Chris Lancelot: Cuts in the right places could benefit the NHS

Although the new government says it intends to maintain spending on the NHS, the sheer size of the UK's budget deficit still makes it a tempting target for future cuts.

The GP Record, by Fran Orford: www.francartoons.com
The GP Record, by Fran Orford: www.francartoons.com

Surprisingly, strategically placed cuts might actually make the NHS both more efficient, and better for patients and staff.

Although an amazing £15.4 billion per year - 14 per cent of the NHS budget - goes on NHS management and administration, that isn't the whole story. Managers are not just an expense in themselves: their decisions can affect the output of front line staff by forcing them to work inefficiently.

Clinicians' time spent on unnecessary, management-driven tasks is time wasted - collecting data, discussing superfluous protocols, having unnecessary meetings.

Nor is it just the meetings themselves: it's the reading beforehand, the follow-up afterwards and the incessant emails - all with massive attachments. (Last month, I received one of 317 pages: when do I find time to read it?) It's the constantly cc'd memos and protocols clogging up our inboxes. It's the ceaseless flow of reports we have to create, vet or submit - often with non-standard local variations inserted at the whim of the PCT.

It's the incessant PCT requests for routine meetings to assess the practice and involving at least one doctor plus two or more members of staff. It's the PCTs insisting that experienced, fully qualified health professionals still have to take time out to attend formal training programmes on topics on which they are already skilled.

And that's just the practice and the PCT. What about practice-based commissioning (PBC)? Our PBC group has meetings (taking up more time) and a huge bill for its managers, yet our PBC achieves little, other than producing statistics of variable quality and shifting resources from one pot to another.

Removing these hidden, parasitic demands on our clinical time would save massive amounts of NHS money, improve our efficiency, and above all, increase morale.

Yes - of course, we need clinician input into management, but in a leaner, more effective manner. Deep cuts in NHS finances can easily be made without affecting patient care: indeed, freed from 'management bloat', the NHS might actually thrive.

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