysts", "service planners" and "access managers" as well as "programme facilitators". Salaries for these posts range up to £60,000. 
In evidence to the parliamentary public administration committee investigation into the effects of government target-setting earlier this month, the NHS Confederation, which represents NHS managers, agreed that there were too many tiers of administration between the government and the health service frontline. 
"We believe the service has become over-bureaucratised and no one has any proper picture of what is going on," said Gill Morgan, its chief executive. 
"One person may be responsible for collecting four pieces of information, but if lots of people are doing that you risk a situation where vast amounts of data are being gathered, possibly for no reason. 
"The most powerful management is really simple, and agreed between all the people involved in it, otherwise it becomes a paper chase." 
To add to the numbers, a new tier of auditors is being recruited to track the extra £40 billion of healthcare expenditure announced in this year's budget. 
The NHS Confederation is currently collecting details of more than 600 performance indicators that all NHS hospital trusts have to provide every month for the Department of Health. 
The process will be completed next month and will be used to mount a protest to the government about the amount of working hours swallowed up by such activity.