Editorial: DoH must get tougher with its weak managers

When is a 1.5 per cent pay increase not a 1.5 per cent increase?

It's a question GPs in England might well ask themselves after reading the results of this week's GP investigation into where the £105 million extra primary care funding for 2008/9 went.

We have already reported that how much you received of the £5 million for global sums depended on your correction factor status, and also that the payment of the £50 million for clinical directed enhanced services was delayed through most of 2008/9.

Now we turn to the remaining £50 million to improve access.

More than a third of PCTs had not made any plans to invest the money in GP services, almost half could not provide a breakdown of how the money was spent and seven PCTs claimed they had never received the money.

Some even spent your pay rise on GP-led health centres or balanced scorecards.

NHS founder Aneurin Bevan famously said that he wanted 'to be able to hear the clatter of the bedpan of the hospital ward, in the office of the minister'.

At least two Labour health secretaries have been heard to use this quotation to distance themselves from this 'monolithic centralism' and emphasise how devolving responsibility to local managers was key.

This is all very well but as important is the quality of the local managers assuming these new responsibilities.

Current health secretary Andy Burnham might not want to hear the clatter of a Portsmouth bedpan from his central London office but he should be able to guarantee the management expertise of those dealing with it.

Our investigation found that a sizeable proportion of managers had no idea how half the 2008/9 GP pay rise was spent or knew that it did not go to GP services.

Now is surely the time for tougher DoH regulation of weak managers.

 

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