NHS trust plans to cut consultant posts to make savingsBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7520.797-a (Published 06 October 2005) Cite this as: BMJ 2005;331:797
NHS trust plans to cut consultant posts to make savings
An NHS trust in England has announced that it will cut consultant and house officer posts next year. The cuts are part of plans to find its share of savings being demanded to make up for budget overspends by other trusts, and a survey of medical directors has warned that similar cuts may be made elsewhere.
Oxfordshire Mental Healthcare Trust has proposed that it will cut seven consultant posts by March and reduce by six or seven the number of new senior house officers recruited over the following 12 months, in addition to closing one adult ward and reducing out of hours and occupational therapy services. It is making the cutbacks after being told by Thames Valley Strategic Health Authority to cut £5.9m ($10.3m; €8.7m) from its budget to help the strategic authority make savings needed after cost overruns in other Thames Valley trusts.
The cuts represent about 10% of the trust’s operating budget, said a spokesman, David Penney. He said the trust expected to allow the posts to fall empty as consultants retire or move on but warned that redundancies could not be ruled out. The proposal has yet to be finalised, he said, as it must be open to public consultation for three months.
Many trusts have raised the prospect of recruitment freezes this year, but until now they have all targeted administrative and nursing staff.
The head of the BMA’s consultants’ committee, Paul Miller, said that cutting consultant posts was "outrageous" and unprecedented. "This is not the right way to save money," he added. "This is the first time we’ve ever heard of consultant numbers being cut because of financial constraints."
But the proposed cuts in Oxfordshire could be followed by similar reductions in other areas in the country after a year in which a quarter of local NHS trusts reported deficits, said Dr Miller. "We have just completed a survey of more than 120 medical directors across the country, and we found deficits were extremely common, running up to £25m," he said. "The average was £6m."
"Many said they are probably facing the prospect of cutting consultant posts, and some are even talking about redundancies. The problem is not confined to mental health—there are many acute trusts facing severe deficits," said Dr Miller.
Mr Penney said mental health services were an easy target for health authorities looking to save money. He said that Oxfordshire Mental Healthcare Trust had balanced its budget for five years running and achieved below average costs for services, according to national league tables, but was being asked to cover overspending by primary care trusts. "We need more investment, not less," he said.
A spokeswoman for the Department of Health said the government discourages any cuts in consultant numbers. "We believe trusts can manage deficits in ways that don’t impact on patient care. We have provided guidance on alternative ways to cut spending, such as spending less on agency staff."
The total deficit across the Thames Valley authority area is now running at about £25m, but a spokeswoman said the authority hopes to be close to breaking even by the year’s end. "Plans are being made which explore options for doing this, but these have not yet been finalised," she said.
The health department said that the number of consultants is higher than ever and that most NHS organisations’ books are in surplus or balance. "The final audited accounts for 2004-5 show a net deficit for the NHS as a whole of around £250m. Whilst this overspend is a tiny proportion—0.4%—of the total NHS budget of £69.7bn, we are taking it very seriously and will ensure that all NHS organisations manage their finances well."
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