Wednesday, 5 November 2008

Got a drink problem? You need a manager.

This morning I have read of yet another fine initiative to turn Britain into the health capital of the world. The government is to spend £6million on areas worst hit by alcohol related problems. It is not yet clear what is meant by this, but I presume it means areas of the country with large numbers of alcoholics or large numbers of drink-fueled crimes.

Call me an old cynic, but GPs and hospitals already give advice about excessive drinking. They can spot a heavy boozer at 100 paces. The sensible ones give advice and make available methods to help people cut down if they want to, but they are not miracle workers. If someone does not want to stop drinking he will not stop drinking, whatever his doctor says. I should declare an interest here, I have been a heavy drinker all my adult life. My GP is a sensible chap, he knows there is no point nagging me because it won't change my ways, nonetheless he raises it every time I see him because it is his professional duty to do so. There is no reason to suppose the position is different for every other GP. So what can the extra £6million do?

One might observe in passing that the government does not have £6million spare. Perhaps one consequence of them being so deeply in hock is that they just don't care anymore, but it does seem bizarre that they can throw money they don't have at a problem they already address as fully as it is practical to address it.

The brief report I read on AOL news is a little unclear because it says £3million will go to twenty of the poorest Primary Care Trusts, £2.7million to regional managers, £1million to a new Alcohol Learning Centre and £450,000 to the "National Support Team". Presumably there is some overlap because these figures total £7,150,000, but it seems tolerably clear that the money is going to be spread so thinly that no substantive good will result. £3million between 20 Trusts is just £150,000 each, let's call that one manager, two or three assistants, an office and stationery for one year. £2.7million to the regions presumably relates to the 28 Strategic Health Authorities, that is just under £96,500 each, or one manager, a part-time assistant and office and stationery. And we know full well that the regional managers will be responsible primarily for processing reports coming from further down the chain. £450,000 for a national team of anything in the NHS is just tea and biscuit money; so that leaves us with £1million to set up an Alcohol Learning Centre. The report says nothing about how this Centre will be funded year-by-year.

Perhaps £1million out of the 6 will actually go directly into something that might improve patient care, the rest will be spent generating and circulating paper. What better example do we need of the futility and wastefulness of government-led, top-down management of a service. Any service.


Mark Wadsworth said...

Do you have an up to date link? I might nominate these people as 'Quango of the week'.

Stan said...

Another problem which the government think can be solved by throwing money at it.