Press release: Claim that the NHS has too many managers is misleading and dangerous, claims new SMF publication

19 May 2004

Claims that the NHS has too many managers and administrators are not only untrue, they are hugely damaging to the morale of hardworking NHS staff, and to the quality of the health debate," says Nigel Edwards, Director of Policy for the NHS Confederation in an SMF publication launched today. This view is backed by evidence from a new survey which has found that over half of people believe that NHS managers make up 20% (see 'Notes to Editors') or more of NHS staff when, in actual fact, the figure is only 2.8%.
In Managers: can the NHS manage without them?, Edwards calls for 'a more honest and sophisticated analysis of the real challenges facing the health service, and a proper debate about the role that management plays in delivering better patient care'.

Edwards argues that the poll results show that the public are being seriously misled regarding the role and number of managers in the NHS. The poll found that 86% of people believe that more than 10% of the NHS budget is spent on managers and 68% believe that it is over 20%. In truth the amount of the NHS budget spent on managers in only 4%. Despite these results, 75% of people believe that good management can improve healthcare. (see 'Notes for Editors').

The debate on NHS reform is dogged by the popular opinion that money is being wasted on an army of managers and administrators. At best, they are believed to be ineffectual; at worst, positively harmful to clinical effectiveness and to patient well-being. Taking on these claims, Edwards sets out the changes taking place in the NHS and the benefits they are bringing to patients, arguing that none of these improvements are possible or can be sustained without good management. Managers are overseeing one of the largest healthcare building and recruitment drives in the world. They are also implementing vital reforms in primary care and IT infrastructure, as well as the modernisation of pay and conditions for over 1 million staff.

"The nostalgic idea of a healthcare system governed by superintendents, GPs and matrons is becoming a dangerous one. Public demands for fair, responsive health services that make the best use of resources and new technology have meant that public health services across the world have changed.  These changes need to be managed."

Notes for editors

1. Research poll conducted by ICM Research Limited, March 31st - April 1st 2004. 
Sample size - 518

Question 1     To the best of your knowledge, which of the following best describes the proportion of the NHS workforce that you think is made up of managers? 53% of people answered over 20% of NHS workforce.
Question 2     To the best of your knowledge, which of the following best describes the proportion of the NHS budget that you think is spent on management?
Question 3     Do you agree with the following statement:- "Good management makes a difference to patient care"

2. Nigel Edwards is Director of Policy for the NHS Confederation, the membership organisation that represents all Strategic Health Authorities and over 90% of Trusts and PCTs in the UK.  His role is to influence health policy on behalf of member organisations and to help focus the dialogue with Government, the Department of Health, and with other partner organisations.  Prior to joining the NHS Confederation Nigel ran London Health Economics Consortium, a research and consultancy company owned by the London School of Hygiene and Tropical Medicine and the University of York.  His main interests there were in developing strategic plans for health economies and in research into new models of care delivery.  Nigel is an Honorary Visiting Professor at the London School of Hygiene and Tropical Medicine.

3. The Social Market Foundation (SMF) is an independent think tank that explores ideas that link the state and the market to create the just, free and prosperous Britain of tomorrow. www.smf.co.uk 

Contact details

For copies of the publication and more information, please contact Jonathan Williams on 020 7227 4405 or email jwilliams@smf.co.uk

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