NHS ‘manager bashing’ is ‘explaining away’ problems in health service

The NHS Confederation said ministers have ‘looked for other culprits’.
Funding for the NHS estate has been criticised in a survey (Peter Byrne/PA)
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Ella Pickover14 June 2022

Government “manager bashing” in the NHS is an attempt to “explain away” problems facing the health service, one leader has suggested.

Matthew Taylor, chief executive of the NHS Confederation organisation which represents NHS services, said a decade of austerity, workforce and capital funding have led to issues in the NHS.

But ministers have “looked for other culprits”, he suggested.

Last week a major review into NHS leadership was published and Health Secretary Sajid Javid pledged to overhaul management in the health service.

We have got to increase capital investment … and develop an urgent workforce plan

Matthew Taylor, NHS Confederation

The Messenger review, headed by the senior former military officer General Sir Gordon Messenger, concluded there was an “institutional inadequacy” in the way leadership and management in the sector was trained, developed and valued.

The review found evidence of “poor behaviours” including discrimination, bullying and blame cultures.

While Mr Taylor largely praised the contents of the review, he told HSJ (Health Service Journal): “If you can’t recognise that the fundamental reasons (why) we face this yawning capacity gap are to do with, particularly, the decade of austerity, but (also) other failings to address capacity issues like workforce and capital, then you have to look for other culprits and you end up manager bashing and talking about wokery, because it becomes a way to explain away the reality that the patients and the public see.”

Speaking ahead of the NHS ConfedExpo conference in Liverpool, Mr Taylor also dismissed Mr Javid’s recent suggestion that the NHS does not need more money.

“We need a recognition that over the next decade we are going to need spending to grow four per cent a year in real terms because of the aging population and some of the catch-up that we need to do. We have got to increase capital investment … and develop an urgent workforce plan,” he said.

It comes as the organisation released a new survey revealing concern over the crumbling state of NHS buildings.

NHS Confederation said more capital funding was needed to upgrade run-down buildings, patient transport fleets and IT systems.

A survey of 182 NHS leaders in England found that nine in 10 believe their efforts to reduce the size of the waiting list are being hampered by a lack of investment in buildings and estate.

One primary care clinical director in the South East told NHS Confederation: “We’re working in a 1950s tin roof health centre servicing 34,000 patients with no ability to provide fit-for-purpose 21st century healthcare. Our ability to meet patient expectations and political promises is impossible unless significant investment in infrastructure is made.”

Two thirds of leaders who responded to the poll said they do not have enough capital funding to meet “digital ambitions” including rolling out electronic patient records

Health and Social Care Secretary Sajid Javid pledged to overhaul management in the health service (Peter Byrne/PA)
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Mr Taylor said: “The huge gulf in the NHS’s capital budget combined with a decade long underinvestment in estate, infrastructure and IT systems has left the NHS with run-down buildings, a major maintenance backlog and limited potential for maximising the use of digital technology.

“The Government needs to urgently unlock the capital funding that has already been promised so that work can finally begin up and down the country on new builds as well as addressing the maintenance backlog.”

Ministers also need to make further investment in the next spending review, he added.

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