(Voodoo) voting intentions of GPs and NHS managers
There were two purported polls of medical professionals this week. A survey by Pulse, a magazine for GPs, surveyed 326 GPs on their voting intentions and found support standing at CON 52%, LAB 8%, LDEM 22%.
Meanwhile a survey of NHS managers by the Health Service Journal found voting intentions at CON 29%, LAB 50%, LDEM 16%.
I can’t actually vouch for either of them. The latter one smells a bit voodoo-ish – it seems to have been a survey of visitors to the HSJ site, and I’ve no idea if measures were taken to ensure respondents actually were NHS managers, and even if they were, how representative of NHS managers they would have been. Equally, I don’t know how those 326 GPs in the first poll were selected or how representative they were.
Even if we take it as “just a bit of fun” though, the contrast between NHS managers and GPs is stark to say the least!
UPDATE: A comment from a contributor below suggests both polls were just done as open access polls on the respective websites, with no obvious attempt at doing any weighting or controls to get an accurate sample. With that in mind, fun though the contrast is, they probably don’t tell us anything at all about NHS managers or GPs.
What does “NHS managers” actually mean?
Buggered if I know how they define it. My assumption would be non-medical NHS staff at a managerial level.
Simply an observation – not partisan!
Both these polls presumably refer only to the English NHS.
However, last night I spent some time chatting to a nice Irish lady from Ipsos-Mori who had been commissioned by the Department for Health to seek views on their reaction to swine flu. I wondered why she was asking a Scot.
Shirley Williams was on the radio today wishing that MP’s got the same basic salary as GP’s. Considering the manager of my local hospital gets £170 000 a year and probably earns less than some GP’s here that tells you just how much doctors earn.
WOLF: Your comment is a load of rubbish. Where are your facts? How an MP deserves as much as a 5 yr (minimum) trained prof. doctor is way beyond me.
GPs voting against a government that has changed the goal posts and failed to take their intended policy to the full doesn’t surprise me!
The NHS needs more private sector influence and GPs know this. (and I’m not a Tory voter or GP btw).
As a Conservative I am rather happy with the contrast in these two polls and am tempted to say that they hardly surprise me.
But of course you couldn’t wish for a more glaring contrast had Cameron, Hague and Lansley & Co had been allowed to conduct the poll themselves!
Still, they weren’t and I am sure that I and many other campaign managers will be making good use of these results
The breakdown of the public sector voting intention is very interesting (even amazing). It looks as though NHS managers feel grateful to labour, but GPs do not.
I wonder what the split is between all frontline, GPs, nurses, fire men and women, teachers and the administrators, quango heads on the other. I suspect it would have very similar results
Seems that the kind of people who fill in surveys on HSJ (ie NHS Beaurocrats who have time on their hands) are worried that the Tories will cut their jobs. I hope they do, there are far too many useless NHS managers. Meanwhile the people who actually deliver patient care understand what a disaster Labour has been.
Anthony
Your provision of an alternative thread didn’t work!
GPs will vote in favour of a Tory govt in general as they will then get their hands on the cash and convert it into profit not care.
I wont generalise as not all GPs would do this – my local practice is excellent, caring and progressive. I have been registered with GPs ( more than one!) who refused bllod tests when required as the cost too much.
NHS Managers could be a CEO, a ward sister or a Modern Matron. All of whom have worked amazingly to get waiting times for cancer treatment to two weeks, and others 18 weeks. These are not fat cats but professional and inspiring leaders who keep you, your mother, father and offspring fit and healthy 360 days a year. NHS Staff other than those that can personally gain from puse string control (GPs) would be mad to vote Tory and so would anyone else. Otherwise by Christmas 2010 your Gran will wait two or more years in agony awaiting her new hip Then all you’ll do is moan about it……….
I seriously can’t imagine that a reduction in the numbers, pay or conditions of NHS managers is going to lead to 2 year waits for new hips. More likely the opposite….
After a lifetime in private industry and working for myself, I joined the NHS to see out my last few working years and get a bit of a pension after Gordon Brown stole most of the value from my private ones. Sorry if that sounds partisan, but its true.
I work as an analyst at a very junior ‘managerial’ level – i.e. one person works for me. The survey results are pretty much in line with what I would expect. I come in contact with a lot of GPs, and also fellow admin/bureaucratic staff like myself.
