Two written answers from the Department of Health and Social Care

The Department of Health and Social Care has provided the following answer to your written parliamentary question (119388):

Question :To ask the Secretary of State for Health and Social Care, what estimate he has made of how many additional health professionals he needs to recruit to NHS England in 2022-23. (119388)

Tabled on: 07 February 2022

Answer:
Edward Argar:

The Department has made no specific estimate. In July 2021, the Department commissioned Health Education England to work with partners to review long term strategic trends for the health workforce and regulated professionals in the social care workforce. The Department has also recently commissioned NHS England to develop a workforce strategy which will set out its conclusions in due course.

The answer was submitted on 22 Mar 2022 at 11:16.

 

This is a strange reply. How can the NHS have put in a large demand for extra Ā cash when it has no idea how many extra Ā people it needs or wants? Wages and employment costs are its main item of spending.

How can it claim to have a serious working plan to get the waiting lists down if it is not recruiting a decent number of doctors, nurses and other medical professionals to carry out the operations and treatments needed?

What do the senior managers administrators Ā do that prevents them from knowing how many staff they need? What signal does it send to medical schools and potential students that the near monopoly employer still does not have a plan to recruit more staff?

 

The Department of Health and Social Care has provided the following answer to your written parliamentary question (119392):

Question:
To ask the Secretary of State for Health and Social Care, what forecast he has made for the likely increase in staff costs for 2022-23 for NHS England. (119392)

Tabled on: 07 February 2022

Answer:
Edward Argar:

A forecast has not yet been made. The Government is seeking pay recommendations from the independent Pay Review Bodies (PRBs) for most public sector workers not in multi-year pay and contract reform deals. Remit letters were issued to the PRBs in November 2021. As the PRBs are independent, the Government cannot pre-empt the recommendations, which we expect to receive in May 2022.

The answer was submitted on 22 Mar 2022 at 16:18.

 

This reply confirms that the NHS had not forecast the detailed spending needed to get waiting lists down when it was agreed to impose a tax and send that cash to the NHS. I find this surprising. Surely NHS managers need to know staff numbers and staff costs before submitting a bid for more money for waiting lists?

 

115 Comments

  1. Fedupsoutherner
    March 29, 2022

    It seems to me that this government hasn’t a clue how much of anything is required to implement any of their pie in the sky policies. Why worry when there’s a never ending pot of money called the taxpayer? This government (can we call it that) is the most irresponible and useless bunch of idiots ever to grace parliament. The future of the UK is not looking good.

    1. Shirley M
      March 29, 2022

      +1 FUS. I would go further and say the future of the UK is looking decidedly bad. It will probably still be an improvement for all the ‘uninvited guests’, but the quality of life for the majority is going downhill rapidly while we pay for the rest of the world to be ‘saved’.

      1. alan jutson
        March 29, 2022

        +1

    2. Lifelogic
      March 29, 2022

      “the most irresponsible and useless bunch of idiots ever to grace parliament”

      Idiocy or vested interests or even just corrupt self interest?

      Quite some stiff competition here though – The Ted Heath (no loss of sovereignty common market without the people’s consent), Wilson and Mr (98% income tax/IMF) Denis Healey, John (ERM fiasco) Major still no apology from the pathetic man, War on a lie and botched devolution Blair, boom and mainly bust, save the world, pension thief – Gordon Brown, the appalling dishonesty of Theresa (cheat the voters of Brexit) May…

      1. Peter Wood
        March 29, 2022

        LL,
        and yet all were democratically elected. What’s to be done when we, in the 21st Century, find ourselves governed by such as May and Johnson? We need a better system to find and encourage to run for election the best of us, not the ‘last one left standing’ or the jester who’s only in it for the beers and giggles.

      2. Original Richard
        March 29, 2022

        Lifelogic :

        Yes, there is some stiff completion.

        But if this Government allows BEIS to continue with its Net Zero Strategy to power the whole country on ā€œthe breezes that blow around these islandsā€ (PMā€™s Conservative Party conference speech October 2020) coupled with the electrification of everything, without building any replacement nuclear for base load or CCGT plants to act as backup, nor invest in the supply of gas, then they have the potential to completely destroy our economy, democracy and security through expensive and intermittent energy.

    3. Peter
      March 29, 2022

      NHS is clueless yet unconcerned about staff costs. They probably do not like to admit this but will carry on regardless unless a big scandal arises in the media.

      NHS Management needs to be culled and replacement with a smaller number who are genuinely capable of doing the job.

    4. Neil Sutherland
      March 29, 2022

      And the ‘opposition’ parties peddling identical policies are worse. The illusion of choice in a pseudodemocracy.

    5. glen cullen
      March 29, 2022

      Whatā€™s the vision of all these policies, what will we look like by the end of this parliamentā€¦..not what was envisaged by the electorate reading the Tory manifesto ā€“ apart from heading in a woke, green, socialist direction; I donā€™t know this governments vision

    6. Timaction
      March 29, 2022

      Indeed they are. It’s clear that our host has the same frustrations as the rest of us. Hence his questions that confirm THERE IS NO PLAN. Just window dressing. We need huge reform in our public services to remove the left wing pro EU, mass immigration climate change religion, pc/woke mob . It’s also time to call out the former conservative now Liberals, high spend and waste Tory’s. Incompetence doesn’t do them justice.

      1. Iain Gill
        March 29, 2022

        yes indeed

      2. X-Tory
        March 29, 2022

        Yes, Sir John’s questions invariably reveal that the NHS has no business plan whatsoever. They don’t know how many operations they will do, how many staff they will have, what their spending will be or what they will do with the money that they will be given. They are utterly clueless in every way. The NHS is appallingly mismanaged and a total shambles. And yet … despite all these revelations Sir John still refuses to publicly state that he has NO CONFIDENCE in Sajid Javid.

