The claim
“Last year alone 5,000 new managers were employed in the NHS yet there was barely an increase of less than two per cent in the number of nurses….We now have more bureaucrats and administrators in the NHS than we have hospital beds.”
Nick Clegg, Liberal Democrat leader campaigning in London, 3 May 2010
The background
Ah yes, those managers and administrators. They really bear the brunt of all parties’ talk of cutting waste.
Today, Nick Clegg hit the campaign trail in Blackheath, south east London. He was asked how to make savings for the public purse without affecting frontline services. He used the NHS to illustrate his point.
“In the NHS we’ve got to identify those areas where money is being wasted,” he said. And what is that waste? Bureaucracy, according to Clegg. And once again those faceless managers, bureaucrats and administrators were listed as one of the ways to show where priorities have gone awry, along with the NHS IT database and pay of senior executives.
He’s not the only party leader that’s talked about NHS managers in this campaign so FactCheck decided to dissect the NHS management numbers.
The analysis
At face value, Mr Clegg’s numbers hold up. Looking at hospital beds first, there were 159,386 beds available each day in NHS hospitals in England in 2008/09.
The NHS Information Centre puts the number of NHS infrastructure staff at 236,103 in September 2009, up from 219,064 in 2008.
Removing “hotel, property and estates” staff, in other words caterers, caretakers, laundry staff and domestic services, from this total, the numbers still balance in Mr Clegg’s favour, with 167,544 staff left. (If you look at full-time equivalent numbers as opposed to headcount, that total falls to 150,696).
As for the recruitment of managers versus nurses last year, a census from the NHS Information Centre shows that on 30 September last year, 375,505 qualified nurses were employed in the NHS, up 1.9 per cent on the previous year or 6,268 nurses.
This includes GP practice nurses, but not bank nurses, midwifery and health visiting staff. If you include them the number of nurses rose from 408,160 in 2008 to 417,164 in 2009 – 9,004 nurses.
At the same time, 44,661 managers and senior managers were employed, an increase of 4,748, or 11.9 per cent, on the previous year.
But, lest you think the NHS is a management-heavy organisation after the claims of politicians, the health think tank the Kings Fund points out in its election 2010 analysis, managers and senior managers only make up 3.6 per cent of the total NHS workforce.
The number of managers and administrators (based on the calculation above) make up 11.7 per cent of NHS staff. Nurses make up 26.2 per cent of the workforce.
In their 2007 report on NHS management, the NHS Confederation, which represents NHS organisations, argued that this was relatively low compared to the size of the organisation – the proportion of managers in the whole UK workforce was 15.5 per cent in 2009.
The verdict
Mr Clegg gets a Fact rating as all his number are accurate – the actual number of nurses employed was higher than the number of managers, but proportionately Mr Clegg’s point holds.
But a focus on management statistics can provide a skewed picture of the NHS workforce as managers make up just over three per cent of the health service staff.
