Letters

Published: 27/05/2004, Volume II4, No. 5907 Page 22

I refer to HSJ's story about the shock-horror revelation that two-thirds of finance directors are part time (news, page 7, 13 May).

I was pleased HSJ explained this clearly in the story because in other media bulletins the strapline has been misleading; in fact the figure is only 10 per cent of what most people traditionally consider 'part time'.Of those, I suspect many are either interim or people working flexible hours, something the NHS has encouraged and been applauded for. The two-thirds quoted were considered part time because they were also responsible for IT, human resources, estates and other such functions.

The shock-horror is generated because these organisations have budgets of similar size to Costa Coffee's and Wessex Water's, yet of course we know these types of commercial organisations have financial directors with similarly large portfolios. I suspect next week there will be an outcry about increases in the number of managers. Except there will not be. As recent studies confirm, management costs are actually declining as a percentage, which leaves the NHS as one of the most efficient health services in the world.

Notwithstanding the debate about the PCT management infrastructure, of which there has been much comment, there is an implied slur on NHS finance in suggesting that many finance directors work part time. The implication is that by having a portfolio of services, the finance director is somehow not able to do their job properly.Yet NHS finance directors' track records speak for themselves. The service has continued to balance its books in recent years, despite huge cost pressures and massive structural upheaval.

The Audit Commission's recent financial management report did raise concerns about PCTs' financial management capacity to meet future challenges such as payment by results and patient choice (and these are challenges the finance function is well aware of and preparing for). But it also stated that the basics of financial management at most NHS bodies are sound and provide effective control for today's health service.

Mark Knight Chief executive Healthcare Financial Management Association