        1. Iain gill
          March 30, 2022

          The health secretary job is impossible to do well.

          The useless layers of dhsc and NHS management and their organisational fashions are the problem, and the institutional refusal to say that the emporer has no clothes.

      3. John Hatfield
        March 29, 2022

        We need huge reform in our public services starting with the BBC.

    7. Nottingham Lad Himself
      March 29, 2022

      Conservatives are very interested in power and in the trappings of power, but not in doing work.

      Simply gaining an insight into what is happening in the complex real world requires work.

      This country is in big trouble.

      1. Mickey Taking
        March 29, 2022

        That’s just what I thought with Gaitskell, George Brown, Wilson, Callaghan, Foot, Kinnock, Blair, Brown, Miliband, Corbyn…I pause due to doubt over is Starmer a leader.

        1. Peter2
          March 30, 2022

          Spot on MT

    8. MFD
      March 29, 2022

      +1
      FuS
      Far too many MPs and menbers of the Lords. We need to reduce both houses by at least 60%. We also need a system for vetting candidates to allow us to sort those with useful qualification from those unqualified in life skills.

    9. agricola
      March 29, 2022

      +10
      Well done SJR for drawing attention to this inadequacy. Even more worrying is this governments failure to take advantage of Brexit. I say this because it is an opportunity to create national wealth. NHS failures in planning lead to the wasting of taxpayers money. Meanwhile Boris only hints at his energy plan that is yet to materialise. Reform need to start playing centre stage lest we arrive in 2024 with Labour the only option, which means no option.

    10. L Jones
      March 29, 2022

      We shouldn’t call them ”useless”, ”incompetent”, ”unthinking”, etc.
      That’s letting them off the hook. They know EXACTLY what they’re doing. There are enough of them to weed out any that are ”bonkers”. Thus the ones left are simply following the plan – not blindly thrashing around playing catch-up. That’s being far too forgiving.

  2. David Peddy
    March 29, 2022

    This is quite typical of the NHS .
    They don’t make plans by analysing the situation/problem/ issue and calculating their needs.
    They think of a number ( they only think in billions by the way ) and just mouth this

    1. Lifelogic
      March 29, 2022

      Such are state monopolies and free at the point of use (or more likely delay or non treatment) makes this even worse. The NHS have no need to serve and rely on paying patients they are just a nuisance. Far better to deter them as far as you can. If they die before getting their operation or are deterred from coming that saves the NHS money. Also free at the point of use kills nearly all competition.

      Lots of private doctors now charging about Ā£70 for a 15 minute appointment same day or next day despite the NHS being “free” as you often cannot get these “free” rationed and delayed appointments. Though then you cannot get NHS prescriptions so these usually cost you more too.

      Can we have free and fair competition between state and private people where are the competition authorities. You have to pay four times over to go private once in taxes for others to use the NHS, then taxes on the extra you earn to pay you medical insurance, then you medical insurance bill and then 12% insurance premium on top. So most get Hobson’s choice of the NHS.

      1. Iain Gill
        March 29, 2022

        I notice that even if you have surgery which causes incontinence the NHS does not provide incontinence products, not even immediately after the surgery in the hospital. As far as I am concerned this is as basic as wound dressing. Yet they waste money on diversity officers, and rainbow paintings.

        Absolute disgrace.

    2. Lifelogic
      March 29, 2022

      They do not care about patients as the patients do not pay. Best to deter them coming or delay them so that is what they do in general. Then they can spend more money on admin. salaries, gold plated pensions, settling the many legal claims, sorting out diversity and changing the names of the NHS trusts and their emblems every year or so.

    3. Ian Wragg
      March 29, 2022

      It’s all about resources, money. Year on year they must bleat that they don’t have enough resources, money so Joe public can be fooled into blaming the government for delays and backlogs.
      It’s time an independent auditor was appointed to oversee the waste and over staffing which is a feature of the NHS.
      They could also report on the number of clinically obese that are employed.

      1. Ian Wragg
        March 29, 2022

        Update, wind is supplying 1.17gw or 3.5% of demand.

        1. Beecee
          March 29, 2022

          And The Friends of the Earth have taken out full page adverts in the newspapers today, exhorting the PM to stop opening new oil and gas fields and, as well as home heat pumps etc, to invest in Wind and Solar farms.

          Do these people ever analyse the consequences of the policies they demand be implemented?

          1. Fedupsoutherner
            March 29, 2022

            BeeCee. More imortantly do the ministers ever analyse what they are being persuaded into doing? Perhaps some shoukd stop considering the whims of their partners?

          2. MFD
            March 29, 2022

            I cannot understand the use of agricultural land for solar panels which also need expensive infrastructure to get the power to the grid. Every building should be roofed with solar panels- schools, supermarkets, factories and storage and distribution centres all have ready installed connections to the grid.

            It is so stupid not using what we have already got!

  3. Mark B
    March 29, 2022

    Good morning.

    How can the NHS have put in a large demand for extra cash . . .

    Because it is the NHS, Sir John and knows that Labour would be all over it if the government refused. Ie ā€Rotten Tories starving our beloved NHS again !ā€

    Wages and employment costs are its main item of spending.

    Ka-ching ! How many NHS Managers / CEOā€™s earn more than the PM ?

    . . . recruiting a decent number of doctors, nurses and other medical professionals . . .

    You cannot just suddenly create these people from nowhere. It takes many years to train a doctor and a nurse. Currently we are importing these people, some with dubious qualifications.

    What do the senior managers administrators do that prevents them from knowing how many staff they need?
    &
    . . . near monopoly employer . . .

