False Economy uncovers 50,000 NHS job losses


8:00 am - February 23rd 2011

by Sunny Hundal    


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False Economy – the cuts campaign website that formally launches today (Wednesday) – reveals that more than 50,000 NHS staff posts are set for the axe, destroying government claims that the NHS is in safe hands.

David Cameron then famously claimed before the election that he would “cut the deficit, not the NHS”.

However less than 10 months into the coalition government, the reality couldn’t be more different, with NHS cuts across the country.

The national total is already twice the previous estimate of 27,000 job cuts, published by the Royal College of Nursing (RCN) last November.

False Economy’s figures have been collated for the most part from NHS trusts themselves under the Freedom of Information Act but also include figures sourced by the RCN Frontline First campaign, as well as press reports and foundation trusts’ annual plans published by the national regulator Monitor.

False Economy allows people to upload details of local cuts, provide testimony on how the cuts will affect them and promote local groups and activities.

UNISON General Secretary Dave Prentis said:

The Tories are not the party of the NHS – they are the party that will destroy our NHS. Losing 50,000 health workers will hurt. It’s only a matter of time before the toll of bed shortages and ward closures mount up. With fewer nurses on wards, the return of long waiting lists, and a rise in cancelled operations, patient care will be an early casualty.

Shadow health secretary John Healey said the figures called into question the Tories’ handling of the health service.

The government is piling extra pressure on the NHS with its huge, high-cost reorganisation and by breaking the prime minister’s pledge to give the NHS a real rise in funding next year.

David Cameron promised to protect the NHS but cuts on this scale will hit patient care, and there’s a big risk that we will now see the NHS go backwards.

More coverage: Guardian, Daily Telegraph, Independent, BBC online

(Disclosure: I’m on the False Economy working committee)
From a press release

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About the author
Sunny Hundal is editor of LC. Also: on Twitter, at Pickled Politics and Guardian CIF.
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Reader comments


We are all so not all in this together.

As the tories draw up plans to make the UK the lowest tax base for global elites. The tory race to the bottom is on.

What initially strikes me is the extraordinarily wide variations in prospective job cuts in hospitals I know something about as well as the complete absence of other hospitals in the reports of cuts, possibly because these omitted hospitals did not respond to the inquiry:
http://www.guardian.co.uk/society/patrick-butler-cuts-blog/2011/feb/21/13000-nhs-jobs-at-risk

We are talking in terms of orders of magnitude here with job cuts at some hospitals 10 or more times greater than at others, which is much larger than differences in the sizes of the respective hospitals. I suspect there is a good deal more to this story to come out yet.

From patients’ perspectives, it would be helpful to have more light shed on what is happening to treatment waiting lists and whether particular clinics, specialist units or out-patient services are to close or shrink.

From a personal perspective, I’m aware of some cuts affecting my healthcare but these have been cleverly rationalised so I would be hard pressed to make politically credible complaints. In one case, I shall need to resort to the private sector to make up for the withdrawal of NHS care services I previously had but then some friends, with similar healthcare issues, were already in that position for one reason or another.

*sigh*

Another article from the Left twisting the facts for political point scoring

http://www.spectator.co.uk/coffeehouse/6725008/50000-nhs-jobs-to-go-apparently.thtml

To summarise, False Economy has described the following as cuts;

– Natural wastage (retirement)
– Job transfers (from one hospital to another)
– Job vacancies (!)

Since the coalition took over, total NHS headcount has increased 3261, with 2484 new Doctors. The number of managers has fallen by just over 2000.

Which doesn’t look like a cut in staff numbers now does it? It does look like a cut in the number of managers though, which is exactly what the coalition promised.

So basically, I call bullshit on False Economy, Sunny and Unite…

@ 3 Tyler

“*sigh*…… Another article from the Left twisting the facts for political point scoring”

I’m not sure which I find most amusing; the concept that the current cuts will somehow result in no job losses other than all those wicked back office people/consultants/managers, or the idea that the right are somehow immune from twisting the facts!

You must think we all sailed up the Clyde in a banana boat Tyler!

