Why does the NHS spend only 2% of its budget on admin?
Dear Editor,
Juliet Dobson asks if time is running out to resolve the NHS workforce crisis (1). In this context, Chris Hopson, Chief Strategy Officer NHS England, proudly claimed in a BBC Radio 4 Today Programme interview with Nick Robinson on 29 March 2023 that the NHS spends only 2% on administration compared to 4.2% in Germany and 8.3% in the US (2). These data are from 2016; comparing admin costs in a National Health Service with multi-payer health systems is like comparing a pear with apples (3). Robinson did not challenge Hopson on low admin costs and if this is indeed a wise use of taxpayers’ money. In a recent editorial on the death of the dictaphone the BMJ warned “we should continue to value the medical secretary as a conductor of care, even when the music changes and the tempo of technology ramps up.” (4). Most NHS consultants had their medical secretaries cut as part of “efficiency savings” and are now supported by underpaid pool administrators with some of the lowest employee retention rates. NHS doctors spend far too much of their precious time on admin tasks and typing. NHS consultants are leaving in droves to work abroad or for the private sector and, no surprise, it’s in the private sector where they find medical secretaries, medical scribes and personal assistants. I argue the NHS should spend more money on better qualified administrators supporting consultants (and other clinicians) to focus on patient-facing work and medical leadership.
Rapid Response:
Why does the NHS spend only 2% of its budget on admin?
Dear Editor,
Juliet Dobson asks if time is running out to resolve the NHS workforce crisis (1). In this context, Chris Hopson, Chief Strategy Officer NHS England, proudly claimed in a BBC Radio 4 Today Programme interview with Nick Robinson on 29 March 2023 that the NHS spends only 2% on administration compared to 4.2% in Germany and 8.3% in the US (2). These data are from 2016; comparing admin costs in a National Health Service with multi-payer health systems is like comparing a pear with apples (3). Robinson did not challenge Hopson on low admin costs and if this is indeed a wise use of taxpayers’ money. In a recent editorial on the death of the dictaphone the BMJ warned “we should continue to value the medical secretary as a conductor of care, even when the music changes and the tempo of technology ramps up.” (4). Most NHS consultants had their medical secretaries cut as part of “efficiency savings” and are now supported by underpaid pool administrators with some of the lowest employee retention rates. NHS doctors spend far too much of their precious time on admin tasks and typing. NHS consultants are leaving in droves to work abroad or for the private sector and, no surprise, it’s in the private sector where they find medical secretaries, medical scribes and personal assistants. I argue the NHS should spend more money on better qualified administrators supporting consultants (and other clinicians) to focus on patient-facing work and medical leadership.
(1) BMJ 2023; 380:p681
(2) www.bbc.co.uk/sounds/play/m001kgyz (1:55)
(3) www.americanprogress.org/article/excess-administrative-costs-burden-u-s-...
(4) BMJ 2022;377:o1192
Competing interests: No competing interests