    You have, inadvertently answered your own question. They are a monopoly who have no competition and thereby no means of comparison. If shop (a) did better then shop (b), come the end of the year which shop do you think would have the most customers ? This question is neither a trick or hard to answer.

    Currently I am working on a project which has a tight deadline. I have been asked to work some extra hours (paid). We know the deadline. We know what needs to be done. And consequently we can determine what hours need to be put in. Because if we did not, and failed to achieve our deadline the client would be unhappy and will go elsewhere in future. Tell me where I can go to receive medical treatment ? Yes I could pay, but I am already paying and I am expected to pay even more in future.

    Again. Would it not be better to remove the healthcare as benefit ? Then people can choose to go private and be treated far quicker, thereby releasing resources for the NHS.

    1. Narrow Shoulders
      March 30, 2022

      Quite, if Private Medical Insurance is offered to all employees it is not discretionary and is not just for the big wigs.

      There is benefit to the NHS in having a greater percentage of the workforce on private medical insurance so why tax it and charges ERS on it as a benefit.

      We have staff who don’t take up the offer to save 20% tax. Shocking, and the insurance company offers video GP consultations which would take even more pressure of the system without the Ā£70 charge @LL refers to above.

      Remove the tax charge without delay.

  4. DOM
    March 29, 2022

    The unionised public sector and especially education and NHS has the Tory party and its leaders by the balls and it will take (to waste) whatever cash amounts it likes from the taxpayer when it wants it. The NHS can block reforms and act without accountability knowing a neutered Tory party won’t stop them

    The taxpayer is being openly abused by a Tory party who are electorally petrified of being seen to be on the wrong side of the NHS.

    Thatcher didn’t gain power in 1979 by promising to spend more taxpayers money

    As an aside. To see a Tory Minister doing the bidding of the RMT and the NEU is pathetic. The Tories have zero shame

    1. Lifelogic
      March 29, 2022

      Under Thatcher we had tax relief for company and private medical insurance plus no 12% IPT tax. This expanded the private sector, got more money into medical care overall and lightened the load on the NHS. Alas now it is now subject to tax, NI & IPT tax. Freedom, real choice and a level playing field is what is needed in Heathcare, Education, housing, broadcasting, dentistry… between state and private.

    2. Sir Joe Soap
      March 29, 2022

      We need a new party to rid us of these 3 socialist ones. Split them down and beat them.

    3. SecretPeople
      March 29, 2022

      A Telegraph article from 28 March, ‘Rishi Sunak gets a slap for spending like Cecil B DeMille’, concludes:

      “It was a low-tax slap caught on camera before a global audience of dozens. Later, the committee issued a statement:
      ā€œWestminster does not condone Thatcherism in any form.ā€

    4. Everhopeful
      March 29, 2022

      +many
      Spot on as ever Dom!
      I still donā€™t really understand why they are so weak kneed.
      Are they truly LibDems or cowards.
      They canā€™t be bothered about elections cos they pursue the MOST unpopular policies.

    5. DavidJ
      March 29, 2022

      +1

  5. turboterrier
    March 29, 2022

    If there was ever confirmation needed that the whole of the Department of Health and Social Security are not fit for purpose the replies qualify for the gold and silver medals.
    No wonder it is called a bottomless pit regarding public funding. Don’t know about another reorganisation more like demolish it and start again.
    Printable words fail me. It needs sorting it cannot be allowed to continue in its present guise.

    1. SM
      March 29, 2022

      Totally agree – these (and other) Depts are administered by people who could not run a whelk stall.

    2. Lifelogic
      March 29, 2022

      Not just the NHS but also police, the judicial system, jails, defence procurement, border force, transport, the energy and business department, education, social services, the planning system, local authorities, the pensions systems, the FCA, the bank of England… spending nearly 50% of GDP and delivering back very little indeed of any real quality or value.

      1. Timaction
        March 29, 2022

        Indeed. Since the election of Blair (1997 – now 25 years ago) all Health, Police, Councils, Fire Service, Head Teachers, Civil Serpents of all description etc etc Have had their selection processes changed to ensure only left wing Pc/woke types can make it to the top decision making roles. As this Government has been in office for 12 years we can only come to the conclusion that they not only know this but actively support it! That’s why we have useless public services as they are NOT selected on any skills or ability.

    3. DavidJ
      March 29, 2022

      +1

    4. Timaction
      March 29, 2022

      +1

  6. Cheshire Girl
    March 29, 2022

    Governments never give straight answers. They just waffle.

    The truth is, we are in an almighty muddle here, due in part to uncontrolled immigration, and they donā€™t want the public to know how bad it is.

    1. Lifelogic
      March 29, 2022

      Ministers/politicians in general either say things so obviously true as to be not worth saying, or they waffle saying nothing at all or they say things that are (usually obviously) just blatant lies like “the climate emergency is the largest issue facing the world and renewables are the solution” “or we are cutting taxes when they are putting them up massively”. These lies are often just before elections or referenda also when trying to cover up gross state sector incompetence like Hillsborough, the very many appalling NHS scandals, the Grenfell Tower cladding & senior fire service incompetence, the blood transfusions scandal, police service incompetence…

    2. turboterrier
      March 29, 2022

      Cheshire Girl

      Well slap my bum. Who would ever have thought all these people coming in would have an impact on services?
      You and I do as does a large proportion of the public. Sadly the vast majority of the parliament choose to ignore this fact.
      Why they no think, let alone listen?

    3. Shirley M
      March 29, 2022

      +1 Cheshire Girl.
      Uncontrolled immigration = even scarcer housing, even scarcer NHS availability, even scarcer access to doctors/dentists/education, etc.
      Uncontrolled immigration = MORE hotel rooms to be paid for, MORE pollution, more traffic on the roads, more demands for energy/food which equates to MORE imports and MORE dependency on hostile countries, etc.

