§ Dr. MarekTo ask the Secretary of State for Health (1) what proportion of total NHS expenditure has been spent on the employment of managers, advisers, administrators and clerical staff within the whole of the NHS in each of the last three years for which figures are available;
(2) what was the cost of employing managers, advisers, administrators and clerical staff in NHS hospitals in each of the last three years for which figures are available;
(3) what was the total cost of employing managers, advisers, administrators and clerical staff by (a) the regional health authorities, (b) the district health authorities and (c) the family health service authorities in each of the last three years for which figures are available.
§ Dr. MawhinneyThe information available is shown in the tables. The figures need to be treated with caution. The number of managers has been deliberately increased since the mid-1980s—not just since the reforms—because the service was previously undermanaged. Much of the increase arises from the reclassification of existing staff, including many senior nurses, as managers. General and senior managers account for only 2 per cent. of the total national health service work force in England and 3 per cent. of the total NHS expenditure on salaries and wages. The number of administrative and clerical staff in clinically related posts has increased over the last few years in order to free clinical staff to concentrate their skills and experience on direct patient care.
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Table 1: Proportion of total hospital and community health services expenditure on general and senior managers, G and SM, and administrative and clerical, A and C, staff Year 1990–91 1991–92 11992–93 Total Revenue Expenditure £000s 14,709,704 19,733,405 20,756,848 G and SM Salaries £000s 251,474 383,837 494,111 G and SM Salaries as Percentage Proportion of Total 1.7 1.9 2.4 A and C Salaries and Wages £000s 1,187,029 1,383,434 1,499,557 A and C Salaries and Wages as Percentage Proportion of Total 8.1 7.0 7.2 1 Provisional.
Table 2: Expenditure on general and senior managers £000s 1990–91 1991–92 11992–93 Regional Health Authorities 24,142 46,922 59,106 District Health Authorities 223,221 277,179 286,487 SHAs 4,111 5,440 7,933 Total 251,474 329,541 353,526 1 Provisional.
Table 3: Expenditure on administrative and clerical staff 1990–91 1991–92 11992–93 Regional Health Authorities 122,372 131,276 109,104 District Health Authorities 1,042,144 1,056,824 903,911 SHAs 22,513 26,757 29,805 Total 1,187,029 1,214,857 1,042,820 1 Provisional. Notes:
1.Total revenue expenditure is of health authorities and trusts including hospital, community health, patient transport, blood transfusion and other services.
2. Salaries and wages costs are the gross pay costs of directly employed staff including employers' national insurance and superannuation contributions.
3. Accounts and financial returns of family health services authorities do not contain any breakdown of expenditure between staff groups.
4. Salaries and wages costs for general and senior managers in trusts were £54.3 million in 1991–92 and £140.6 million in 1992–93.
5. Salaries and wages costs for administrative and clerical staff in trusts were £168.6 million in 1991–92 and £456.7 million in 1992–93.
Source: Annual accounts—1990–91—and annual financial returns—1991–92 and 1992–93—of regional and district health authorities, NHS trusts and special health authorities in England.