Almost half of all NHS staff are managers, administrators or unqualified assistants, it has emerged, as Boris Johnson came under pressure to insist on health service reforms as the price of increased funding.
The proportion of clinical staff who are professionally trained has declined from 55.5 per cent in 2013 to just 52.5 per cent now, meaning 47.5 per cent of staff have no medical qualifications.
Separately, it has emerged that the number of NHS managers paid more than the Prime Minister is about to rise to more than 400. Some hospitals have as many as nine managers earning more than Mr Johnson’s ￡157,000.
MPs said the figures showed that with ￡36 billion extra going to the NHS and social care, funded by a 1.25 percentage point increase in National Insurance, it was time to have a root and branch review of NHS spending.
One said it was time to have an “honest conversation” about the NHS to avoid the UK becoming “a health service with a country attached to it”.
Figures published by NHS Digital show that the number of managers, backroom staff and unqualified assistants employed by NHS Trusts and Clinical Commissioning Groups has steadily crept up as a proportion of the total staff since 2013.
Record number of support staff
Although the number of professionally qualified clinical staff - who include doctors and nurses - is at a record high of 629,151, numbers of infrastructure and support staff have increased at a faster rate, accounting for 568,596 of the near 1.2 million total.
Critics of Boris Johnson’s tax rise fear the money will be squandered on an increasingly bloated NHS bureaucracy because the money was awarded before the Government had calculated exactly how much money was needed, and for what.
Huge sums could also be swallowed up by pay rises and executives who are currently being recruited to run new integrated care boards.
On Wednesday, The Telegraph reported that the NHS is hiring an army of 42 new managers on salaries of up to ￡270,000 to run the new bodies.
The latest figures show that 374 managers in the NHS already earn more than the Prime Minister, meaning that figure could go above 400 when the integrated care boards come into being.
The Telegraph has also established that some NHS Trusts employ multiple directors on salaries of more than ￡200,000.
Time for an honest conversation, says MP
Manchester University NHS Foundation Trust pays Sir Mike Deegan, its group chief executive, ￡280,000, while eight other managers at the trust also earn more than ￡160,000, including two who top ￡200,000.
King’s College Hospital Foundation Trust in London, which pays its chief executive Professor Clive Kay ￡300,000, has three other managers on more than ￡180,000.
Oxford University Hospitals NHS Foundation Trust pays five managers more than ￡165,000, including Dr Bruno Holthof, its chief executive, who earns ￡290,000.
Marcus Fysh, one of five Tory MPs who voted against the Government’s proposed tax rise, said: “We are all very grateful to all of the staff who work incredibly hard for the NHS, but it’s time now to have an honest conversation about [the service]. It should not be a sacred cow.
“We need to consider various different types of reform to make sure frontline staff have the best opportunity to help their patients in the way that they want to.
“We are now a health service and social entitlement system with a country attached, and that is not sustainable.”
Money should go to the frontline, says minister
Helen Whately, the care minister, said she was “concerned” about some of the huge salaries being paid to NHS managers.
She told Times Radio: “I am concerned when I see, and I get briefings on, exceptionally high levels of pay, for instance, of chief executives being paid an unusually high level.
“And I think the NHS does really need to set out its arguments for when it is paying higher than expected levels of pay. There has to be a really good reason. But I also recognise you do clearly need to pay people the appropriate amount for roles that involve a lot of responsibility.”
Asked about managers being hired on ￡270,000 salaries to run the integrated care boards, she said: “It’s clearly a big number. One thing I’d say is, yes, we need people who are doing senior jobs in the NHS, we need to attract really good people to those jobs and reward them for the responsibility they are taking.
“On the other hand, I do feel very strongly that the money we put into the NHS needs to go to the frontline.”
Sajid Javid, the Health Secretary, admitted on Wednesday that the NHS waiting lists would get worse before they get better.
Speaking on a visit to Moorfields Eye Hospital, he said: “The waiting lists will go up before they go down again.
“We’ve seen that around seven million people haven’t come forward in the normal way because of the pandemic.
“We want them to come forward and we want to tell them the NHS is open for them.
“But I know with this catch-up fund, and the innovation the NHS can do, we can tackle the waiting lists.”
A spokesman for NHS England said figures for unqualified staff included nursing assistants and healthcare assistants who worked with patients, meaning the number of staff working on wards was higher than 52.5 per cent of the total.
NHS England also said that some of the 374 current managerial roles which come with salaries higher than the Prime Minister’s would be abolished when the 42 new integrated care boards began work next April, subject to parliamentary approval.