      WHY???? The UK is to be sacrificed on the altar of climate change (and political stupidity) in order to ‘save’ …. who exactly? Those hostile countries? The empire builders? The aggressive countries? The communist countries? Every country needs to be ‘saved’, except the UK, yes?

      1. Fedupsoutherner
        March 29, 2022

        Shirley. Spot on. What’s the point of saving the world. .ha ha.. when the country ends up brig a banana republic?

    4. DavidJ
      March 29, 2022

      +1

    5. Timaction
      March 29, 2022

      Well, if you allow over 700,000 people in every year do they then wonder why there is insufficient health, housing, education and other public services for the indigenous population? We don’t have a housing crisis, we have a mass immigration crisis and a very incompetent Government. The boat people at Ā£5 million a day to support when it would be cheaper to give them a one way plane ticket straight back to where they come from. If the law needs changing to facilitate this, CHANGE THE LAW and grow some courage to attack the left!

      1. Fedupsoutherner
        March 29, 2022

        Time action. Their mobile phones should give some clue as to where they originate from.

      2. Diane
        March 29, 2022

        The 5million a day as I understand it is simply hotel accommodation. There is far far more to take into account than just that. Ā£10million to Belgium just recently, mere drops in the ocean for some. The new legislation is I believe still going through its backwards & forwards motion until it is watered down as far as is possible, not that it’s very substantial to start with and, we are told by some, won’t work. Will it be updated so that any mobile phones might in future be legally retrieved and checked by our authorities on the arrival of all the uninvited, unknown, undocumented migrants, entering our country by illegal means. 395 / 12 boats arrived yesterday 28th (BBC) The report also states total 4559 this year to date.

    6. MFD
      March 29, 2022

      Well said CG

  7. Lifelogic
    March 29, 2022

    Indeed – but to not worry JR they will have plenty of diversity officers on circa Ā£100K each it seems. Clearly the NHS managers think these are the most vital people to be recruited. We may only have half the doctors and nurses we need but at least we have hit our diversity targets. Of course if you have diversity target you cannot recruit the best at the same time. You either recruit the best for the jobs and get whatever diversity that results in or you recruit on diversity ground and get the lower quality that must mathematically result from this restriction.

    Only about 50% of UK trained doctors start or stay with the NHS for long. Many just get better paid jobs outside medicine, others leave the country. This as the NHS treats many junior doctors very poorly indeed – both in terms of pay, proper specialist backup and training, the undue pressures placed on them and the blame they often receive (often quite wrongly too). This a particular problem at they often have large student debt for 5-6 years of degrees). A vast waste of very expensively trained doctors. The NHS also undercut UK doctors wages by bringing in cheaper often less well trained overseas doctors.

    1. X-Tory
      March 29, 2022

      Yes, the fact that this government has not banned the role of ‘diversity officer’ (not just in the NHS but in the public sector as a whole) PROVES that, despite all their rhetoric designed to fool the public, this government is just as woke and politically correct as Labour. THERE IS NO DIFFERENCE BETWEEN THEM. The pretence that there is a difference is a LIE. That’s why I no longer care if voting for a smaller party (such as Reform UK) ‘lets Labour in’. So what? Until the Tories SACK all the parasitical and trouble-making ‘diversity officers’ there is no difference between the Tories and Labour any more.

      1. Narrow Shoulders
        March 30, 2022

        There is as you say, no need for diversity officers. Just write the needs to ensure equality of opportunity and a diverse workforce into every HR operative and manager across the public sector and performance manage against it.

        Many millions saved and holistic initiatives developed instead of ad hoc bandwagon jumping.

        1. Narrow Shoulders
          March 30, 2022

          Hr and manager job description

  8. Sea_Warrior
    March 29, 2022

    Seeing your first question, and the dreadful answer, my immediate thought was: ‘How can the NHS have put in a large demand for extra cash when it has no idea how many extra people it needs or wants?’ But I see that you got there first. Financial planning at Health is of the New Labour model – just tossing in large bundles of cash in an effort to impress voters.
    My policy for May remains to spoil my ballot-paper. I won’t be alone in doing that. Johnson has to go!

    1. Narrow Shoulders
      March 30, 2022

      I am a big fan of the spoiled ballot paper but our Conservative Council does a very good job and I will be supporting them with my vote.

      Local election, local issues.

  9. Donna
    March 29, 2022

    The NHS demanded more money to help clear up the backlog the NHS created by effectively closing down the service” for two years.

    All this disgraceful Government asked was “How much?” And then reached into OUR pockets yet again.

    In a real Democracy, these charlatans would be ousted at the first possible opportunity the electorate got. Unfortunately, under our Shamocracy, the so-called alternative is even worse. And that’s all that might save them.

  10. wanderer
    March 29, 2022

    Until the general public are made aware of the black money hole that the NHS is, and the poor level of service it gives compared to other systems around Europe, then no politicians are going to be able to change much. They should have seen that the Covid/SAGE fiasco was another way the NHS management was manipulating support.

    1. Mark B
      March 30, 2022

      If you can convince people to stand outside their houses every Thursday eveing and clap their hands like performing seals, all to ‘Save Our NHS’, then you know that this Sacred Cow can never be dealt with.

      Labour and the Unions have moved their paracitic existance from industry to the State Sector and the NHS is right at the heart of it all due to the emotions it can arouse from Joe Public.

      We now exist to serve the NHS (State).

  11. Nigl
    March 29, 2022

    Sorry for the brevity and rudeness but itā€™s utter bollocks. Weak Ministers led by the nose by the NHS taking the public for fools yet again.

