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From Yahoo News:

The NHS has wasted at least £46m on needless jobs including spin doctors, an art curator and a car park officer, the Tax Payers’ Alliance (TPA) has claimed.

It says the NHS had created 1,129 unnecessary jobs in areas such as public relations, the European Union and “green” staff – enough to pay for 1,662 fulltime nurses.

The campaign group said between 2002 and 2013, the NHS budget increased from £57bn to more than £105bn but that a large chunk was being thrown at unnecessary jobs.

There’s a number of points we can make here. The first is, of course, that the Taxpayer’s Alliance is being disengenuous. One could argue their very name is disengenuous, given that they appear to be a business funded astroturfing operation that *claims* up to 75,000 supporters but never releases the figures. But, even leaving aside that simple snark, in making the emotional comparison between these jobs and the extra nurses that could be employed, they are – well – operating in bad faith.

They don’t want extra nurses. They are small state conservatives. They want the NHS budget to be less, and as a consequence, their taxes to be less. There is nothing intellectually wrong with being small state conservatives, wanting the NHS budget to be less, and wanting your taxes to be less. Each are arguable positions, each I may disagree with somewhat (and, pretty much, for the same reasons I disagree with the nationalise everything brigade on the left – because they operate with an overly idealistic and naive view of what would happen next – faith in the market, faith in the state, is still faith), but it’s an arguable position with honest antecedents.

Pretending you want to cut state waste here for the state employ more people there, however, is a lie, if what you really want is to, well, cut the state.

There follows a corollary argument, which is, what do they think 1662 extra nurses would do to the NHS? It is a lovely striking figure, but since the NHS itself admits to around 2300 hospitals, what they are talking about is less than an extra nurse to each hospital. Most hospitals employ hundreds – or even thousands – of staff. The addition of less than 0.75 more nurses in each would make little difference, mmmm?

There is also the point that, if the NHS has a budget of £105 billion, and the most you can identify being “wasted” is £46 million (£45.3, actually, chaps, but had to push it to “almost £46 million” rather than “Just over £45 million”…no offence, but I was taught to round down on numbers below .5…know warrimean?), you aren’t doing very well. Every large organisation – public and private – will have a degree of waste about it. Don’t get me wrong, I’m sure there are examples of waste in the NHS and in the public sector that dwarf this, and I wouldn’t turn my nose up at £45.3 million in a big sack, and in a perfect world the NHS wouldn’t be wasting £45.30, but still…it does count as small potatoes within the budget you are looking at.

Then, there is the final part of the argument, which is their identification of “waste”. Pausing to nod at the art curator and say “well, you know, I agree with the TPA in that instance”, glossing over their identification of a “Car Park Officer” as an unnecessary job (Hospitals, big buildings. Tend to have car parks. These tend to need to be managed. Having a guess that Car Park Officer isn’t quite as unnecessary as you may think), wandering past the diversity and equality and green and EU representation officers and thinking “Well, I’d need a tad more explanation as to what they do before I cast judgement, but I can certainly see you may have a point”, we get to the meat of the waste – £34 million on PR.

Now, again, I’d love the NHS to not need PR. I’d love NHS Trusts not to need PR. But should a – say – disengenuous astro-turf organisation spend a lot of time demanding breakdowns of information via Freedom of Information requests, with the intention of rubbishing said NHS, said Trust, whatever…what would your average organisation do? Public, private, it matters not a jot. They’d need someone to go out in front of the cameras and answer those stories. They’d need to get their message across. Generally, those people would need to be professionals, and paid a commensurate salary. If you want transparency from an organisation – any organisation – then fair play, and common sense, would argue that the organisation should be able to employ someone to deal with that, someone who can answer questions, someone who can explain the organisation’s perspective – we call that “PR”, I believe.

And – when they weren’t fielding such queries – perhaps they’d be trying to get messages out to the public about health initiatives, services available, about how to look after themselves, how to recognise this ailment or that, where they could go for treatment for this disease or that. Etc etc etc (Which – possibly – in the long term preventative sense of medicine may have more of a benefit to the population than, oooh, say, an extra 0.72 nurses in every hospital in the land).

(There is, of course, a further irony in the fact that the TPA are, basically, a PR organisation for a particular view of the world, with a couple of researchers thrown in. Unnecessary jobs, chaps? Really?)

Do I know whether the number of PR professionals employed by the NHS (less than 0.5 for each hospital) is necessary? No, I don’t. Do I want to live in a world where the NHS doesn’t need PR professionals? Of course I do. Is the latter likely to happen, if there exist organisations whose raison d’etre is to use freedom of information laws as a baseball bat to smack the NHS around?

I don’t need a report to tell me the answer to that last one.


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