The cost of managing our health

This briefing paper has been lying around the doldrums of the Northern Ireland Assembly website for a couple of weeks now ever since it was submitted to the Health Committee. The BBC did dip into it on November 4, but in the interest of transparency, I feel the figures should be laid in full for people to properly grasp the true extent of what managing our health system costs.

The paper reveals the cost of managing the health system here and the salaries paid to directors in each of the five Health and Social Care (HSC) Trusts, but more on that later.

First off the whole point behind the Review of Public Administration (RPA) and merging of the 18 legacy health trusts into five new HSC Trusts was to cut overall management and administration costs of the health service here. The total management costs of the legacy trusts in 2006/07 was £113m. After the first year of the five ‘new’ HSC Trusts along with the Northern Ireland Ambulance Service (NIAS) an apparent £5.6m was saved with an £107.5m management spend.

However by 2008/09 the total management spend was back in excess of the 06/07 level to £120m. In response, the Department of Health gave the Northern Ireland Audit Office this spiel:

“When the 2006-07 management costs are rebased to 2008-09 levels factoring in inflation, Agenda for Change contracted progression and a change in employer’s superannuation rate, there is a real terms savings on management costs of almost £6.7m.”

Wouldn’t be like a health service press office to bury facts amongst almost impenetrable jargon.

Anyway here are the salaries in all their glory:

Belfast Health and Social Care Trust:

Executive Directors

Chief Executive – Mr William McKee (£145,000- £150,000)

Director of Social Services, Family & Child Care – Ms Bernie McNally (£75,000 – £80,000)

Medical Director – Dr Tony Stevens (£190,000-£195,000)

Director of Finance – Mrs Wendy Galbraith10 (£105,000-£110,000)

Director of Nursing, Older People, Medicine & Surgery – Ms Valerie Jackson (£50,000-£55,000).

In October 2009 Ms Jackson was seconded to Northern Trust and Ms Nikki Patterson ( £40,000- £45,000) became Acting Director of Nursing and Mr Brian Barry (£30,000 – £35,000) became Acting Director of Older People, Medicine and Surgery. NB – This means there are now two people doing a job previously occupied by one

Directors

Chief Operating Officer & Deputy Chief Executive – Mr Hugh McCaughey (left the Trust in May 2009) – (£15,000-£20,000)

Director of Mental Health & Learning Disability Services – Mr Brendan Mullen (retired in September 2009) (£40,000-£45,000)

Director of Clinical Services – Dr Patricia Donnelly (£95,000 – £100,000)

Director of Specialist Services – Mrs Jennifer Welsh (£75,000- £80,000)

Director of Head & Skeletal Services – Miss Patricia O‟Callaghan (retired in July 2009) (£20,000-£25,000)

Director of Human Resources – Mrs Marie Mallon (£95,000 – £100,000)

Director of Planning & Redevelopment – Ms Denise Stockman ( £80,000- £85,000)

Director of Performance & Delivery – Mrs Catherine McNicholl (from September 2009) (£5,000- £10,000)

Director of Nursing & User Experience – Ms Brenda Creaney (appointed January 2010) (£55,000-£60,000)

Non-Executive Directors

Chairman – Mr Pat McCartan (£30-35,000).

Remuneration range of remaining Non-Executive Directors is £5,000-£10,000: Ms Joy Allen, Mr Les Drew, Professor Eileen Evason, Dr Val McGarrell, Councillor Tom Hartley, Mr Charles Jenkins, and Mr James O‟Kane.

SOUTH EASTERN HEALTH AND SOCIAL CARE TRUST

Executive Members

Chief Executive (resigned April 2009) – J Compton (£140,000 – £145,000)

Acting Chief Executive (as of April 2009) – S McGoran (£90,000 – £95,000)

Director of Adult Services – D Bannon (£60,000 – £65,000)

Medical Director (Consultant, Emergency Dept. Ulster Hospital) – C. Martyn (includes clinical duties) (£170,000 – £175,000)

Director of Primary Care, Elderly & Executive Director of Nursing – C McArdle (£70,000 – £75,000)

Director of Human Resources & Corporate Affairs – E Molloy (£90,000 – £95,000)

Director of Planning, Information & Performance Management – J Simpson (£90,000 – £95,000)

Director of Children’s Services & Executive Director of Social Work – K Thompson (£85,000 – £90,000)

Director of Finance & Estates – Neil Guckian (salary not stated in Annual Report)

Director of Hospital Services – Seamus McGoran (£90,000-£95,000)

Non Executive Members

Remuneration range £5,000-15,000: D. Fitzsimons, C. McKenna, P. Davison, D. Flanagan, F. Graham, D. Mann-Kler, N. Mansley, D. O‟Hara, and J. Trethowan.

SOUTHERN HEALTH AND SOCIAL CARE TRUST

Executive Members

Acting Chief Executive – Mrs Mairead McAlinden (since 01 September 2009) (£80,000 – £85,000)

Chief Executive – Mr C. Donaghy (Until 31 August 2009 when Mr Donaghy took up the post of Interim Chief Executive in the Northern Trust) (£115,000 – £120,000)

Director Children & Young People’s Services and Executive Director of Social Work– Mr B. Dornan (£90,000 – £95,000)

Director Finance & Procurement – Mr M. Dillon (£80,000 – £85,000) (until 30 August 2009 when Mr Dillon took up the post of Interim Director of Finance in the Northern Trust.)

