To ask the Secretary of State for Health what was the average annual cost of employing (a) a senior manager, (b) a consultant, (c) a senior house officer, (d) a qualified nurse, (e) an ambulance driver, (f) a porter, (g) a medical laboratory, scientific officer and (h) a cleaner in the NHS in each year since 1986–87 at (i) cash prices and (ii) 1986–87 prices.
The information requested is not readily available. The figures shown in the tables are estimated by combining information from national health service annual accounts and from medical and non-medical censuses.
The information available is shown in the table. More comprehensive information about national health service manpower is published in the "Statistical Bulletin on NHS hospital and community health services non-medical staff in England: 1981–1991" and associated press release—H93/626 NHS Non-Medical Workforce Statistics—dated 12 March 1993, copies of which are available in the Library.
|National health service workforce by staff group|
|1988 compared with 1987||1989 compared with 1988||1990 compared with 1989||1991 compared with 1990||1991 compared with 1987|
|Main staff groups||1987||1988||Number||Per cent.||1989||Number||Per cent.||1990||Number||Per cent.||1991||Number||Per cent.||Number||Per cent.|
|Nursing and midwifery staff||397,910||397,650||-260||-0·1||398,050||400||0·1||395,360||-2,690||-0–7||392,200||-3,160||-0·8||-5,710||-1·4|
|Professions allied to medicine||34,940||35,640||700||2·0||36,710||1,070||3·0||37,300||590||1·6||37,960||660||1·8||3,020||8·6|
|Scientific and professional||10,860||11,600||740||6·8||12,080||480||4·1||12,690||610||5·0||13,530||840||6·6||2,670||24·6|
|Other professional and technical||33,170||32,530||-640||-1·9||32,370||-160||-0·5||33,990||1,620||5·0||35,390||1,400||4·1||2,220||6·7|
|Medical and dental||41,570||42,840||1,270||3·1||44,090||1,250||2·9||45,390||1,300||2·9||46,530||1,140||2·5||4·960||11·9|
|Administrative and clerical||113,900||114,720||820||0·7||116,840||2,120||1·8||120,040||3,200||2·7||127,370||7,330||6·1||13,470||11·8|
|General and senior managers||700||1,240||540||77·1||4,610||3,370||271·8||9,680||5,070||110·0||13·340||3,660||37·6||12,640||1,805·7|
|Ambulance (including officers)||19,010||18,760||-250||-1·3||18,860||100||0·5||18,130||-730||-3·9||18,190||60||0·3||-820||-4·3|
Source: NHS Workforce in England/KM49 Census.
All figures are rounded to the nearest 10.
Information for 30 September 1992 is not yet available.
The table reflects some redesignation between staff groups.
Project 2000 trainees are not included in the above nursing and midwifery figures.
Medical and dental staff figures exclude locums.
Nursing and midwifery figures exclude agency staff.
The increase in managers can largely be explained by a phased introduction of a general and senior manager class which includes many people previously classed under clinical, professional and administrative headings. For example, many senior nurses are now counted as senior managers. Management in the NHS still only represents 1·7 per cent. of the total NHS work force and 3 per cent. of all pay expenditure.
Project 2000 nurse training was introduced in 1989 and will eventually become the only form of general qualified nurse training. At September 1990 there were about 3,000 Project 2000 students; at September 1991 there were 10,500. There were corresponding falls in the number of traditional student nurses. Project 2000 students are considered to be supernumerary and are not included in work force statistics.
The general and senior managers category was introduced in phases from 1984 following the Griffiths report of 1983, which identified a severe shortage of managers in the NHS. The first phase was the appointment of a general manager in each health authority and hospital and community health service—HCHS—unit. In 1987, the first senior managers were appointed—up to seven posts at board level in each health authority. In 1989, the senior manager class was extended to staff below board level, and to those in family health services authorities and HCHS units. Virtually all general and senior management posts created up to 1989 replaced posts formerly counted within the administrative and clerical and other staff groups. In 1990 and 1991, transfers of staff into the senior manager category from other staff groups continued. New funds were provided as a planned strengthening of the personnel, information and finance functions in preparation for the NHS reforms.