GPs are of course small businessmen. It is just that for most of them their main contract is with the NHS. As such, you would expect them to have the same sort of approach as most businessmen – i.e. dislike of government interference. This is certainly true of those I come in contact with. Rightly or wrongly, the perception is that Labour tend to try to micromanage everything, while the Tories are more hands-off.
The NHS staff however have mostly worked all their lives in either the NHS or have transferred from some other public sector job such as the council or the Post Office. I have found that they have very little understanding of the real world, and very little concept of trying to get value for money from the services they provide, because there always seems to be more money available. Therefore they see the impending Tory government as a threat because again rightly or wrongly they are perceived to be likely to clamp down on spending on the bureaucracy of the NHS.
So whether the polls are scientific or not (and probably they are not), they do seem to be in line with my experience at least. I have noticed a rise in anti-Labour feeling amongst my colleagues recently though. I wonder if there have been polls like this before, so we could see any trends?
Pete B
“Rightly or wrongly, the perception is that Labour tend to try to micromanage everything, while the Tories are more hands-off.”
I got told off by Peter Cairns for posting some stuff because “this is a UK site”. It is, but I’m going to risk his wrath because it isn’t just an English site.
You may want to look at what is happening in Scotland where the current Government has a policy of not “micromanaging everything”, but has increased the proportion of funding to be spent by NHS and LAs while removing the targets (unless agreed by central government and the spending agencies), and also removing the bureaucratic (and expensive) need to report back on that spend.
Audit Scotland has been requiring public agencies to drive down bureaucratic spend by combining back-office services that the Tories disaggregated last time they had any power here.
The HSJ one which I took part in was sent to anyone that subscribes to HSJ which will include General managers, but also Medics Nurses, therapists and Scientists.
GP one I do not know but even as a bit of fun it feels close to reality as GP’s have traditionally been against whoever is seen to be bossing them around from Whitehall and that has been Labour for the past 12 years.
I was also interested this week in the Commonwealth Institute survey of GP’s in several countries. http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2009/Nov/A-Survey-of-Primary-Care-Physicians.aspx
One question was asking GP’s re their views of their Health system and 50% of UK GP’s said Fundamental Changes are needed, which in isolation looks high, but of the 11 countries in the survey that is the lowest figure with the exception of Norway and Netherlands. i.e. GP’s everywhere do not like the system they work in.
To the option “System needs to be completely re-built” all countries responded with numbers less than 7% (UK was 3%), with the exception of Germany at 31% and the US at 15%. The German GPs are obviously upset about something.
The commonwealth fund Survey has some useful info but of course politicians will take individual items out of context.
Neil A – you seem to have missed the point, my comments werent about pay and conditions they were about investment in people, in oure numbers terms. In 1994 the Tories slashed student nurse numbers by 1/3 and this then lead to us recruiting overseas massively in 2000 onwards. Thus if you have a desire to comment please make it from an experiential, evidence based position.
Pete B – you are right in part, howver the NHS does work on a much better value fo rmoney basis. However there is a true cost to delivering NHS care, if you cut it too deeply eithe rby reducing pay per person you wont attract suitable candiates (nursing is now a complex role). If you cut it so that you reduce headcount of staff then someones mother wil lie in bed soaked in urine because there simply isn’t time to get to them. Yes I am biased but nearly every NHS employee will give above and beyond, so lets please see continued investment in sensibe pay and sensible staffing levels.
Wht we all agree on is removing Price Waterhouse Cooper types (and their costs) as they dont know what they are looking at and ask staff on the ground to advise how to make improvements,
@C,
Please point to where I mentioned “nurses” in my (very short) post. My point is that money spent on managers, who never carry out a single operation, is money that can’t be spent on other things.
Anthony:
The readership of the Journal embraces the highest paid of the people whose job titles proclaim that they are “managers” and the aspiring trainee in a paramedical or service department at the lowest level of management above the purely supervisory, together with hospital medical staff.
Readership, sales and advertising income are closely related by the job adverts pages.