    The fact that they are not embarrassed by such a ridiculous response says it all.

    1. X-Tory
      March 29, 2022

      And it took them SIX WEEKS to come up with this ‘non-reply’. Six weeks to say ‘we don’t know’. Really, the level of moronic incompetence is quite astonishing.

  12. DaveM
    March 29, 2022

    ā€˜Surprisingā€™ isnā€™t the word John. I know from extensive first hand experience that other government departments have to produce 95% accurate 10 year spending forecasts to even get a bid in front of the minister.

    Unfortunately all these answers do is confirm about the NHS what most have us have known for years anyway.

  13. Nigl
    March 29, 2022

    And in other news the DT highlights the ridiculous posturing of the government and particularly Grant Shappless in relation to P and O. Misleading the public in as much as he had been made perfectly aware of the trouble the company was in advising them to take ā€˜whatever commercial decision that is neededā€™. When they did a sudden bout of amnesia affected him and he and Boris etc took the opportunity to deflect the narrative from the governments self created cost of living crisis.

    The DT ends with the phrase we know so well. They are taking the public for fools.

  14. Everhopeful
    March 29, 2022

    Indeed.
    Lewis Carroll yet again.
    However, I bet the reason they donā€™t know numbers is because they are planning to give the NHS as we know it, the chop!
    And greedy machinations have left us with few alternatives.
    Open a totally unregulated health shop on every street cornerā€¦ten Bob a go.
    Why not?

  15. Aaron Shone
    March 29, 2022

    ā€˜ā€¦develop a workforce strategy which will set out its conclusions in due course.ā€™
    Soā€¦ when?
    When is the commissioned report due? Who is responsible for holding the responder accountable for this meaningless response, and how?

    Most of the official responses to questions you post on your blog would have resulted in some sharp words from the questioner had I provided them in a professional context.

    ā€˜Aaron, what are your project and resource financials for the budget discussion next month?ā€™
    ā€˜I have no specific resource plan, and I am working on a project plan which will be delivered in due courseā€™.
    Ludicrous. My professional competency would be questioned, my suitability to deliver the work made suspect, and the chance of further work in peril.

    Censure the responder who supplied this answer for incompetence. Insist on SMART responses (specific, measurable, actionable, realistic, time-bound).

    How can you or any politician have any credibility holding the government and civil service to account if you let this utter rubbish pass as a response to an official question?

    1. Timaction
      March 29, 2022

      Good questions. It begs the question why do the NHS need so many managers when they don’t know the basic response to simple questions from JR? If the Minister accepts answers he or she is given from the NHS then they are as incompetent and should be sacked as well!

    2. hefner
      March 29, 2022

      Aaron, Even better, ask for SMARTER (s.m.a.r.t + Evaluated* and Reviewed%) and one realises that no government since the ā€˜50s (when these management ideas started to be floated around) has ever been able to produce results fulfilling these seven conditions in any project development, execution and assessment.
      * by users and/or customers
      % by independent but knowledgeable people.

  16. Sharon
    March 29, 2022

    This goes back to a blog a few weeks ago , when JR gave the example of going shopping.

    Instead of asking each NHS trust what is needed in the way of extra staffing, costing that and then deciding how much of that cost is feasibleā€¦ theyā€™ve just sat staring into space with no clue. Eventually, I suppose, theyā€™ll hire more staff to sit and pluck a figure from the air. Sorry if that sounds cynical.

  17. oldtimer
    March 29, 2022

    By now you should not be surprised. The NHS is no longer accountable to MPs and Parliament via ministers in charge. Instead ministers are accountable to the NHS for delivering obscene amounts of cash voted through by compliant MPs who should know that their place is not to ask obvious but embarrassing questions but to simply say Aye when more cash is demanded – with no questions asked.

  18. Mike Wilson
    March 29, 2022

    I find this surprising. Surely NHS managers need to know staff numbers and staff costs before submitting a bid for more money for waiting lists?

    I presume this is sarcasm. I find it unsurprising. Expecting forecasts of staff numbers and costs assumes the NHS is full of competent managers and administrators. As anyone with experience of the NHS knows, it is a shambolic money pit. I feel sorry for the nurses and doctors forced to work in such a poorly managed environment. It must be soul destroying to be committed to your work but have to work under a vast, useless, overpaid management.

    1. Timaction
      March 29, 2022

      Exactly the same could be said for the Home Office (probably most other Government departments) who in my experience are a bunch of know nothings working from home, doing nothing, on flexi time! How many lost foreign offenders haven’t been deported? Boat people never being deported. Not any use whatsoever to the public, so should be disbanded.

  19. Brian Tomkinson
    March 29, 2022

    More evidence that this is the worst government and parliament in my lifetime.

  20. alan jutson
    March 29, 2022

    Just another example of how far Governments have lost the plot over the years, because this is not new.
    Raising taxes to gain extra money, with not a clue as to how it is going to be spent, or indeed how much value you are going to get from it.
    Multiply that by all of the Departments, as the NHS cannot be the only one, and you begin to understand the extent of the seriousness of the problem .
    Question is, who is going to get to grips with it, and when !

    1. Timaction
      March 29, 2022

      ……………….Question is, who is going to get to grips with it, and when ……………..
      No one will sort this as the current leader won’t let any of the “Spartan’s” anywhere near the levers of power. Only Net zero loons and supporters of mass immigration need apply!

  21. Mickey Taking
    March 29, 2022

    It serves two purposes – first a vote winner (we are allocating more money to the NHS), and secondly to get the usual annual suspects effectively saying the NHS ‘will’ fail without more money when it clearly already has failed off the political agenda.