@ Galen

In cash terms the NHS is actually recieving a small increase, even if in real terms that translates to a smallish cut thanks to inflation…which is the same kind of way Brown used to twist facts.

Regardless, there *are* more Doctors now than when the coalition came to power. That is a fact. And this has been done in the way they said they would – by trying to get rid of as much of the beaurocracy as possible. As has been shown, staffing levels in the NHS have actually *increased*.

That’s a whopping 3% of the NHS workforce, over 4 years. Given the annual staff turnover in the NHS that’s practically a rounding error.

@ 5 Tyler

The NHS isn’t my area of expertise, however even if the fe nuggets you are so keen to polish and show for our edification are accurate (heaven forfend of course that there be any ideological agenda there……!), that doesn’t mean that the general picture of the budget cuts conforms to the Coalition’s wet dream about being able to cut “waste” whilst magically leaving everything else unchanged.

Every time you turn on the radio or TV at present there are stories about job cuts directly affecting front line services; they aren’t all going to come out of “waste” or bloated bureaucracy.

Finally, don’t expect anyone other than convinced Coalition partisans to actually fall for the “it was that bad boy Brown, he done it and ran away!”. It just won’t wash, sorry. We all know the situation would be just as bad, and probably a good deal worse, if we’d had a Tory government when the recession hit.

0.75% of the workforce each year for four years

THE SKY IS FALLING!!!!

@ 8

Since the NHS is supposed to be the largest employer in Western Europe, I imagine that the figure of 0.75% might still add up to a fairly big number; and of course your comedy dismissal will no doubt comfort those poor unfortunates who lose their jobs…..

…..oh, wait I forgot, that would assume people like you had a conscience.

@ Galen

NHS productivity fell between 1997 and 2010, whilst private sector productivity increased every year (as should be the norm across all industries given improving technology and practices fyi).

At the same time NHS spending shot up (and thats before counting PFI). A large part of that increase in spending went on higher salaries.

I think there is some serious scope for efficiency savings.

((and seriously, even if we take the FE number of 50k job losses, we are still talking only around 3% of the NHS’s total headcount. If you use other more reliable figures we are talking about an insignificant %)).

All smoke, no fire despite the Left trying to fan it as hard as they can.

@ 10

“For the Tories to crow about NHS jobs smacks rather of hubris. While it’s commendable that the number of managers has fallen since the election, the time to take stock will be after the health service has had time to implement some of the £20bn efficiency savings demanded by the chancellor. While every effort will naturally be made to protect doctors and nurses, early evidence from the unions and NHS trusts themselves suggest it will be impossible to make those kind of cuts without slicing through tens of thousands of frontline staff.”

http://blogs.channel4.com/factcheck/factcheck-whats-the-bottom-line-on-nhs-job-cuts/5766

Read some of the numbers in the article above: if you look both at what is planned over the next few years, and even in some cases at the decline in numbers which has been going on in some job types since as early as 1998, it kind of gives the lie to the idea that there is in fact no fire, and that it was all Labour’s fault anyway.

@9 Galen

1-2% of the NHS workfore *retire* every year….

…so 0.75% “cut” of the workforce per year in real terms just means not replacing as fast…..in other words natural wastage.

@10

“A large part of that increase in spending went on higher salaries.

I think there is some serious scope for efficiency savings.”

Yeah, paying people less will make them work better won’t it. Idiot.

@11 Galen

“the time to take stock will be after the health service has had time to implement some of the £20bn efficiency savings demanded by the chancellor”

Enouh said I think….can’t really complain about what might possibly happen in the wet-dream world of the left-wing. What would you say if Doctor and Nurse numbers actually increase despite said efficiency savings? What on Earth will you Lefties whine aobut then?

@13 Phil

Paying them more certianly didn’t, did it? NHS employees managed to do less work for more pay.

I.e. productivity decreased in the NHS

Idiot.

Jobs cuts and NHS spending cuts are by no means the only concern of patients.