Acting Director of Finance – Mr Stephen McNally (since 01 September 2009) (salary not stated in Annual Report)

Director Mental Health & Disability (also the Executive Director of Nursing) – Mr F. Rice (£90,000 – £95,000)

Medical Director – Dr P. Loughran (£185,000 – £190,000)

Directors

Acting Director of Performance and Reform – Mrs Paula Clarke (since 01 September 2009) (salary not stated in Annual Report)

Director of Human Resources and Organisational Development – Mr Kieran Donaghy (£75,000 – £80,000)

Interim Director of Acute Services – Dr Gillian Rankin (from 01 December 2009) (£85,000 – £90,000)

Acting Director of Older People and Primary Care Services – Mrs Angela McVeigh, (from 01 December 2009 when Dr Rankin took up the post of Interim Director of Acute Services) (salary not stated in Annual Report)

Non-Executive Members

Chair – Mrs A. Balmer (£25,000-£35,000)

Remuneration range of remaining Non-Executive Directors: £5,000-£10,000: Mrs D. Blakely, Mrs R. Brownlee, Mr E. Graham, Mr A. Joynes; Mrs H. Kelly, Mrs E. Mahood, and Dr R. Mullan.

NORTHERN HEALTH AND SOCIAL CARE TRUST

Executive Members

Interim Chief Executive – Sean Donaghy (£75,000 – £80,000- from Sept 2009)

Director Medical and Governance – P. Flanagan (£140,000 – £145,000)

Interim Director of Finance – B. Scott (£70,000 – £75,000)

(Acting) Finance Director – Marjorie Crilly (salary not stated in Annual Report)

Director of Planning Performance Management and Support Services – M. Sloan (£85,000 – £90,000)

Director of Mental Health and Disability Services – O. Donnelly (£65,000 – £70,000)

N. Guckian – (£35,000 – £40,000- left Sept 2009)

Director of Human Resources – J. Melaugh (£70,000 – £75,000)

Acting Director (from 16 February – 3 May 2009) – M. Roulston (£5,000 – £10,000)

(Acting) Director of Primary Care and Community Care for Older People’s Services and Executive Director of Nursing – Una Cunning (salary not stated in Annual Report) NB – How does this job title even fit on her door!

Interim Director of Acute Hospital Services – Valerie Jackson (£35,000- £40,000)

Director of Children’s Services (also Executive Director of Social Work) from May 2009, Cecil Worthington (£75,000-£80,000)

Non-Executive Members

Chair – J. Stewart (£25,000 – £30,000)

Remuneration range of remaining Non-Executive Directors: £5,000-£10,000: C. Ackah, R. McCann, S. Forsythe, P. Montgomery, J. Moore, M. Rankin, and D. Whittington.

WESTERN HEALTH AND SOCIAL CARE TRUST

Executive Members

Chief Executive – Mrs E. Way (£115,000 – £120,000)

Director of Women and Children’s Services – Mr J. Doherty (£90,000 – £95,000)

Director of Finance and Contracting – Mrs L. Mitchell (£80,000 – £85,000)

Director of Acute Services (from 18/11/08 to 17/05/09) – Mr A. Corry Finn (£80,000 – £85,000)

Director of Primary Care and Older Peoples Services – Geraldine Hillick ?

Medical Director – Dr A. Kilgallen (£100,000 – £105,000)

Directors

Deputy Chief Executive/Director of Planning and Performance Management to 17/05/09 / Director of Acute Services (from 18/05/09 to 30/10/09) – Mr J. Lusby (£95,000 – £100,000)

Director of Human Resources – Mrs N. Sheerin (£75,000 – £80,000)

Director of Adult Mental Health and Disability Services – Mr T. Millar (£60,000 – £65,000)

Director of Acute Hospitals (Seconded by HSC Board from 01/11/09 to 30/04/10), Mr M. Dickson

Director of Planning and Performance Management (Acting – from 18/05/09) – Mrs S. Groogan (£60,000 – £65,000)

Director of Strategic Capital Development (Commenced from 18/05/09) – Mr A. Moore (£60,000 – £65,000)

Director of Primary Care and Older People (Acting – From 04/12/08 to 17/05/09) – Mrs G. Hillick

Mrs M. Kelly (Mrs Kelly had been on secondment to the Western Health and Social Care Board from 17/11/2008. She applied for voluntary early retirement with effect from 16/12/2009 and was accepted with employer support).

Non-Executive Directors

Chairman – Mr G. Guckian (£25,000 – £30,000)

Remuneration range of remaining Non-Executive Directors: £5,000-£10,000: Mrs J. Doherty, Mrs S. Cummings, Mrs S. O‟Kane, Mr C. Mulgrew, Mr B. McCarthy, Mr N. Birthistle and Mrs B. Stuart.

CONCLUSIONS

  • Out of the five Medical Directors across each HSC Trust, only C. Martyn in the South Eastern HSC Trust is listed as having a clinical role.

John Crompton (Chief of the HSC Board) has previously quoted a figure of 4.1% of total income for the amount spent by the five HSC Trusts on management costs. He said:

“Spending 4p in every pound to manage and administer £4 billion worth of expenditure is not unreasonable. We may debate how it was spent, but it is not unreasonable to spend that amount of money.”

However in concluding, the report submitted to the Assembly Health Committee states the spend is not so clear-cut:

The information provided by the Trusts would lead to the conclusion that, aside from posts that are clearly assigned as corporate management or management of a group of professional staff, it is not an easy matter to disaggregate the management components of other jobs paid on AfC Bands 8 and 9. The Committee may wish to investigate further how the management costs within the annual accounts are calculated and do they take into account the management components of jobs which also have a professional or clinical remit?

There are a lot of figures above to digest and I invite anyone who wishes to glean over them to submit their own analysis.

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About AldousDuke
Mid Tyrone journalist, not so freelance any more.

2 Responses to The cost of managing our health

  1. Alan Law says:

    I liked the Una Cunning title…it made me smile on a number of levels…

  2. Alan Law says:

    It remains unexplained why Medical Directors retain their consultant’s salary even though they have ceased to have, in most cases, any clinical responsibilities.

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