Here’s a question: how many NHS senior managers have been made redundant following a reorganisation only to be appointed to a senior management post in another part of the NHS? The National Audit Office found it was one in five.

About 2,200 senior managers were reported to have been re-employed soon after had being made redundant with large pay-offs. And the cost to the NHS is estimated to be £430m.

‘It has been suggested senior managers taking redundancy packages over £100,000 should be banned from applying for a post in the NHS for 12 months’

Many of these pay-outs involved a one-off payment of over £100,000. Good luck to them, I say. It’s very unpleasant being made redundant, worrying about how you will pay the mortgage and whether in the current climate you will find another job.

Here’s another question − in light of the fact this is not the first major reorganisation of the NHS in the last 10 years − how many senior managers have had multiple redundancies and received a big payout every time, before being re-employed? Now, that’s not a sensible or financially justifiable use of an NHS budget that is under severe pressure.

Putting the ‘N’ back into NHS

The big issue is not the size of payout; the issue is that given the “N” in NHS stands for “national”, why are senior managers not offered redeployment elsewhere in the NHS? If they turn down a reasonable offer of a comparable post then they would not be entitled to redundancy.

No doubt some people would say uprooting family, changing schools and selling a house to move to the other end of the country is unreasonable but these are senior managers − this is exactly what they do in pursuit of promotion and the route most of them followed to become a senior manager.

It has been suggested that senior managers taking redundancy packages of over £100,000 should be banned from applying for a post in the NHS for 12 months. This would seem an unfair restriction but it does raise the question that if we need so many managers, why did we let them go?

Of course, the real answer is to stop costly reorganisations and spend the money on employing doctors, nurses and carers − not paying staff to leave.