@C
I agree with Neil A. Indeed, my earlier post was specific about cutting down on bureaucracy (therefore by implication, not nurses). There is a vast amount of overlap between departments in the bureaucracy, together with politicking and empire-building. Most of these people think they are doing the best job they can, they have just never been exposed to the disciplines of the real world. For instance, it’s virtually impossible to lose your job apart from for gross misconduct. In the rare cases where a department cuts back on head-count in my experience another post is found elsewhere for the people cut.
Where I work, two PCTs recently merged, and I naively thought that there would be some rationalisation. It is true that one or two directors went, but were soon replaced by others. For instance, the duplicate Finance Director moved on, but we now have things like a ‘Community Outreach Director’, an ‘Associate Information Director’ etc etc. I know of no-one lower down who lost their jobs.
To get back to the poll, these people are not completely stupid, and realise that the Tories may well crack down on waste and duplication. Hence they tend to support Labour.
OldNat
You and I are going to get banned for repetition.
It’s a pity that the data is dodgy for this issue is the one more than any other that I really want to see good E&W v Scottish data for.
I got really excited by the headline, because I thought I might see a difference between the two NHS systems that would have the highest relevance for gleaning information about the SNP’s prospects.
There are two SNP ministers who are making an impact. One of these is the Rural Affairs minister whose work I, like most of the Scottish population, know little about because the press ignore him.
What he does happens to be important for the constituencies which the SNP holds or have hopes or winning.
Most Glasgow or Edinburgh voters do not know who Richard Lochhead is or what he does. Few have even the slightest interest in fishing quotas, raptors or pig welfare. I’m not very sure what a raptor is.
The other SNP minister who is delivering votes to the SNP by the bucketload in Nicola Sturgeon.
I spent 17 years as the Treasurer of one of the smallest health boards. No health minister in either system has made a more positive impact on staff.
The NHS is a huge employer. Its staff are in every constituency. Many of them have careers which have only marginal opportunities for employment in another industry. All of them have friends and family to whom they complain about work problems.
Any fool can manage the NHS because there is so much committment to the plainly obvious aims of the organisation and to professional standards and the respect of colleagues, that good people will overcome bad systems, even at some cost to themselves.
It’s more sermon on the mount than jobsworth. People care, and not just people in white coats, wages clerks too.
It’s common on these pages to classify people as “parents” “home owners” “public sector employees” and to imagine that they will vote according to these classifications according to whether the government of the day has effective policies which benefit these groups. All of us are capable of being classified in many ways, but one’s employment is a big part of one’s life.
It isn’t simply a matter of pay or benefits or job security.
Many people are turned off politics. That is less likely if your employer is controlled by doctrinaire politicians with flavour-of-the-month instant managerial solutions, reorganisations and “reform” every three or four years, and if you are at the coalface and see that these things don’t work and waste money which would be better spent in other ways.
It wasn’t always so, but nobody now at work will remember the Butskillite consensus of sensible pragmatic management by the likes of the widely admired Enoch Powell.
Imagine then how you would feel when, after decades of being messed about you get a health minister who says:
“Its wrong. We’re not doing it.” [Privatised cleaning]
It’s the way she says it too. You just know that she means it. It isn’t the Westminster formula “We have no plans to .. .. [slaughter the firstborn or whatever]. That too often means the plan isn’t ready or agreed – yet.
If I was in charge of the SNP’s election campaigns I would think it worth paying for a reliable poll that shows what these polls might have done.
If ever there was a need for separate Scottish Data, this is it.
NHS managers voting Lib Dem is like turkeys voting for Christmas!
Let’s not forget who created all these unnecessary, expensive managerial posts by creating a ridiculous market system in the NHS – Margaret Thatcher!
Get rid of the “market” and pointless targets, dispose of the accountants and statisticians needed to monitor them and give control back to medical staff. This is actually Lib Dem policy; how strange that the Conservatives also now realise the stupidity of what they created.
Not surprising that many doctors support the Conservatives; they are high earners and know which side their bread is buttered.
OldNat and John B Dick. It seems the English could learn a lot from the Scots on this one.
Tony Fisher. When will Labour take some responsibility and stop blaming Lady Thatcher for everything? I have checked the NHS employment details: Non-clinical managers and senior managers were 22000 in 1997, and 39000 in 2005. Nearly doubled in less than 10 years!
I should explain that the terms “managers” and “management costs” as used in the NHS are without meaning.
