'Jobs can be at risk'

'Jobs can be at risk'

Sharon Alcock BBC Radio Five Live Health Correspondent

Finance directors in the NHS have told BBC Radio Five Live they are being put under too much pressure to achieve the government's waiting list targets.

They claim attempts to raise concerns that the government¿s aims are unrealistic are often quashed.

The comments come as the Audit Commission reported spot checks of more than half of 41 NHS trusts had "made mistakes" with their waiting list figures.

Finance managers from seven trusts told of their concerns that there's now unbearable pressure on them to meet targets as well as balancing the books.

There might be a risk of being held to account for the comments I have made and possibly risk of threatening their employment

Finance director, anonymous

Steve Simmons, who was a finance director and chief executive at several trusts in the South West, and who left of his own accord last year, now acts as a 'trouble-shooting' consultant.

He spoke to the BBC after colleagues in the NHS urged him to represent them. He called for a more honest debate.

"All politicians like to encourage the public to believe they have the magic wand which will put all things right - it's not quite that easy.

"My colleagues are all very grateful for the extra money that's been put into the system.

"Everyone realises this is a high profile, high stakes situation.

"And having to say to your boss - who has to say to his boss - that despite the extra funds, you're struggling to achieve what you're supposed to, is very difficult.

"And in some situations it puts your job at risk. Most people are inhibited about talking openly about the pressures they're experiencing."

Under the spotlight

The finance directors say a true picture of the state of the NHS is being kept from members of the public, and that politicians are deceiving patients about what can realistically be achieved.

They all support the government's plans for the health service - but accuse ministers of using heavy-handed tactics to achieve them.

One manager, who spoke anonymously, has worked in several NHS trusts in the South of England.

One was placed under close scrutiny after a damaging report from the Commission for Health Improvement.

He said staff found being under the spotlight was very difficult.

"It can be very demoralising on all the staff, I think inevitably the board feel it very hard and are very focussed on the particular issues which are causing the spotlight to be concentrated on you.

"That filters down, and there's a danger it can pull the whole organisation down.

"Clearly, waiting lists were key problems in many areas, but hospital management should be about much more than managing waiting lists.

"If those particular targets are not met, then your star ratings are affected - and it becomes clear that people's jobs are on the line.

"You just see people disappear overnight - it seems to be as quick as that."

He added: "The frustration is that these are often people who've got many year¿s experience in the NHS.

"And because of one or two problems that arise when they are in that job - they lose that job. That's very sad for the NHS."

Public perception

Another finance director, with more than 25 years experience in the health service explained why he felt unable to be interviewed 'on the record'.

"I feel it would place my organisation and chief executive at some risk and that I would not wish to do.

"There might be a risk of being held to account for the comments I have made and possibly risk of threatening their employment."

He said they could be at risk from "the employer at the top".

When asked if he meant Health Secretary Alan Milburn, he said "He is at the top, yes."

BBC Five Live also heard that the amount of money being put into the health service is far less by the time it reaches trusts.

One finance director whose region faces deficits of more than £50m this year said: "There's an ongoing issue about how the public perceive money is spent.

"They believe large amounts go on management.

"If you look at the NHS, management costs are less than 4% which is very low for such a colossal organisation.

"They don't understand why the things the government is promising aren't available straight away.

"They're not told about top-slicing, that millions are taken out before trusts get a bite of the cake, for IT developments, to fund negligence claims, pay the NHS National Insurance bill.

"And when we get the money in one hand, we have to make savings of 1% to hand back on the other."