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Bill for "constipated" Health management rises to £10m

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Thursday 02 March 2023

Bill for "constipated" Health management rises to £10m

Thursday 02 March 2023

Campaigners are calling for an audit of the senior leadership structure in Health after it emerged that the annual bill for managers now stands at £10.1m, having shot up by more than £3.5m since 2019.

The top-level staff spending was revealed in a response to a recent request under the Freedom of Information Law, showing that “management staffing” within Health and Community Services accounted for nearly 6% of the Department’s annual budget.

The news comes as the Jersey Evening Post revealed today that £200,000 is due to be spent over just three months on a team of five UK health consultants brought in to improve the department in the wake of a damning report by Professor Hugo Marcie-Taylor - who himself has now been contracted to work three days a week at a rate of £1,440 a day.

It also comes weeks after the Treasury Minister said the Health Department - which needed a £13.3m emergency bung in 2022 to deal with "unavoidable pressures", partially due to missing a £6.5m savings target - would this year have to "live within their budget".

"Why do we need more managers than beds?"

Reacting to the new management spending figures, Peter Funk, of the Friends of Our New Hospital Group, criticised what he described as an "exponential" rise in healthcare managers recently, from 12 managers in 2012 to over 150 by the end of 2022.

Another member of Friends of Our New Hospital Group, Brigadier Bruce Willing, described the amount of money being spend on management in HCS as “ludicrous”.

“We have 146 overnight beds in the Hospital and 153 managers at Grade 10 and above. It's a small hospital - why do we need more managers than beds?” he asked.


CLICK TO ENLARGE: HCS management staffing budget, 2019-2023.

“The whole management system is constipated,” said Mr Willing. “They’re like hamsters spinning in their wheels.”

He also claimed that the “ridiculous” number of managers “causes real difficulties on the ward floor”, sharing concerns that frontline healthcare staff often have to spend more time doing paperwork than dealing with patients. 

"It gets in the way of everything," he said.

Calls for an audit

Calling for an audit of HCS management, Mr Willing described the current system as “ineffective and unaffordable”.

He said the money spent on “farcical” management staffing would be better used to pay nurses, invest in better medical equipment, and to design the new hospital.

He said: “Bad management causes a waste of both time and money, and gets in the way of everything. A lean organisation focuses on delivery, not bureaucracy."

"I am not concerned about these costs"

Responding to the statistics, Health Minister Karen Wilson said she felt the level of spending on managers was not a cause for concern.

She said the rises reflected "usual contract negotiations for managerial roles and approvals of the [States Employment Board]".

Health Minister Karen Wilson.jpg

Pictured: Minister for Health and Social Security, Deputy Karen Wilson justified the increase in spending.

"At this moment in time, I am not concerned about these costs as the rate over five years is low," she added.

The issue of managers "mushrooming" at the hospital is one that has been raised continuously in recent years.

In 2021, the Friends of Our New Hospital Group published a report criticising both the vacancy rate, and an “increasing” number of health managers.


Pictured: The 'Friends of Our New Hospital' asked why there were so many managers while clinical staff fell short.

The group's 'Management of Jersey's Health System' report detailed concerns that the hospital's leadership structure was impacting the culture within Health.

They claimed that friction was caused "when nursing staff and consultants see... jobs advertised at levels above their pay grade and hard-pressed medical staff pass office doors with ever more silly management job titles."

