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Tuesday, December 22, 2009

The cost of reform

It has taken many months to get the information from the Welsh Assembly Government but at last the Western Mail has been successful.

They quite rightly point out that although the number of local health boards shrank from 22 to seven and dozens of highly-paid top management posts disappeared, no-one was invited to apply for voluntary redundancy or otherwise forced to take it. Despite questions in the Health Committee and Plenary all we have been able to get from the Minister on this is vague statements about her not being in favour of redundancies and that Health Boards are working out their new organisational structures.

That may be true but it does not give us any comfort about the level of forethought and planning that has gone into this organisation and its outcome. What seems to have come from it is more organisational instability and the diversion of more resources from front-line services.

The Western Mail has got confirmation from the Assembly Government that 56 NHS executives whose jobs disappeared have been kept on without a permanent role:

A breakdown shows that the 56 executives without new roles include five chief executives, nine medical directors, 12 nurse directors, 14 finance directors as well as 16 “other” directors. The salary ranges and averages of the displaced executives include LHB chief executive salaries of £71,000-£81,000, with an average salary of £78,000.

A trust nurse director’s average salary is £104,000; an LHB nurse director’s pay ranges from £52,000-£81,000, with an average salary of £64,000.

An LHB finance director’s salary ranges from £64,000-£86,000, with an average salary of £75,000, while a trust finance director’s ranges from £81,000-£120,000, with an average of £93,000.

Other LHB directors’ salaries range from £53,000-£86,000 with an average of £63,000; other trust directors’ salaries range from £74,000-£110,000, with an average salary of £92,000.

No trust chief executives remain displaced.

Our conservative estimate of the cost of employing the displaced executives is £3.7m on an annual basis.

This is quite a contrast to a recent Health, Wellbeing and Local Government Committee where I questioned the Minister as to why a consultation revealed by an FOI in June showed that the government anticipated spending £13.5 million on post re-organisation redundancies for senior staff, despite the Minister having promised a no-redundancy policy.

The Minister seemed unable to answer any questions as to how much was being spent on employing former Senior Managers at their prior salaries, as well as how much would be saved as a result of the re-organisation that was completed in October this year.

I have been quite clear in my interventions on this matter that although I do not want to see people lose their jobs, it is an inevitable part of reorganisations of this sort. Senior staff should not be paid to do unnecessary jobs. Money saved should be invested back into frontline services. That is how the re-organisation was sold to us and that is the direction it should have taken.
Has "Agenda for Change" from five years ago finally worked its way through? (http://www.healthdirect.co.uk/2006_02_19_archive.html refers.)

I would ask the question at the Local Health Board's AGM, only that LHB is no more.
It is not just the position of senior managers that needs to be considered. The reorganisation abolished the internal market in the NHS which was said to be expensive to operate. What has happened to the staff who were employed to administer the internal market?
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