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NHS Lothian has cut 125 jobs already in its bid to cut £31 million from its annual spending, according to the Evening News.  To meet its target it needs to find another 600 full time equivalent posts this year that it no longer needs, and then another 1,300 on top of that during 2011.

When the Board has made these efficiencies its overall headcount will reduce from around 29,000 to 27,000 – the number of full time equivalents (FTE) going down from 19,500 to about 17,500.

These are huge numbers – some two thousand people who had jobs won’t have them by the end of next year or, put another way, some two thousand people who might have hoped to be employed in the NHS to replace people who are retiring or moving on know already that that “in” door is closed.

Last week’s report of the Independent Budget Review Group is clinical (no pun intended) in its assessment of the cost of staffing the NHS, stating baldly:

Payments to those working in the health sector comprise the largest single component of wage costs for the Scottish Government.  The cost of employment in the Scottish NHS increased by around £1 billion between 2004-05 and 2008-09 – an average annual increase in pay costs of 6.3 per cent.

So, if you are shaving down the NHS workforce by about seven percent, how do you do that without having to stop doing things that you have been doing that have been good for patients?

NHS Lothian in its submission to the Scottish Government in June on efficiencies suggested that 333 of the 734 posts to go this year would be in nursing and midwifery a cut of 3.5 percent in the total FTE posts. 

On top of that there would be the loss of a further 59 medics’ posts (3.4%), 53 Allied Health Professionals (3.7%), 100 in support services (4.8%) and 124 in administrative services (4%).

By contrast, NHS Lanarkshire has told the Government that it will be making its saving of 123 posts entirely from administration and management, cutting the number of such posts by 6.6 percent.

It is worth pointing out that, though a lot of posts are being cut, a lot of people will still be employed.  The NHS, after all, is a pretty huge institution.

We often hear that only the Chinese Army and the Indian State Railways employ more people — with 2.3 million and 1.5 million staff respectively — than the 1.3 million employees of the NHS in the UK.  It’s also fair to say that the populations of India and China are somewhat larger than that of the UK.

And in Scottish terms, NHS Lothian, even by the end of next year, will employ more than the largest private employer in Scotland.  Tesco has a habit of growing, but will its current 22,000 workforce have grown to match Lothian’s 27,000 by the end of 2011?

Either the NHS is big enough in Scotland to be able to pare away at it for the next few years without affecting patient care; or it is its very size that allows the NHS to deal with so many sick people, and to deal with them properly.  Will any politician be willing to find out which is the right answer?

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