Magazine article The Spectator

The Curse of Management

Magazine article The Spectator

The Curse of Management

Article excerpt

Everyone knows that the National Health Service employs too many managers and too few nurses. Enter any saloon bar in the land and you will be told as much. But this popular wisdom finds shockingly emphatic confirmation in a new pamphlet, Resuscitating the NHS, written by Dr Maurice Slevin, a cancer consultant, and published by the Centre for Policy Studies. Dr Slevin points out that since 1995 the number of senior managers in the NHS has increased by 48 per cent, and the number of managers by 24 per cent, while the number of qualified nurses has increased by only 7.8 per cent. In September 2001 the number of management and support staff employed by the NHS was 269,080, compared with 266,170 qualified nurses. The NHS employs about four and a half times more managers, administrators and support staff in proportion to its nurses than a large private hospital in central London does.

As Dr Slevin remarks, some consultants ,are old enough to remember the days when a large teaching hospital was run by a governor, a matron, an accountant and several secretaries'. There is simply no need for the ever-growing army of bureaucrats which the NHS is recruiting. Yet unless radical changes are made to the service, the lion's share of the very large additional sums of our money which the government is devoting to it will be wasted on the employment of yet more managers.

The Prime Minister's advisers see this scandalous waste of public money unfolding before their eyes, but the only way they can think of averting it is to insist on better planning. In other words, by trying to correct the problem they will actually make it worse. For as soon as you seek salvation in the abstraction known as `better management', you open the way to yet greater expenditure on managers. The essential problem, which lies beyond the scope of Dr Slevin's pamphlet, is found in the managerialist illusions of those in power. It is now almost half a century since C. Northcote Parkinson pointed out that `Work expands so as to fill the time available', but the examples he gave, showing a rapid increase in admiralty officials at the same time as a rapid fall in the number of warships, officers and seamen, seem modest in comparison with the prodigies of bureaucratic empire-building that have occurred since.

For a more up-to-date, though less witty, analysis of this phenomenon, it is worth turning to a book called Managing Britannia, published last year by the Brynmill Press. …

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