NHS adds 4,000 more managers but loses GPs

Credit: This story was first seen on The Observer

The number of NHS managers has grown by almost 18% in the four years since the government introduced a ‘bureaucracy-busting’ shakeup of the health service, according to the latest official data.

The rise of about 4,650 in total management posts since April 2013, when the controversial Health and Social Care Act came into force, contrasts with an alarming fall in the number of GPs over recent months at a time of unprecedented demand for health care, The Observer reports.

The figures have drawn criticism from the British Medical Association (BMA), who say ministers are failing in their central objective of shifting more resources and manpower from back-office posts to the front line.

NHS Digital figures show management posts have risen from 26,051 in April 2013 – the month when the highly controversial act pioneered by then health secretary Andrew Lansley came into force – to 30,724 at the end of last year, the latest date for which data has been released. This is a serious embarrassment to the government, which insisted when pushing through the legislation in the last parliament – in the teeth of huge opposition from the medical profession – that a key benefit would be a freeing of resources to redirect effort to the front line.

The BMA said that it would be distressing for patients to learn that management posts were rising as GP numbers continued to fall. The latest data shows 92 GP practices closing in 2016 as GP numbers fell by 400 between October and December. Dr Richard Vautrey, deputy chair of the BMA’s GP committee, said: “Patients will be bemused that when their care is being undermined by GP and nurse staff shortages, the number of administrative posts has risen again. With the NHS at breaking point, we need ministers to get their priorities right. They need to follow through on their election pledges and invest in recruiting more GPs so that we can offer enough appointments to the public.”

Under David Cameron’s premiership, the coalition government said its health reforms, which handed control over commissioning services to GPs, would “cut the number of health bodies to help meet the government’s commitment to cut NHS administration costs by a third, including by abolishing primary care trusts and strategic health authorities”.

The process now appears to have gone into reverse. Between 2015 and 2016 the number of managers and senior managers in the NHS in England increased by about 3.5% in hospitals, trusts and clinical commissioning groups.

The current health secretary Jeremy Hunt announced plans in 2014 to “train and retain” 5,000 more GPs by 2020, a pledge since watered down to also include doctors in training. According to the latest NHS England figures, however, 92 practices closed in 2016, up 114% on GP surgery closures in 2014. While 34 merged with other practices, the remainder shut completely.

Last week a survey carried out by the University of Exeter found that two out of every five GPs in the south-west of England were planning to leave the profession, with many citing workload and low morale as reasons.

There are also fears that an exodus of doctors and nurses from other EU countries will accelerate as the UK prepares to leave the EU. A total of 2,348 doctors from the 27 other EU states left NHS England between July and September 2016 compared with 1,281 in the same period in 2015 – a rise of 83%.