We continue to overlook the indisputable evidence of the continuing postcode lottery in the standards and extent of NHS care. The NHS brand conveys very different implications for healthcare in different regions:

“The scale of the ‘postcode lottery’ of care that patients can expect across England, and the different amounts of money health authorities spend on problems, has been highlighted for the first time in an NHS survey published today.” [November 2010]
http://www.telegraph.co.uk/health/8158059/Postcode-lottery-of-NHS-care-revealed-in-full.html

“An atlas published by the Government that maps variations in health spending and outcomes across England has highlighted some significant regional differences including amputation rates among diabetics. . . .

“Amputation rates among diabetics showed one of the most striking variations. Data revealed that the amputation rate for patients with Type 2 diabetes in the South West (3 in 1000 patients) is almost twice the rate in the South East. The Charity Diabetes UK was also concerned that the data showed less than half those with the disease (Types 1 and 2) had received nine key healthcare checks.”
http://www.mddus.com/mddus/news-and-media/news/november-2010/nhs-variation-atlas.aspx

The differentially high rate of diabetes-related amputations in Devon and Corwall is a clear indication of poor standards of post-disgnostic diabetes care in that region.

When Primary Care Trusts (PCTs) are abolished and their treatment commissioning functions transferred to local GP-managed consortia, the question is whether those local consortia will continue to monitor the treatment outcomes of patients in the way that PCTs do now – this was the source of the treatment data showing the high rate of amputations in the SW region. In short, among pending NHS reforms being pushed through by the government, job cuts are not the only cause for patient concerns.

@14 Tyler

“If” is the important word though isn’t it? If numbers of doctors and nurses actually increase, I’ll be the first to acknowledge the fact and cheer about it. However, the fact that numbers may have increased in a six month snap shot period doesn’t actually tell us much does it?

The RCN seem fairly convinced that front line numbers are going to fall over the next 5 years, and of course that’s assuming you feel the current number of nurses is adequate. Do you?

I reckon there will be plenty of other Big Society disasters to whinge about Tyler, trust me.

@ 10 Tyler

Honestly, your faintly hysterical need to prove that actually *nothing* is happening just makes you look odd.

I’m quite happy to accept that efficiency savings are necessary, and that oftentimes the approach of the last government of throwing money at things was not the best policy, and that salaries for admin and fat cats are not a great use of resources.

However your bland statements about falling productivity are simplistic, and as unconvncing as your narrative, which is simply the opposite ideological extreme from the “lefty” claim that the sky is falling you so assiduously trumpet above.

Why are you so unwilling to accept that front line jobs will be cut; that seems to be the inevitable consequence of the squeeze in budgets, despite any temporary good news based on a short term increase.

50 000 jobs to be cut – if this is true (no-one seems to have disproved Tyler’s alternative figures, just pointed out that they (too) might be ideological), then there still remains a huge so what.

This press release shows no evidence that there has been any analysis of the distribution of these job losses, the impact on care or anything like that. It simply assumes cuts in jobs are bad. Whilst this is true for anyone losing their job (I note the lack of usage of words such as redundancy, so I assume that those actually losing their jobs are very few?), it may not be the case for the NHS – you have to prove this (or at least show a logical argument why it may be so).

At the moment this just seems to be a case of adding up a set of non-quality checked figures (if Tyler is correct – another accusation no-one has answered) for changes in staffing and declaring these are ‘job losses’, an emotive term which implies sackings and redundancies but actually here clearly means reduction in the overall number employed. Politically clever, for five minutes until someone actually looks at the figures.

@19 watchman

As you say, these claims often are ideological, whichever side of the political divide the person making the claims comes from.

I think it is true in general that you have to treat claims with caution. However, from even a cursory glance at sources on line, it it pretty obvious that cuts in front line jobs are inevitable, and that indeed the numbers in certain areas has already been cut significantly (see the link I posted above for a few examples).

If hospitals are cutting nursing jobs, and the RCN itself predict 27,000 nursing jobs will be lost, isn’t it incumbent on those like Tyler and cjcjcj to say why they think that isn’t a problem? Are they all surplus to requirements now?

@5 Tyler

“In cash terms the NHS is actually recieving a small increase, even if in real terms that translates to a smallish cut thanks to inflation…which is the same kind of way Brown used to twist facts.”

