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dinalvek

Management? Their role vs their cost?

12 posts in this topic

Working as a SHO in very busy underfunded London Mental Health Trust, we are often under huge pressures to discharge/not admit patients.

I am aware of the huge financial problems faced, however, we often see/hear about managers gross incompetence and misspending while medical staff work over and above the call of duty to keep the hospital going.

I wanted to hear about other trusts' problems or gripes about any incompetencies noted and seen at work, it doesn't all have to be serious, after all, without humour, I would have hit the bottle years ago...

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imo managers would be a good thing for the nhs and they would be worth their cost.

the problem is that the nhs doesn't really have managers, it has overpromoted nurses and /or admin staff that got management jobs cos there was nowhere for them to go. many of them lack management skills and they have given the managers a bad name, but it wasn't really their fault cos of the fact that the managers are not actually allowed to manage because they have to respond to repeated centrally driven targets and policy changes.

medical managers are a problem in the same way as the other types. they are often in post cos no-one else would agree to do it rather than because they are good at it.

i must now say that the above is a general statement and is not based on my opinions of my current employers. complaining about managers is easy but pointless. if you disagree with what they are doing then imo it is your duty as a doctor to point out what they are doing wrong to the appropriate people and tell them what they should be doing.

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A large ,grossly incompetent bureaucratic class is the hall mark of a decaying system. Our NHS has a lot in common with the soviet steel industry. Endless targets and meetings about meetings abound in the NHS.

I think it is time that someone came in and completelty overhauled the whole system. What is needed is brutal cuts and changes not the current system of bringing in more staff to add further layers of intractable management.

It also staggers me how the policy of the health service seems to change at the whim of the health minister. What is needed is long term planning not political manovering.

more controversially there are whole 'professions' in the NHS that do little and could be done by others.

I mean does it take a 'smoking cessation officer' to tell someone how to stop smoking or a dietician to tell you not to eat chips?

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Do these managers know what is management?

I agree with J the mangaers nothing but over promoted nurses or social workers, the ward nurses who were ward managers when i joined 3 years ago are all sector managers now responsible for psychiatric services in a whole area.

What NHS needs is trained managers from management schools and People with mba in finance,human resources etc should be recruited at appropriate levels, Nhs will sink if the management is not good and if its run by people who will have mild to moderate L.D if an IQ test is done!

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'Nhs will sink if the management is not good and if its run by people who will have mild to moderate L.D if an IQ test is done!

Thats a strong statement to make :o

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I am sure there are incompetent staff members everywhere, of all levels. We are all quick to point the finger at nurses, Hca's etc, but many of our colleagues can also fall into this bracket. I agree that many of mangement are promoted clinical staff who do not have the relevant expertise or skills needed, but then, also, as the biggest employer in Europe, surely the NHS should be able to acquire at least some of the top mangaers available. I know it is easy to point fingers at managers, but it seems that there are huge problems with simple solutions available which don't seem to be solved at times.

Also, I read that NHS has only around 30-40% medical staff, the remainder being clerical/non medical/managerial. Has anybody else heard this statistic or can verify it.

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Dede iam talking from my personal experience.I have worked in a ward where there was no supply of cotton swabs(Gauze was being used instead of cotton swab) why? because one of the managers thought that this would save the trust a lot of money!!

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In my view the problem is to do with a public funded system. The NHS owes it accountability to the government as a whole. Business minded individuals who are very good at what they do and in essence quie ambitious, risk takers and highly driven do not work usually in such environments. My point is it is difficult to employ the best brains in management in a vast public sector as the NHS.

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management consultancy is itself a very competetive field.the best of course go where the challenge and money is,but its a tight market and a global one now. apollo hospitals management india and a few other private hospital chians in south asia are putting bids for nhs management contracts.

the uk which is in the top ten competetive countries list has been told by economists that it will lose its competetiveness due to continueing public spending and have pointed to the nhs as a major revenue drain.

gordon brown has told imf that he will be dealing with this,and it means bringing in private sector managers and moves.he has promised to level out spending in 2008 and cap expenses.i feel slowly, subtly and management principles used in the private sector will be used.it will not be about needs or services needed.it will be about cost control.

managers and cost control measures are going to become a feature over the next decade or so. the effects will be at all levels.

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The goverment knows that they have overspent in the NHS, clogged the system up with staff that aren't needed, all in the bid to create more job oppurtunities to please their voting public.

When people in the NHS at the ground level start making noise about the difficulty they encounter in providing services, goverments response is to bring in more managers to manage the managers already on ground.

Then policies & targets are churned out for trusts to adopted and painted to the public as providing a more effective and efficient service to meet carers and users needs when it actual fact the services provided are usually not up to scratch and just a govt cost saving scheme rather than evidence based best practise.

The reality is that public funding of the NHS can't continue and the govt are not ready to admit this openly simply because it would be a negative mark against the labour govt which would have a dramatic effect at the next elections which they want to hold on to. So instead they are slowly introducing changes that have the mark of privatisation so that we the public will all get used to the idea that we will have to shell out a little more money for health services

 

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I dont think the staff will allow the govt to get in management from countries like India to run the NHS.There will be widespread opposition to such a move from the overpromoted nurses and social workers who will feel threatened.

The only way Nhs can survive is by privitising it and iam sure the patients will get quality medical care and will not have to wait months to get simple operations like cataract.

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its not the country of origin but the fact that these management consultancies are multinational and the their expertise and input will be quite high up at national level and to do with funding and costing advice.i doubt that most us will ever be aware of this happenning if it does and power to recruit and implement will be taken quietly and at governmental level.

i guess we'll only become aware when the rug is suddenly pulled from underneath us.unfortunately the colleges and unions which should represent our best interests will continue to be the proverbial ostritch with the head in the sand harping about how important and indispensible we are,when these silent but powerful forces which are alreaday acting pick up momentum.

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