  22. Philip P.
    March 29, 2022

    It may be difficult to foresee how many staff you’re going to need, when you are applying pressure on them to undergo a medical procedure many of them don’t want. They may also wish to leave rather than take part in a vaccination programme of children that is looking more and more dubious. If I were an employer, that sort of uncertainty about my staff would make my forward planning difficult.

  23. XY
    March 29, 2022

    Hmmmm. Consulting PRBs… doesn’t that mean that they’re planning to dole out the cash to existing staff?

  24. Bryan Harris
    March 29, 2022

    This is a strange reply.

    To say the least — It goes well beyond incompetence and mismanagement.

    So millions are going to be robbed with extra NHS taxes to support something that they cannot define, and seem to have no idea how the money will be spent, except on more management bureaucracy.

    It would appear that apart from not being able to budget or make use of simple principles to make sure extra funds are targeted and spent wisely, HMG has reverted to full blown socialist economic methodology: THROW enough money in the general area of a problem and eventually it may go away.

    I trust our host will keep badgering the ministers to inform us exactly what benefit, if any, we are getting from so much extra unnecessary taxation!

  25. ChrisS
    March 29, 2022

    These answers to nicely focused questions prove everything that is wrong about the NHS and the management of wider government financing.

    Blair and Brown comprehensively proved that just throwing money at the NHS without clear, measureable targets just does not work. They simply ended up with the highest paid doctors in Europe. Now a Faux-Conservative government is doing exactly the same, and the results will be just as disastrous.

    While “Our NHS” remains the holier-than-though organisation that it is, things will never change. It needs to be taken out of the political arena and treated as the commercial service that it really is, albeit one that is. state owned.

  26. DavidJ
    March 29, 2022

    “The Department has made no specific estimate.” Incompetent or what?

    Also the words “in due course” do not give me any confidence. More likely a case of kicking the can down the road in the hope that they can avoid the issue. It is simply unacceptable that such people are able to access and squander taxpayers’ money.

  27. JoolsB
    March 29, 2022

    Who needs Doctors? According to this clueless useless Government, employing Managers at Ā£270,000 a pop will sort out all their problems. I can tell you John, morale has never been so low in the NHS. I would worry about keeping the doctors theyā€™ve already got every bit as much as about recruiting new ones. Does this idiotic Government know how long it takes to train a Doctor yet so many are leaving the profession or thinking of leaving. One way to help keep newly recruited doctors if the dumbos in charge had a brain between them is to use some of the money to write off the Ā£80,000 + debt they have accrued learning medicine and are now having to to pay off out of their meagre salaries. After all, they are happy to write off the debts of those whoā€™ve done worthless degrees and are now working in the local Pizza Hut. 78% of student debt is written off by the Government, i.e. the taxpayer, for those whoā€™ve done worthless degrees but not for the very professions the country needs. Instead of Sunak finding ever more ways to screw even more money out them re. Student debt, he should be trying to find ways to make the system fairer for those doing STEMM subjects and deter the worthless degrees. But Sunak and his master donā€™t do fair do they John?

    We are being governed by donkeys and I apologise for insulting donkeys.

    1. No Longer Anonymous
      March 29, 2022

      + 1

      More like Ā£100k student debt for a doctor with intercalation – aspiring to be a surgeon, after six years of training and study… on top of the BMAT and UKCAT exams taken during A levels.

      “How many health professionals he needs to recruit…”

      I was reminded of when Jack Ramsey “… has *joined* the Royal Marines.” according to the press.

      As if all you do is sign these people up as an when you need them.

      Tories reward all the wrong behaviours and punish all the right ones.

    2. Shirley M
      March 29, 2022

      +100 and more, JoolsB. More training places for the medical professions would also be a wise decision, which is why this government will never do it! Make the training free in exchange for a guaranteed number of years working for the NHS. If they leave the training, or the NHS earlier, then the student must repay the taxpayer for the training received. That’s how many professional companies provide expensive training to their employees.

    3. Margaret Brandreth-
      March 29, 2022

      What many just simply don’t comprehend is that Drs and Nurses training never ends . A medic in his 3rd year will be working on the wards and taking the same decisions as a student who has done 4 or 5 years, every one will call him Dr as a grace and favour title, but he is one of the staff who have not yet completed their time. A Nurse must train to be a Nurse general practitioner for sometimes 20 -30 years or more. Getting fixated on time training is just a figure for the convenience of those who don’t fully understand. During the training of the supposed 7 years another Ba hons is advisable for the sake of job hunting and then of course there is an extra 3 years to make a GP or the continuing exams we take to further our careers. As a Nurse I personally have done 25 years academic, so have many others and that does not include the re registration peer assessed training required by both Drs and Nurses. Incidentally The title ‘Nurse’ is the only registered professional title A Dr is a registered medical practitioner and is not a Dr unless he has a doctorate , which many in these research centred days have.

      1. alan jutson
        March 30, 2022

        Margaret I take your point, but there are many professions that still require additional knowledge and development throughout a working life, which include: scientists, designers, engineers, mining experts, then there are those who work in the newer and developing technologies of computer science, robotics, communication, just to mention a few.
        Few people can really afford to simply stand still, because you then get left behind.
        Certainly agree medical science and treatment have moved on in leaps and bounds but so have many other industries.

    4. Original Richard
      March 29, 2022

      JoolsB :

      Agreed.

      If the universities were made to provide the loans for at least the tuition fees then we could expect to see a reduction in the number of worthless degrees.

  28. John Miller
    March 29, 2022

    When I had to earn a living, giving answers like this to clients would have meant that within days, I wouldn’t have any. “I can’t be a**d” doesn’t get you any money, so why should NHS managers and civil servants get any?

