Public sector warned on redundancies and contract changes

I have worked in both Private and Public sectors. Both have pros and cons in terms of efficiency and staff productivity. I now work for the NHS.

We have 4 local healthcare Trusts in our county. Each has its own Chief Executive, and a tranche of directors, associate directors and managers. The largest of these Trusts wants to stay more or less independent from the others, and the smallest is so top-heavy with administrative staff that it could virtually disappear entirely with hardly any affect on patient care. Above this, is the Strategic Health Authority, who don't deal with patients at all.

Instead of having one healthcare organisation covering all healthcare needs of all patients across the county, the answer to the current financial debacle is to lay off cleaners, cooks, nurses and therapists, and freeze all recruitment. Also, spending on maintenance and new work has been reduced or stopped, so that the buildings will gradually fall into disrepair. Virtually all of this work is contracted out to private sector businesses, so the private sector will be hit as hard as the public sector.

I've only worked for the NHS for 3 years, so I can't be sure, but wasn't it less wasteful and more efficient before the creation of individual Trusts, and the requirement to tender everything (including patient care) to independent healthcare providers? If the Government wants to know where all the NHS money is going, it should look carefully at PFI schemes...

I firmly believe that a well-run, well-organised public sector organisation can be easily as efficient as a private sector company, and often with better staff morale. The trick is having good management, not lots of management.