I am 45. That means I’m old enough to have been writing about politics at a time when political attacks on ‘NHS managers’ were a routine part of political debate and media coverage, standing alongside ‘yobs’ and ‘asylum-seekers’ as the nation’s villains.
It’s also old enough to get me a Covid-19 vaccine, injected into my arm on Saturday morning at a GP surgery in south London by a student doctor from a nearby teaching hospital. Watching the performance of the vaccine centre, doling out hundreds of vaccines each hour, I was reminded of all those promises from all those politicians about getting rid of fat cat NHS managers.
The current narrative around the NHS says that clinical staff – nurses and doctors – are the heroes of the pandemic. When people display ‘thank you NHS’ posters, they’re thinking of medical professionals.
But Britain’s successful vaccine rollout hasn’t been solely a medical triumph. It’s been a logistical one. As my vaccinator cheerily admitted, there’s no great clinical skill to giving an injection. The skills that put that jab into my arm and the arms of hundreds of others on Saturday morning were organisational ones.
And yes, some doctors and some nurses were doubtless involved in devising and managing efficient vaccine centres like the one I visited. But so too were managers, the non-clinical staff once routinely derided as bloated bureaucrats. The same is true of the bigger organisational project that procured, stored and delivered millions of doses of vaccines. The heroes of the vaccine rollout don’t wear capes, but nor do they only wear white coats or scrubs.
The toxic notion of a vast and costly NHS management cadre is embedded deep in popular imagination. But it really doesn’t show the reality. Depending on how you count, fewer than 40,000 of the NHS’s 1.3 million-odd employees are managers, and some of those are clinicians with management responsibilities. That’s around 3 per cent. In the UK workforce as whole, around 10 per cent of us are employed in management functions. (Check out the good work of the King’s Fund for more on this)
Even more importantly, there is evidence that – shockingly – more and better management of NHS bodies actually delivers better healthcare. In 2018, Professor Ian Kirkpatrick of Warwick Business School found a ‘strong statistical link between an increase in the number of managers and the performance of hospital trusts on a number of measures.’ In other words, more managers = better NHS.
Will the vaccine drive be enough to persuade the UK to share my urge to declare ‘We love NHS managers’? Of course not. But it should cause politicians to think twice before bashing the people who have made that all-important vaccine rollout so fast and smooth.
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