You have to spend (more) to save (less)

The Daily Telegraph today quotes official figures which reveal that local health bodies have increased their spending on temporary and administrative staff from £45 million in 2003/4 to £115 million in 2008. That is an increase of 114 percent in just five years.

This may be small beer compared with the billions which are being thrown about now, but as has been pointed out such the spending would now pay for about 4,000 extra nurses! (Last year the number of managers in the NHS was increasing twice as fast as the number of nurses.)

Why should there be need for such temporary spending? (The government has been trying, unsuccessfully, to cut management costs. This was why two years ago they halved the number of primary care trusts.)

The expansion is almost certainly for a mixture of reasons, but probably arises from similar problems which afflict education.

Health provision is based on a target- led culture, where the targets are finely tuned from Whitehall, and is subject to regular change and reorganisation. Administrators need to make regular local changes, which requires a continuing army of pen pushers.

Whatever the cause, it is a shocking indictment of the service, and may go some way to explaining why we have European levels of spending but much poorer results, especially in areas like cancer treatment.