  29. Original Richard
    March 29, 2022

    Yesterday we learned how the Secretary of State for Environment, Food and Rural Affairs was unable to answer a question and today it is the Secretary of State for Health and Social Care.

    The Treasury will not tell us the cost of BEISā€™ Net Zero policy and the Home Office will not inform us of the cost of their policy to invite thousands of unidentified fighting men into the country by offering them 4 star accommodation, Ā£40/week pocket money and the freedom to roam our streets.

    The Civil Service are in control and not our elected representatives in Parliament and they are not prepared to answer any questions.

  30. Pat
    March 29, 2022

    Sir John,

    As we learn in today’s Telegraph that NHS trusts are asking male cancer patients and men undergoing X Rays whether they are pregnant, it begs the question of how much money and time is being wasted on such procedures being imposed on the NHS and patients.

    I leave it to others to raise examples of other arcane NHS practices or indeed the motivation for their imposition.

    This situation is incomprehensible to many constituents who struggle to even see a doctor and it remains to be seen whether there are any MPs brave enough to actually represent their constituents in Parliament by challenging this woke attack on the NHS.

    1. Shirley M
      March 29, 2022

      OMG Pat. I didn’t see that. The NHS desperate to waste even more money in their eagerness to cater for the miniscule number of men (or women) who ‘identify’ as the opposite sex, and to hell with causing unnecessary extra work, confusion, upset and offence for the 99.9% majority.

      Equality disappeared a long time ago in the UK. There are few things where double standards do NOT apply, be it race, sex, age, justice, education … whatever you can think of, basically, there will be double standards in plain sight.

  31. Lily
    March 29, 2022

    The questions were addressed to the Secretary of State and his department – they are the people who should be working out future needs, not the NHS. Sajid Javid admitted last November that the government’s election promise to provide 6000 more GPs by 2025 is not going to be fulfilled. Meanwhile, nearly 800 medical graduates are currently on a reserve list for a place to start FY1 training, the highest number on record. The department for Health and Social Care is failing in its duty both to the NHS and to the wider Social Care systems. Ask any foster carer or anyone involved in the voluntary sector.

    1. alan jutson
      March 30, 2022

      +1

  32. BOF
    March 29, 2022

    Ask, and ye shall receive. Always far more than needed and if there is anything left it can always be wasted elsewhere. The Tories will never refuse, Labour will never refuse and the remaining rabble will go along with it. After all, it is for a good cause, the NHS!

    I am sure this will go on until the public sector and in particular, the NHS, brings the country down financially. The NHS must surely be the most powerful political influence in the country.

    Tragically Sir John, with all your straightforward and well directed questions,you get the same fobb offs that the rest of us get.

  33. a-tracy
    March 29, 2022

    Edward Argar should be ashamed of this answer. You asked a question about 2022-2023, not five years forward.
    Staff planning is a strategic process written by HR teams, who seem now to be too worried about diversity instead of planning for what they require on the front line and hiring the right people. This department has had the extra money but they’ve done no planning for extra qualified staff? What? Or is this all going on pay increases for staff already in place?

  34. oldtimer
    March 29, 2022

    Yesterday my wife attended a hospital for a precautionary eye scan and consultation. This time at this particular hospital it only took about 2 hours. There was no sign of staff shortage, only of staff abundance. At least the administration was somewhat better than another hospital`s eye department administration where (this was in pre-covid times) it was normal to have to wait many hours after the appointment time to be seen. These delays were clearly a case of maladministration not of staff shortages.

    1. alan jutson
      March 29, 2022

      Ah the old trick of booking everyone in at the same time, usually 9.00am and then let them wait in the order they turned up, with the flies put in that order in a pile as they arrive.

      1. alan jutson
        March 29, 2022

        Oops should be files, not flies put in that order, in a new pile as they arrive.

        Auto correct strikes again.

      2. a-tracy
        March 30, 2022

        Alan, it is a ridiculous method of running appointments, private hospitals donā€™t need to. Some people always turn up early for their slot, if someone is late the private appointment doctors/consultants just see the later appointment first and make the late arriver wait when they turn up. Can you imagine a private hospital getting away with telling 20 people all to turn up at 9am.

  35. JohnE
    March 29, 2022

    The Government has made nursing a much less attractive profession by:
    1. Making nurses borrow money to pay for their own training.
    2. Charging interest on those loans at rates linked to RPI, which is out of control. RPI is phased out as a measure for anything which is payable by the government but retained for student loans.
    3. Restricting pay rises to well below the level of inflation so that pay gets steadily worse every year, and quickly worse this year.
    4. Meddling with the pension schemes so that staff feel the need to leave in order to protect their entitlements.
    4. Driving organisational reforms in the NHS which have made everything worse.

    1. a-tracy
      March 29, 2022

      JohnE, only English nurses have had to pay for their own training, so are Wales, Scotland and N Ireland full up to the brim with nurses with some going spare who even if they work in England donā€™t have to pay the graduate tax?
      English nurses are only the same as any English graduate in any discipline, maths, chemistry etc. that get a degree because theyā€™re the brightest and can help to propel the UK to greatness and for themselves to potentially earn over Ā£28,000 pa shortly after qualifying in basic pay plus an excellent package of holidays, enhanced overtime, full sick pay and superb pension. 4. What would you say if the government proposed to offer NEST pension the same as in other jobs and a big pay increase so that the NHS employee could choose for themselves how to spend that allowance and of course pay a big tax bill if they take it as earnings instead?
      2. Excessive Interest on plan 2 student loans are offensive for all English graduates.

