Report on NHS reveals ‘astonishing’ explosion in central bureaucracy - The Telegraph - 15.05.22

By Laura Donnelly, Health Editor for the Telegraph says: "Ahead of a leadership review in the health service, analysis shows the number of officials has more than doubled in two years".


NHS bureaucracy has doubled since the pandemic despite little change in the size of the frontline workforce, an explosive report reveals.


The figures come as a record 6.4 million people - one in nine of the population - are on waiting lists, with record trolley waits in Accident & Emergency departments.


And it follows concern that an extra £12 billion a year funding boost, funded by a 1.25 per cent National Insurance hike, which came in last month, will be swallowed on management salaries, instead of clearing the backlogs.


The new analysis shows that the number of officials working in the Department of Health and NHS England has more than doubled in two years, with even sharper rises seen at the most senior levels. Meanwhile the number of nurses rose by just seven per cent, think-tank the Policy Exchange found.


Its experts said the trends showed an “astonishing” explosion in central bureaucracy, calling for an urgent review and action to slim down and streamline its workings.


The findings come ahead of a review of leadership in the NHS by a former army general.


Sir Gordon Messenger has been sent in by Sajid Javid, the Health Secretary, amid concern over the quality of management in the NHS as the service faces the biggest backlogs in its history.


The general has been asked to stamp out “waste and wokery” in the health service and ensure “every pound is well spent”.


The analysis shows that the total pay bill at the Government department and central body in charge of the NHS has doubled in the two years since February 2020, from £42 million to £83 million.


The workforce of the bodies rose from 7,883 to 14,515 over the period, with the number of senior officials rising by 125 per cent.


Even these figures exclude health agencies - such as the UK Health Security Agency - and its predecessor Public Health England, which expanded during the pandemic.


Meanwhile, the nursing workforce rose by just seven per cent - from 298,632 to 319,808, despite desperate shortages of frontline staff.


It comes as Boris Johnson orders a Civil Service cull, with 91,000 jobs due to go in order to cut costs by £3.5 billion.


Separate published figures show 125 health officials - including 50 at NHS England - earning more than £150,000.


The highest paid is Amanda Pritchard, the head of the NHS, who is being paid £255,000 - almost a third more than her predecessor, Lord Stevens who stood down last year.


The organisation, which is currently merging with a number of other health bodies, including NHS Digital and Health Education England, is currently setting up a new strategy unit.


But Policy Exchange said the growth of the organisations must not be allowed to continue unchecked, warning that far too much taxpayers’ money is being spent on functions which duplicate each other.


Robert Ede, head of health and social care at the think-tank, said: “The uptick in the number of frontline NHS staff has been dwarfed by the astonishing increase of central bureaucrats - and this must be urgently addressed.”


The report shows some of the steepest rises in bureaucracy come at the top of the health bodies.


The figures show a 130 per cent increase in senior roles at NHS England in just two years, while the senior headcount at the Department of Health doubled.


“This continued growth in the size of the centre should not be deemed sustainable as we move from pandemic to endemic,” the report warns.


Official figures show 6.4 million people on waiting lists at the end of March, up from 6.2 million in February - the highest number since records began.


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