“When I use a word,” Humpty Dumpty said, “it means exactly what I want it to mean!”
It was my responsibility to draw to the attention of a Health Board the predicted effect of any proposed development or other change on their “Management Costs”, as measured by a formula and presented in the Annual Accounts. The Board had one of the highest costs as measured by the formula.
In reporting the fact, I explained why the effect would be so and mentioned some of the more bizarre anomalies and the fact that no accountant had had any part in the design of the formula.
One member said that I shouldn’t ever again mention “Management Costs” and though that was not voted on or minuted, I took it to be the view of the Board, and never did.
“Managers” are probably sometimes almost all the people who don’t wear uniforms or white coats and didn’t earlier in their careers including some who are clerical workers. At other times it will mean those in positions of some responsibility for other staff.
That doesn’t mean they necessarily do much management as I understand it, but then I’m an old nit picker with a Diploma in Management.
If you think that the polls referred to above are unreliable, then you’d better not take at face value NHS costs, unaudited targets, waiting lists. PRP and the like.
If I was looking for information for management purposes, I would avoid all that stuff in case I forgot where the “facts” came from and relied on it by mistake.
I worked with one Board Chairman who, while recovering from influenza, spent his time analysing performance data and came into the office with dozens of questions. Our performance on nearly everything was either remarkably good, or remarkably bad.
He did an excellent job, because the Chief Officers whom he asked for explanations couldn’t think of anything he’d missed.
We answered his questions. He never looked at the data again.
“Tony Fisher. When will Labour take some responsibility and stop blaming Lady Thatcher for everything? I have checked the NHS employment details: Non-clinical managers and senior managers were 22000 in 1997, and 39000 in 2005. Nearly doubled in less than 10 years!”
Pete B
I’m not saying that Labour hasn’t made things a lot worse. I’m not a Labour supporter – I’m an alienated Conservative!
Pete B
For 17 years I ran the finance department of a small Health Board serving a declining population initially of 30.000. There were five hospitals, GP’s Dentists etc.
We also dealt with some staff records and data.
A couple of years after I had left, I was told that I had been replaced by “half a dozen” people.
I still don’t know if that was literally true.
If you are Old Labour looking at the what Nicola Sturgeon is doing in the Scottish NHS, you might think it very Left, Socialist even.
That would be a mistaken analysis. She’s only chipping away at the margins of the things that don’t work. Not doing things, rather than doing them.
The NHS is, and can only ever be, a near monopoly, and it also has no choice but to provide a service to whatever kind of patient needs treatment.
A management philosophy of Left or Right is less relevant than the fact that these constraints are inescapable.
Pragmatism is the SNP’s USP because they cannot afford to lose pro-indpendance voters whether from the left or right.
They have now brought wholly into the NHS an privatised facility whch had no other customer. The Health Secretary said that they would save the profit element, but that’s only the half of it. There are many costs that will be saved also.
The response from the CBI was a predictable recitation of the free market Credo. It was of no practical relevance simply because there is no market.
Fundamentalists, religious, political or some other thing are the source of nearly all the worlds problems.
Any benefits of competition from the internal market in the NHS are debatable, possibly intangible and ephemeral. The cost in so-called “managers” and computer systems is clear and real. External economies of scale can be bought into by real managers without government direction or any political rationale.
The NHS which we have does not have the costs that insurance based systems do. Every paperclip and office building the insurance companies have is paid for by someone. So too is the fraud by doctors, patients and insurance companies.
The Scottish NHS, because of the success of the response to the 19thC Cholera epidemics, still has significantly higher funding than in England. The level of funding is comparable to Continental countries who have the additional costs of insurance systems.
The morbidity justification that is used to defend the difference is irrational, and not the reason it is there. Nobody can calculate the extra cost of serving sparse populations.
The Scottish NHS has enough money to provide an excellent service and can be better managed to produce savings. The focus should not be a hate campaigh against “Managers” but freeing them and motivating them to cut out useless processes while staff are reduced by natural wastage according to progress and not pre-selected targets
What will the incoming government do to remove this excess subsidy? Change the funding formula?
(Here’s a clue: there is an SNP government in charge of the Scottish NHS. Their main objective is to persuade Scots that independence is a good thing.)
