Bureaucracy is ruining the NHS

More than forty years ago, working in the NHS, I was promoted. One of my duties was to be reporting on the number of section 4 and 5 beds on each ward.

“What are they?” I asked.

“You don’t need to know” was the reply. “Just get the figures from the sister-in-charge on each ward every month and send them to the Ministry.”

I duly went to the first ward and got a figure. On the second ward the sister was on the ward when I arrived. She looked round the beds and appeared to be counting.

“What are section 4 and 5 beds?” I asked.

She looked at me. “I don’t know, I just go eeny meeny miney mo.”

Other ward sisters told me the same thing so, for the next two years, I sent in meaningless figures for someone to solemnly enter and report on. When I suggested this was lunacy I was told to shut up and get on with it.

Since then, I have seen a huge increase in management within Britain’s hospitals and a decrease in nursing staff. Labour scrapped in-house nurse training and didn’t provide enough university places. The Coalition did nothing to rectify that situation. 80,000 young people were turned down for nurse training last year because there were no places available and yet we recruit thousands from overseas, often from countries with a desperate need to retain the nurses they trained to treat their own sick.

Now we have the scandal of specialists and nursing staff pocketing thousands of pounds for a single shift working as a locum, with surgeons costing nearly £3,700 and nurses up to £2,200. The bill for agency workers hit £2.6bn a year in England as senior A&E specialists profit from hospital trusts’ inability to retain or recruit staff. The number of foreign nurses and midwives registered in the past 12 months grew to 8,200 from 6,200 a year earlier as the number trained here slumped by more than 8,000.

One trust’s struggle to hire salaried staff was so acute that it was paying £1.5m a month to employment agencies for supplying all sorts of temporary staff. The proportion of NHS trusts in the red has soared and is it any wonder.

Today, on radio, I heard Dame Julie Moore, who received a DBE for services to healthcare and who is a graduate nurse and Chief Executive of University Hospitals Birmingham NHS Foundation Trust, claim that micro-management . . .in other words over-bureaucracy ….is ruining the NHS. What was an illness all those years ago has become a disease and all the political parties do is try to outbid one another, bandying around eye-watering sums which will, even if they materialise, be swallowed up by the over-documented cash-digester our NHS has become.

Wouldn’t it be wonderful if they stopped making the NHS a political football and formed an all-party commission to keep it safe.


  1. Not forgetting the terrible PFI 'deals' that mortgaged hospitals up to the hilt but initially at least kept the figures of the public debt totals. Finance as well as beds can be massaged!


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