Comment / A sense of value

As you read this, we will be nearing the end of a long election campaign. The debate is, as ever, frustratingly simplistic for those of us working closely with the system. We know it looks like £8bn is the very minimum we need to make the Five-year forward view a reality. And even then the service faces monumental efficiency targets. 

These targets are only achievable if politicians are brave enough to support real transformation, which may involve new models of care, removing capacity in some places and rationalising in others.

We have been part of the NHS Confederation’s ‘election challenge’ discussion setting out organisations’ priorities for the next government.  My fear of a possible hung parliament is stalemate and fudge for some time, when 2015/16 is by far and away the toughest year so far. Once again it will be down to people like you to keep the ship moving to deliver seemingly impossible targets with limited resources.

I am also taken this month by Managers in Partnership’s work on ‘respect for managers’.  If one receives poor service in a hotel, the cry goes up: ‘I want to see the manager!’. Yet why in our industry is management so under-valued? I don’t have an answer to this, but we need to stand up for managers, who perform vital support functions in the NHS. I’ve heard at this election more than once the charge that there are too many managers. 

The King’s Fund has perhaps been the most eloquent in debunking this myth polished up for every general election. Its 2011 Future of leadership report is plain. ‘According to the Office for National Statistics, the proportion of managers in the UK workforce as a whole in June 2010 was 15.4%. These statistics also show that there were 77,000 hospital and health service managers across the UK, or 4.8% of the NHS workforce. In other words, the NHS has a managerial workforce that is one-third the size of that across the economy as a whole.’

As our president Sue Lorimer says on page 10, finance and other managers tend to take these attacks philosophically. But the issue of ‘being valued’ was raised in our staff attitudes survey last year and is an issue we take seriously.

The HFMA continues to support its communities in a range of ways. Our Healthcare Costing for Value Institute, launched in April, has started well, with close to 100 members. At its inaugural event, Professor Robert Kaplan was beamed into the QE2 Conference Centre in London. We aim to hold these value masterclasses twice a year along with a regular programme of costing development. We are in a great position to help Monitor achieve its vision for costing (which we support), as well as helping the service practically in a host of areas.

We are also holding important events across the country, from the commissioning annual conference in May to the FT conference in July. Also in July, we’ll host our first general assembly to help the HFMA shape policy and develop clear and unified views on many issues.

I regard the current era as one of opportunity for ambitious and competent people to step forward. And being an HFMA member means that you are already committed to your long-term development and, I hope, to your future ongoing success!