Anthony
From political betting, a poster saying “S[ystem]3 for the Herald tomorrow has the Nats with a big lead for Holyrood 40-32 constituency and 37-29 list but Lab with a big lead for Westminster 39-25.”
Any more info?
For info, I saw both of these polls when they were being taken, and they were equally voodoo-ish – in each case, the magazine’s website advertised a voting intention poll and encouraged their readers to vote. In neither case was there any attempt to obtain a balanced panel, or any control over the number of voters. Both were compiled over several weeks, and were promoted through regular email bulletins to subscribers. Both results reflect both the magazines’ respective general editorial line, and what I would expect the broad political views of their readership to be – but I wouldn’t take either at all seriously.
Should also add: the Pulse survey is not a survey of GPs; it is a survey of readers of Pulse, which is a magazine aimed primarily at GPs. The HSJ survey is not a survey of NHS managers; it is a survey of people who read the HSJ, which is a magazine aimed primarily at NHS managers and people interested in health/NHS policy.
This might seem a pedantic point, but it does mean that is almost certainly false to say, for example, that Pulse surveyed 326 GPs on their voting intentions.
Thanks Tommy, post now updated.
I suggested above that it the SNP’s NHS changes would be welcomed by Socialists..
Pete B says that GPs, as small businessmen, are predominately sympathetic to the Conservatives. I do not doubt it, though I have met many exceptions.
Superficially, one of these observations must be inconsistent with an observed fact.
The last (UK) BMA conference was in Edinburgh and addressed by Nicola Sturgeon, the SNP’s Health Secretary and Deputy Leader. She got several standing ovations (four I think).
Now there were probably more than usual proportion of Scottish members present, and the BMA is much more than GP’s, but I think that this shows that it is unhelpul to assume that any political credo is driving these common sense changes.
Rather it demonstrates that you can get to be Scottish Politcian of the Year, and hugely popular, just by undoing impractical daft ideas which have originated in political philosophies in ignorance of practical issues in the real world.
You don’t need to do anything clever, such is the competition.
@PeteB – having managed a PCT reconfiguration I know of many people who lost their jobs. Yes some new posts have been created and I am not sure of the value they add.
@NeilA – I guess your experience if the NHS must be limited. The issue at hand is that many managers are termed as such yet hold a clinical responsibility and are accountable for the effective dleivery of care. Thus its not a reasonable assumption that all managers have no patient impact as appears to be your assertion.
Lets be honest here, no private sector solution is suitable for the NHS, good bargaining power and efficient use of resources are what we must achieve. However RBS and Lloyds TSB are private and see what they’ve done for us. Thus capitalists keep out of the NHS as you will rue the day you let your chummies interfere and all you will be left with is a system for those who can pay – and lets be honest very few of us (you) would agree to paying for your mothers ten week hospital stay after a stoke…..
I am old enough to remember being ill before the NHS.
I was sweating, in pain, had a fever and was passing in and out of consiousness. My parents sat up all night with me and they were certainly very worried.
The discussed whether they should call the doctor. I thoght they should, but they did not do so. I do not know why.
To-day anyone would say that you were a bad parent if you did not call for help for a child in these circumstances.
There are many reasons why they may not have wished to call the doctor at night.
Had they paid the last bill?
Could they not afford to pay the next bill?
Had the doctor not rendered a bill for the last treatment because he thought my parents could not afford to pay it?
Was the doctor single handed?
Was he himself ill, or very old?
Couldn’t they be bothered going out to the public telephone?
I have seen good hospitals and bad ones, in the UK and other countries. I have been part of the management team that in 1974 was responsible for what was then officially recognised as the worst hospital in Scotland.
Last month my wife was taken in as an emergency in the middle of the night to the hospital staffed by the successors in the same GP practice that was not called to see me when I was a child.
I tried to think of any aspect of her treatment or the service provided by ambulance or hospital that was less than perfect and capable of being improved.
There was only one. The wooden front door of the hospital has seen some service. Often not fully opened because of the wind, it has been knocked about possibly for as much as a century by people passing through with walking aids, wheelchairs and stretchers. It could be replaced by one designed for a higher performance level.
Should I complain to my MSP? The last time I emailed him with a comment about the NHS he FWD’d it to the minister and other colleagues.