Should the NHS cut 137,000 jobs?

The brainiacs at McKinsey argue for a 10% cut in NHS staff - but it's easy for them to say.

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Last Updated: 31 Aug 2010

More NHS controversy this morning, after it emerged that McKinsey has suggested to the Government that it should slash about 10% of the NHS workforce. According to McKinsey, this could save the public purse around £20bn between now and 2014. There’s no doubt that the huge growth of the NHS in recent years has created inefficiencies, and budgets will clearly have to be looked at. But the fact remains that trying to implement cuts like these would be political suicide – so despite inviting the report in the first place, the Government couldn’t reject it quickly enough…

In McKinsey’s report (which has presumably been leaked, given the company’s Bardot-esque aversion to publicity), the big-brained consultants recommended that the NHS could afford to lose around 137,000 clinical and admin staff, while introducing a recruitment freeze and pushing more staff into early retirement. Around 30,000 NHS staff apparently retire every year, while thousands more leave for other reasons – so the number isn’t quite as preposterous as it might first appear.

McKinsey also claimed that an extra £3bn could be saved by making staff more productive, and a further £2bn by better purchasing deals on stuff like food and waste management. Unfortunately, the Government appears to think the whole thing is rubbish, with health minister Mike O’Brien telling the BBC that the NHS needs more front-line staff, not fewer. And naturally, the Tories used it as another stick to beat the Government with, accusing it of being dishonest by promising to protect the NHS and then wasting money on consultants (though apparently this work was unpaid).

The storm of condemnation is entirely predictable, but the fact remains that something sizeable has to be done. The NHS Confederation reckons the health service faces a shortfall of about £15bn over the next five years, due to the recession and rising costs. It’s against swingeing job cuts (as you’d expect) but it recognises the need to find savings somewhere. The NHS already sucks up about 18% of all public spending – that’s over £100bn, 60% of which goes on paying its 1.5m staff. The present Government has pumped in countless extra billions, which has brought down waiting lists but made the service less efficient (indeed, managing this huge and rapid growth without inefficiencies creeping in is a virtually impossible management task, as NHS CEO David Nicholson told us recently).

So at some point, someone in Government is going to have to grasp the nettle and get this spiralling budget under control. But the problem is, none of the parties seem to have the stomach for it – they just talk timidly about ‘protecting the NHS’, refusing even to acknowledge the possibility of cuts. So whatever McKinsey thinks, the chances of any politician sacking 10% of the NHS workforce are non-existent.


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