Oh, and since you are so keen to point out the evils of lefties twisting facts, how about Mr Camreon’s twisting about NHS spending as highlighted again by Fact Checker on C4 News:

http://blogs.channel4.com/factcheck/factcheck-cameron-set-to-break-promise-on-nhs-cuts/5601

This shows that using more upto date GDP deflator figures, and excluding NHS spending earmarked for adult social care (which is a local authority not NHS expense) the cut will be around 1.1%.

So much for Dave’s claim then huh?

Galen10,

If hospitals are cutting nursing jobs, and the RCN itself predict 27,000 nursing jobs will be lost, isn’t it incumbent on those like Tyler and cjcjcj to say why they think that isn’t a problem? Are they all surplus to requirements now?

This is a prediction by a union (or a quasi-union) remember, and those are also not generally balanced. If someone could produce some reasonable figures for the number of nursing jobs lost so far, this might be assessable, but at the moment its another unjustified figure.

But since Tyler has set out a case that the extra investment has made the NHS less efficient, there is actually more of a case there than there is for assuming such job losses would be an automatic bad thing.

@22 Watchman

Time will tell of course; but I’d be much more prepared to trust what the RCN (hardly a nest of militancy) said about nursing numbers than the government. As the C4 Fact check also noted:

“In the last two or three weeks alone, Kingston Hospital announced that almost 500 jobs are set to go in the next 5 years, while another 500 are expected to be axed at St George’s in Tooting and 630 posts are to go at Barts and the London NHS Trust, including 258 nursing posts. And then there’s the Royal Berkshire NHS Foundation Trust – it has to make £80m of cuts and plans to kill off 600 jobs.”

Not all of these will be nursing or front line staff I imagine, but even if they are back office jobs like IT, presumably they will still have some impact. I simply don’t buy the idea that all these jobs are over-paid consultants or managers who add no value.

Galen10,

Neither do I to be honest, but I do believe many of them are only required in order to ensure that front-line staff are not taken away from their jobs by bureaucratic (internal or external) demands on their time.

That is to say it is simplistic (and stupid) to assume that many if any jobs are not useful in helping to deliver a service in the NHS. It is less clear if many of the jobs are required without the current central dictat-controlled environment of the NHS, which requires cascading of initatives and orders, and reporting back up the system (in effect, many jobs exist to insulate the front-line from the system – although as many of these still require contact with the front-line, it will still effect efficiency). I feel that there is plenty of space for cutting jobs if the system is rationalised – although whether Mr Lansley has that realisation is an interesting question.

As has been pointed out already, there are now more doctors and fewer managers in the NHS than there were 10 months ago.

I always thought the idea that people measure health by how much we spend on it bizarre, but now it turns out those same people want to measure it by how many managers are employed by the NHS.

I wonder what it’s like to be so wonderfully naive that you think every penny spent by the government is spent wisely. Must be bliss.

@25: “As has been pointed out already, there are now more doctors and fewer managers in the NHS than there were 10 months ago.”

The repeating focus here on numbers is really completely irrelevant.

What matters at the bottom line is the quality of treatment outcomes for patients, not how many hospital beds there are, nor how many doctors and nurses work for the NHS. And if doctors and nurses are now spending more or most of their time on administrative instead of clinical tasks, why is it a gain if there are now fewer managers or administrative workers in the NHS?

As Disraeli famously put it: There are lies, damned lies and statistics.

When are we going to get to the postcode lottery in the dispensing of NHS treatments, which must matter far more to patients than how many NHS managers have been fired?

Oh look – Channel 4 has comprehensively Fact-checked this and found in favour of False Economy and that the govt is being economical with the truth:

http://blogs.channel4.com/factcheck/factcheck-scaremongering-over-nhs-job-cuts/5775

28. So Much For Subtlety

16. Bob B – “The differentially high rate of diabetes-related amputations in Devon and Corwall is a clear indication of poor standards of post-disgnostic diabetes care in that region.”