      1. alan jutson
        March 30, 2022

        a- tracy
        You are correct about NHS sick pay and pension, both are superb, as would be the redundancy/settlement/compensation package, if by any chance they wanted to move you on !
        Secure employment, and automatic salary increases (within the band grade) are also a bonus many simply do not get in the Commercial World.

  36. Denis Cooper
    March 29, 2022

    I hoped some MP might ask about the economic value of our new trade deal with the EU:

    http://johnredwoodsdiary.com/2022/03/27/taxes-and-sovereignty/#comment-1309076

    But judging by the non-answers to these questions it would probably be a waste of time.

    Nobody in the UK government or civil service has any idea what it might be worth to us; they have ideas about many small potential or agreed trade deals around the world, but not about our biggest trade deal.

    Of course this was just twaddle:

    https://www.reuters.com/article/britain-eu-johnson-biggest-idINKBN28Y1JQ

    ā€œSo Iā€™m very pleased to tell you this afternoon that we have completed the biggest trade deal yet, worth 660 billion pounds a year, a comprehensive Canada-style free trade deal between the UK and the EUā€

    Ā£660 billion a year is about 30% of UK GDP, not bad when our exports to the EU are about 12% of GDP.

    1. a-tracy
      March 30, 2022

      Denis, I really donā€™t understand why the media donā€™t pin Boris down on this, just how much was this poor EU trade deal worth to the UK in Ā£ notes and what % of our GDP is it. It still seems to be a very one way deal.

  37. G.Wheatley
    March 29, 2022

    Sir John,
    The replies to your questions clearly show that these matters have NOT been thought about by Government. The reason for that may well be that the replacement for the NHS – NHSx – is designed to ‘get-by’ on c.25% of current staffing levels with an increase in reliance on A.I. in dealing with patients presenting with symptoms.

    It’s hard enough getting to see a GP (or even a Dentist) these days, and it will become even more difficult with the NHSx initiative.

    The ‘Lesser Spotted General Practitioner’ may well attract hordes of ‘twitchers’ with tripod-mounted telescopes, with some travelling internationally in order to glimpse this increasingly rare animal.

    Dishy Rishi can’t give you costings because his calculator battery has run-down (if indeed a battery was ever in-place).

    1. g.Wheatley
      March 29, 2022

      …..sorry I forgot to add : ….and that may be why the Health Secretary was always unconcerned about sacking 100,000 unjabbed staff come 1st April; because they would not be needed within NHSx ?

  38. Margaret Brandreth-
    March 29, 2022

    Totally off topic but topical.. Will Smith displayed a full emotional loyalty to his wife instead of laughing along with the other morons who think that a person suffering with a medical condition should be mocked . He could of course sunk to the depths of joining them and embarrassing his wife further , but he didn’t , he stood up to them no matter what! There is so much bullying by those who want to take a rise out of people and join together in their mockery as they can’t stand alone :it makes me sick. I was reminded of the film . The Runaway bride , where Maggie was the focus for mockery and unwanted attention, But Gere shouted out against this insidious type of bullying . Believe it or not we have many patients who are emotionally battered by the throngs who bully and the rescuers who say ‘don’t laugh’ whilst trying to ride both sides of the power fence in their vulgar power seeking ways.

    1. Mickey Taking
      March 30, 2022

      How true – most ‘humour’ these days seems to be centred on shock-shouting, swearing, and victimisation of individuals who have some unusual state – it becomes an ostracization by the masses.
      Often known as a cheap shot.
      Hence the rise in counselling sought.

  39. acorn
    March 29, 2022

    The UK should be looking at a Health system similar to the French, Dutch and German models. That is getting away from government open loop funding and converting it to a mandatory health insurance system with co-payments. The latter could be run by the state as a proper risk based insurance business, just like car or house insurance. An organisation that can smell when it is being ripped off.

    See Fig 4 in https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29?utm_source=The%20King%27s%20Fund%20newsletters%20%28main%20account%29&utm_medium=email&utm_ca

    The countries that score highest for performance and value, tend to be the ones that have mandatory health insurance schemes that have to seek value for money; rather than the likes of the UK system that doesn’t.

    1. a-tracy
      March 30, 2022

      Acorn, why do you think they donā€™t? Isnā€™t that what the NHS got away from lots of small UK health systems with private contributions to provide your and your families cover?

      If services are too big for one person to control like the excuse for Cressida Dick then it needs breaking up into more controllable and comparable parts. You can still use nationwide stores for group purchasing discounts if indeed they get them.

  40. forthurst
    March 29, 2022

    Has the Chancellor asked the Arts graduates who mismanage the NHS why they need the extra money?
    Isn’t that his job or is the NHS to be given any money it asks for: highest priority (apart from looking after assorted foreigners) and all that?

    It’s time to recognise that the administration of the NHS is in the hands of duffers whilst many very hard working, more intelligent and better qualified people do their best to provide healthcare in a framework none would design for themselves. Every other Western European country has better healthcare; perhaps they simply don’t see a role for unqualified amateurs in their organisations?
    The implication that those responsible for organising healthcare have no idea how many qualified people they need when it takes seven years to train a doctor to basic qualification is frightening: the country is not in safe hands and no amount of fist-shaking at Putin will change that.

    1. forthurst
      March 29, 2022

      There is another possibility. NHS admin believe they do not need to plan for manpower because they intend to make up any shortfall however large by importing medical staff from countries where how well you get on is determined by who you know.

  41. Narrow Shoulders
    March 30, 2022

    While shocking these answers are unsurprising. Like most public sector endeavours the planning is top down rather than bottom up.

    What should we spend rather than what will be delivered. The NHS is given money for being not for doing.

    Until the funding is based on doing, I.e paid for each procedure and patient interaction there will be no change.

    The dentistry model not the GP model.

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