Belfast Telegraph

Hospital crisis: Northern Ireland has biggest proportion of non-medical staff in the UK

By Adrian Rutherford

Health Minister Edwin Poots has been urged to slash the bureaucracy within our health service amid claims that too much money is being wasted on management and red tape.

Figures indicate our system is top-heavy with administrative staff, leading to accusations that vital funds are being diverted away from frontline clinical care to pay for unnecessary pen pushers.

Yesterday we reported how Northern Ireland has 42% more non-clinical staff – including senior managers and administrators – than England, proportionate to our population.

Yet we have fewer clinical staff, such as nurses and midwives, than Scotland and Wales relative to population. We also reported how an extra £75 is spent on health per person in Northern Ireland compared to England.

Despite warnings from Mr Poots that our health service needs an additional £140m, spending per person has consistently outstripped that of England, where there has been none of the ministerial ultimatums witnessed at Stormont.

Mr Poots has warned he cannot continue to run the health service at its current level in a claim which has led to deep divisions between Sinn Fein and the DUP.

The First Minister and Deputy First Minister have now met to discuss how a resolution can be found to the fractious row.

The Department of Health was unable to provide clear answers for the differential in spending and non-clinical staff when contacted, although they did point out there has been a small drop in some non-clinical staff in the last year. Yesterday there were claims that Northern Ireland's higher spending is a direct consequence of staff mismanagement, with our system comprising too many managers and officials compared to other regions.

Fearghal McKinney, who sits on the Stormont health committee, said the benefit of extra spending here was being lost because of a bloated administration structure.

"While on the face of it this report looks like we are spending more on health, that is simply not the case given the amount of money that is being spent on non-medical staff and management," he told the Belfast Telegraph.

However, the union that represents health workers said the issue was the system rather than staff composition, claiming five health trusts were unnecessary for a population of 1.8 million people.

Details of regional spending and staffing levels are set out in a 2012 report published by the National Audit Office. The document provides the most recent directly comparable figures.

The Department of Health told auditors that spending per head of population was £1,975 – £75 more per person than England.

Auditors also found Northern Ireland had proportionally more non-clinical hospital staff than the rest of the UK.

The number of non-clinical staff employed in hospitals here in 2009 was 42% higher than England (855 compared with 604 staff per 100,000 people). It was also higher than Scotland (797 per 100,000) and Wales (747 per 100,000).

In terms of medical staff – nurses, midwifery and health visitors – we had 1,003 per 100,000 people, more than England's 846 per 100,000. However, in 2009 we were lagging behind Scotland (1,124 per 100,000) and Wales (1,052 per 100,000).

Mr McKinney, an SDLP MLA, described the figures as "startling" and said it underscored his party's call for an examination of every pound being spent.

However, Patricia McKeown from the Unison union said the make-up of the health system was the problem – not the staff.

"It is not about too many managers, it is about the system being set up wrongly," she said.

"In terms of all the admin staff, you need those people for health planning and provision. We don't need five health trusts, we're a small place with a population of 1.8 million people.

"We need one collective health service with proper management."

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