Well no. It may be simply a statistical fluctuation. As long as treatment decisions are made by individual doctors in individual locations, we would expect different outcomes. Some doctors will prefer certain treatments. This is especially true of places with lots of students doctors (such as London) and places with lots of older doctors who may not have kept up with the latest treatments.

This is doubly true of those operations that are rare and involve few patients.

Besides, the postcode lottery is a good thing.

29. the a&e charge nurse

http://leahfraser.files.wordpress.com/2010/01/nhs-commitment.jpg

Ha, ha, ha,ha, ha, ha, ha ………………..

I agree with Zowie Williams,she says, “I don’t think the scale of this destruction is deliberate. I think we’re looking at people with no idea what governing entails, let loose on a system with no clue about its structure and mechanisms. But set that against lives and livelihoods lost, and it will seem a nice distinction”.
http://www.guardian.co.uk/commentisfree/2011/feb/23/tories-not-clueless-governing-cameron

@28: “Well no. It may be simply a statistical fluctuation”

Not so by media accounts – especially when the incidence of diabetes-related amputations in Devon and Cornwall was as much as nearly twice the incidence in the SE region. “Twice” is unlikely to be a mere statistical glitch.

“Besides, the postcode lottery is a good thing”

Really? That is curious since sharp variations between regions or hospitals or practices in cancer survival rates, surgery failure rates, treatment effectiveness and so on is usually taken as a significant early warning sign that something is seriously amiss in treatments or practitioner competences. I can see no persuasive reasons for failing to monitor postcode variations and analyse the reasons for differences.

Differences between the demographics of regions is one reason for expecting variations in the incidence and effectiveness of treatments but we can apply statistical procedures to standardise observed outcomes to allow for demographic variations. I trust the government will be publishing regular Atlases showing NHS care variations. In these stressful times, patients need all the information they can gather about variations in NHS care so they can make better informed choices.

It looks bleak but the NHS needs some pruning but not as much as the CONDEMS want. I have no problem with cutting the bloated administration side of it. However, I don’t see the point in cutting frontline staff when demands on the NHS will be greater and not less in the years ahead.

” I have no problem with cutting the bloated administration side of it.”

FWIW NHS hospital healthcare professionals I’ve spoken with about this say they would appreciate more administrative backup, not less. It’s not stark staringly obvious that there is an economic gain for the NHS if doctors and nurses spend more time on administrative rather than clinical tasks.

33. So Much For Subtlety

30. Bob B – “Not so by media accounts – especially when the incidence of diabetes-related amputations in Devon and Cornwall was as much as nearly twice the incidence in the SE region. “Twice” is unlikely to be a mere statistical glitch.”

What a bunch of media graduates think is irrelevant. Who gives a toss what the media reports. Twice is perfectly reasonable as a statistical fluctuation. For all the reasons I gave. Especially if the numbers are low – having 4 rather than 2 is what you would expect for instance.

“That is curious since sharp variations between regions or hospitals or practices in cancer survival rates, surgery failure rates, treatment effectiveness and so on is usually taken as a significant early warning sign that something is seriously amiss in treatments or practitioner competences. I can see no persuasive reasons for failing to monitor postcode variations and analyse the reasons for differences.”

Taken by who? A noticeable disparity in survival outcomes may indicate something bad. Or it may indicate disparate populations. Or different medical communities. We want differences as there is no other way to show up which treatments work better than others. Also, of course, the only way to enforce similar outcomes is so draconian that we are better off without it.

I see no reason not to analyse them either. I just don’t think they are bad.

“I trust the government will be publishing regular Atlases showing NHS care variations. In these stressful times, patients need all the information they can gather about variations in NHS care so they can make better informed choices.”

Indeed.

@33:

That’s mostly junk and not worth responding to IMO.


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  15. Cameron’s arms deals, public finance surprises and the extent of NHS cuts: political blog round up for 14 – 25 February 2011 | British Politics and Policy at LSE

    […] promise to “cut the deficit, not the NHS”. Liberal Conspiracy notes that this figure is twice the previous estimate published by the Royal College of Nursing last year, and Left Foot Forward highlights further […]





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