“If I got me an NHS fat cat, I wouldn’t have to work at all I’d fool around and have a ball,
“It’s a rich man’s world”¹
In a comment on ‘mydaftlife‘, we questioned the need for more money in the NHS – at least before layers of non-clinical managers are stripped out; bureaucracy reduced dramatically; fat-cat salaries of non-clinicians brought under control. We should add clinicians acting as bureaucrats and improved debt-recovery from health tourists.
Last year ‘The Daily Telegraph‘ alleged amongst other things that:
- Over 600 NHS quango chiefs earned in excess of six-figure salaries.
- Doubling in the number earning more than the Prime Minister in three years.
- The nine main health quangos employed 628 officials on salaries of over £100,000.
- NHS Improvement alone had 79 officials on six-figure salaries.
Many of these high earners make frequent repeated demands on Government [i.e. us, the taxpayers] to increase NHS funding. Read more→
And it doesn’t end at national level. On 27 July 2018, ‘The Daily Telegraph‘ reported that Clinical Commissioning Groups in Sussex propose rationing hip replacements. Patients are expected to endure “uncontrolled, intense, persistent” pain for six months before referral for operations. Coastal West Sussex CCG employed an Interim Chief Finance officer at an annualised salary of £330,000 a year. This could have funded around 60 hip replacement operations². Read more→
Comparison: The Prime Minister is paid £150,402 a year, including the basic salary for an MP, which is currently £74,962. It doesn’t factor in the value of the Prime Minister’s flat in Downing Street, or other official residences – but then, who wants to have two jobs and live ‘on the job’ too? [Source: Full Fact, the UK’s independent factchecking charity.]
Perhaps the salary of Simon Stevens, CEO of NHS England should be capped at the same level as the PM and other senior NHS officials at the level of equivalent Secretaries of State, Ministers and so on down the slippery pole. NHS England’s 2017/18 Annual Report shows that Simon Stevens earnt £190-£195K plus £45-£47.5K pension.
Solution: To his credit, it is reported that, in 2017/18, Simon Stevens voluntarily took a £20,000 per annum pay cut for the fourth year in a row, i.e. circa. 10%.
So, even if the 600 NHS quango chiefs and 628 officials are only earning £100,000 each, a 10% salary cut over for the next four years, would save the NHS £49.12 million.
This would fund dialysis for up to circa 396 patients with renal failure every year.³
There are two types of Health Tourist:
1. ‘Deliberate’ users of the NHS.
2. ‘Normal’ users of the NHS— foreign visitors who’ve ended up being treated while in England.
We concentrate here on ‘Deliberate users’ – those who come specifically to receive free treatment or who come for other reasons but take advantage of the NHS when here.
In July 2014, the Department of Health published its: ‘Visitor and Migrants NHS Cost Recovery Programme‘. Despite this, the ‘Mail on Sunday‘, reported recently that, NHS Improvement estimates hospitals should be collecting £167 million/year from overseas visitors, but are only recovering £113 million, a £54 million shortfall. Read more→
Labour wards are especially affected: two years ago, St George’s Hospital in London admitted that a fifth of its deliveries – up to 900 births – were to women who flew in from outside Europe. That’s a cost to the taxpayer of £6 million – at one hospital..
Recently, NHS Un-Improvement (as it’s sometimes known) launched a crackdown on health tourism sending ‘hit squads’ into 50 NHS Trusts – no doubt at great expense.
Is there an alternative?
UK Aid from the British People, doled out by the Department of International Development (“DFID”), is detailed in ‘Statistics on International Development: Provisional UK Aid Spend 2017‘
Total provisional expenditure for 2017 by “The British People” was £13.933 billion, including £3.828 billion from other Government Departments and organisations.
Notably, one of the other government departments was Health & Social Care: it contributed £101 million of our money – an increase in £55 million over 2016.
So, rather that hiring ‘hit squads’, why does the Secretary of State not just set up a system whereby NHS Trusts simply bill DFID, which pays the Trust and deducts it from its overall budget. Is that too simple for the Sir Humphreys in Whitehall?
After all, one of the objectives of Overseas Aid is to promote economic development and welfare of developing countries as its main objective. What better way of promoting welfare than to pay for the healthcare of their citizens, who come here.
“She could be a poster girl for NHS incompetence, waste and indifference to public opinion.”
Comments on West Hampshire CCG’s Annual Report & Accounts: download here→
¹ Adapted from ABBA “Money Money Money“: writer(s): Bjoern Ulvaeus, Benny Anderson, Stefano D’Orazio
² Based on £5,431 – £5,625 for “Very Major Knee Procedures for Non-Trauma” – Best Practice Tariff, NHS Improvement and NHS England: prices in 2017/18.
³ The National Kidney Federation – average cost of dialysis £30,800/patient in 2010.