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Posted by Lesley Ricketts on
All these managers and still we have a failing health service. The Health Minister may not be concerned about how much they are costing but the tax payer most certainly is!
Posted by Martin on
Someone somewhere is ultimately responsible for this £10 million constipation & should be given a commensurately sized laxative?
It IS about time that THOSE who CLEARLY waste public funds ARE taken to task financially to repay the fiduciary effects of their actions?? This action would SOON put a halt to reckless acts!
Posted by AndrewRoberts80 on
Perhaps if we paid our Ministers a little more and their civil servant advisers a lot less, we might find one who is concerned!
Posted by Aston Francis on
FoI from 31 January 2023, 'Health and Community Services management and administration costs' provided insight into an actual breakdown of the management cost for HCS. 2018 (before Covid) shows £1.773.000 spent on the management costs of the Director General Office (C.Landon). Followed by £460.000 spent on the management by Chief Nurse Office (R.Naylor) and £348.000 for the Medical Director's Office management (Mr P.Armstrong). The latter two increased in 2022 to £755.000 for the Chief Nurse and £700.000 for the Medical Director. These figures do not include related admin costs for these three 'offices', which in total reached £1.913.000 in 2022.
Another FoI from 8 September 2022, 'Health and Community Services staffing' indicated 188 non-medical managers and 141 managers-medical (a total of 329 MANAGERS in HCS). Then we had a bunch of 'independent experts' hired to justify the existence of the top management, to obfuscate the landscape and to help demonstrate the professionalism of those at the top. It started with Kim Hodgson charging Jersey taxpayers over £500.000k for her 'consultancies'. Then the report of Professor Mascie-Taylor (£85.000) followed by his appointment to the chair of the board at £1.440 a day plus accommodation and travel for a year, then another independent board of 'change managers' at a minimum cost of £800.000. How much more we need to spend before the Chief Minister decides to hold those responsible for the chaos in Health to account? Nothing will change before people at the top of the pyramid and the Health Minister protecting them are let go.
Posted by Esporta Johnson on
None of these top executives for the Health Department got selected through an independent and objective process. None of the roles paid hundreds of thousands of pounds got properly advertised. All of them had been hand-picked and then the 'executive search agencies' were hired for undisclosed hefty figures to make an appearance of a 'process'. Kim Hodgson - herself recruited in dubious circumstances (as admitted by then the Chief Minister - see BE January 2019) was used as an independent expert on the recruitment panels, same names of the 'privileged club' rotating throughout these recruitment panels. They were looking for individuals not challenging the status quo, not asking tough questions but ready to repeat the slogans of 'the patients being at the heart of everything we do' and 'there is no place for bullying in our organisation' while respecting the rule of omerta on the actual issues. The last example of Mascie-Taylor recruitment exemplifies the pathological elements of the executive recruitment process. He had served as a personal mentor to Medical Director Armstrong and was chosen by Caroline Landon to write a report as he admitted based on 'anecdotal evidence'. He interviewed some 50 individuals and most of them managers and directors, not a single non-manager nurse or healthcare assistant. Then the £85k report procured without any transparent process recommended creation of 'an independent' board. Thanks to the two Deputies of the Scrutiny Panel the public opinion learned about the Minister of Health actually asking Mascie-Taylor to apply for a non-executive role of the Chair of the Board he himself helped to create. The Minister offered a salary of over £200k for 2-3 days per week plus a relocation, housing, travel and the benefit of low taxes. The top non-executive chairs of the boards in NHS are paid £60-70k p.a. rather than over £300k in this case. Then an executive search agency identified some 50 other candidates of whom only five or two met the shortlisting criteria. The job got never advertised in Jersey. Out of the two final candidates who 'met the criteria' it was the Minister of Health that arbitrarily selected the candidate she wanted to appoint in the first place.
Given the handsome remuneration, detached from the market-value guess how independent will Mascie-Taylor be in challenging the Director General or the Minister. Not being satisfied with one board they soon hired another board of 'fixers' for drivng'change management' in the hospital - again without any advertising spending at least £800k for the five hand-selected individuals. They were supposed to heal broken relationships between the clinicians and the managers and directors. How will they achieve it without firing those who ruined the trust in the first place, those who bullied doctors and nurses for years? £10 Million is a gross understatement. This is purely the personnel cost for the non-medical managers and directors. Add all the experts, boards, reports and administration costs they drive and you will easily exceed £20 Million.
Posted by Bernadette Palmer on
How can the government allow managers to go from 12 managers to 150 in 10 years. This is absolutely ridiculous. Also how can our current health minister think this is justified. Is she serious. If these are her thoughts then she needs to go as well. We have been so unlucky with the health minister what with Renouf who was a puppet and now the current one. I have been writing to both of them for over three years with not so much as an acknowledgment. Maybe she should get one of her 150 managers to do the job for her. Bet there are plenty of feet on desks resting. Get them out and get real Serve your Islanders and stop wasting our money
Posted by Tobias Philpott on
Enough is enough! This government has been in power for 8 months! Instead of showing the door to the incompetent senior health management team, they are not only supporting them but recruiting more of the same. How can anybody defend the stark statistics of snowballing management numbers and expenditure, coupled with not just poor performance but serious allegations of bullying, harassment and collusion between senior managers, to obstruct complaints against them? This health minister is a product of the failing NHS and tried to silence valid criticism of her and her department's performance by Deputies Ward and Howell. She failed to get the support of the Chief Minister in the recent vote of no confidence against her ally, Deputy Southern's attempts to silence her critics. She should resign and Deputy Howell who is both from Jersey and has frontline clinical experience be her replacement.
Posted by Aston Francis on
Excellent suggestion(s) Tobias Philpott. There is a well-established and effective treatment for 'constipation'.
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