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February 16, 2005
A Health Care Manager A Day…
According to the NHS Board Room Pay Report 2005, the pay of NHS chief executives rose 70 per cent in ten years, while nurses’ pay only went up by 50 per cent. The NHS accounts in the year to March 2004 show that the average salaries of chief executives in England was £107,500, with the fattest cat of them all being the chief executive of Hammersmith Hospitals who takes home a tidy £212,500 each year. Meanwhile, many nurses are struggling to make £18,000. Union leaders are not the only ones who should be concerned.
Not entirely surprisingly, there’s strong evidence to suggest that increased spending on medical resources has a beneficial impact on medical outputs. In particular, researchers at the OECD have repeatedly demonstrated that higher doctor numbers are significantly associated with lower mortality, and in its 2003 report International Health Comparisons, the NAO declared that the number of doctors per 1,000 of population is the second most important measure after occupation in terms of explaining variations in premature mortality.
Last year, says the Daily Mail, medical staff made up less than half the NHS workforce: of the 1.28 million staff in the UK, only 663,375 were qualified doctors, nurses, therapists and ambulance staff. In comparative terms, the UK, with 1.8 doctors per 1,000 of the population, ranks at the bottom of the more developed countries. What's more, the UK has the second lowest reported number of practising nurses in relation to the population. The number of specialists also matters: it’s long been accepted, for example, that cancer care is under-resourced. Professor Karol Sikora, former head of the WHO’s Cancer Programme, has shown that ‘Britain has fewer radiotherapists per head than Poland and fewer medical oncologists than any country in Western Europe.’ In light of these deficiencies, the news about executive pay is disturbing.
Too much money is being allocated to bureaucrats when it should be spent on medical staff. Were it the case that the UK could afford to be complacent because of the effectiveness of its healthcare system, these staffing concerns could perhaps be dismissed. But the UK performs poorly on a wide range of outputs, and today, according to Michael Howard, ‘you are more likely to die of an infection you pick up in hospital than to be killed on Britain’s roads.’ In 2002, Tony Blair accepted that his government may stand or fall on the reform of the NHS: ‘if the NHS is not basically fixed by the next election,’ he said, ‘then I am quite happy to suffer the consequences. I am quite willing to be held to account by the voters if we fail’. Hoist by his own petard?
Posted by Nick Seddon at February 16, 2005 04:34 PM
Comments
Now that Blair has succeeded in making our roads so safe, perhaps he will re-direct his focus to reforming the NHS.
Posted by: A.Haktak at February 16, 2005 04:59 PM
1) "higher doctor numbers are significantly associated with lower mortality"
(2) "the number of doctors per 1,000 of population is the second most important variable after occupation in terms of explaining variations in premature mortality"
That looks to me like two uses of statistical jargon that could easily mislead the layman. (1) refers to a correlation, not a cause, with "significant" meaning that the correlation is discernible amongst the scatter in the numbers, but NOT meaning that it is important.
In (2) "explaining" is used in the sense in which it's used in analysis-of-variance work, which is not what "explaining" means to a layman.
Now then, am I right or a meringue?
Posted by: dearieme at February 16, 2005 06:56 PM
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