Statistics from the NHS Confederation (2007) reports a colossal number of employees and patients in the NHS. Managers and senior managers account for 2.8 per cent of the almost 1.3 million staff employed by the NHS. 27 per cent of NHS chief executives come from a clinical background and 50.2 per cent of NHS managers have a clinical background. The NHS deals with over 1 million patients every 36 hours.
There are many hospitals and infirmaries under the NHS management. From the Leighton Hospital and Victoria Infirmary, we can see the typical organisation chart of a hospital in the NHS. Figure 1.1 below is adapted from Mid Cheshire Hospitals NHS Trust (2007).
Figure 1.1 Organisation chart of Leighton Hospital and Victoria Infirmary
In the following sections, we are going to discuss the possible problems in management and organisation, what had caused them, and what would happen if the organisation had taken a different strategy.
1.2 Problems in NHS and Possible Causes
The NHS is set in an environment with ever-changing policies and crisis. The Department of Health (2007) is responsible for frequently changing and implementing policies affecting the NHS. The National Statistics (2006a, 2006b) reports of an ageing population caused by pandemic diseases and lower birth rates; hence the public is pressurising the NHS to improve these numbers. These problems are forcing the NHS to change to cope with the environment.
In Figure 1.1, we have seen the typical organisation chart of a single division of the NHS. The one we have seen is just the tip of the iceberg. According to NHS Confederation (2006), there are 152 primary care trusts and each overseeing many hospitals. With such a huge number of employees, the NHS inevitably created a tall scalar chain in the organisation. The organisation is also split into many divisions managed by the primary care trusts.
Tall scalar chains in the organisation were reported (Management,
Bibliography: ‘Indian Railways: preparing for another sunrise ' 2001, The Hindu, 30 August. Retrieved May 20, 2007, from http://www.thehindujobs.com/thehindu/2001/08/30/stories/0630089e.htm ‘Issues ' 2005, WAL-MART WATCH ‘Marxism at work: Can We Manage Without Managers? ' 2006, Worker 's Liberty, 9 May. Retrieved May 10, 2007, from http://www.workersliberty.org/node/6203 Mid Cheshire Hospital NHS Trust 2007, The Trust Organisation Chart National Statistics 2006a, Population Estimate, Retrieved April 23, 2007 from http://www.statistics.gov.uk/CCI/nugget.asp?ID=6 National Statistics 2006b, Death Registrations, Retrieved April 23, 2007 from http://www.statistics.gov.uk/cci/nugget.asp?ID=952 NHS Confederation 2006, About Primary Care Trust. Retrieved April 23, 2007 from http://www.nhsconfed.org/primary-care-trusts/primary-care-tr-1762.cfm NHS Confederation 2007, Key Statistics on the NHS ‘NI doctors considers NHS resignation ' 2001, BBC News, 27 April. Retrieved May 20, 2007 from http://news.bbc.co.uk/1/hi/northern_ireland/1299901.stm Petra, J, Veltmeyer, H 2002, ‘Worker self-management in historical perspective ', Rebellion, 25 September ‘The Real Facts About Wal-Mart ' 2005, Wake-Up Wal-Mart, Retrieved May 20, 2007, from http://www.wakeupwalmart.com/facts/ ‘The Rediff Interview/ Ashok Bhantnagar, former Railway Board Chairman ' 2003, Rediff.com, 03 July Trigona, M 2006, ‘Zanon: Worker Managed Production, Community and Dignity ', Toward Freedom, 13 July. Retrieved May 10, 2007, from http://www.towardfreedom.com/home/content/view/855/0/