Published: 05/12/2002, Volume112 No. 5834 Page 12

Were middle managers denied voluntary redundancy in the fall-out from Shifting the Balance, while top executives trousered six-figure pay-offs?

Daloni Carlisle investigates In a classic case of what looks like robbing Peter to pay Paul, the NHS appears to have paid a significant number of senior managers six-figure sums to leave the service, while denying voluntary redundancy to middle managers.

And they are pretty cross about it.

But that is 'off the record'.

Officially, both the NHS Confederation and the Association of Healthcare Human Resources Management say there is no evidence that the human resources framework, which calls for redundancies to be kept to a minimum, was unevenly applied in the fallout from the Shifting the Balance of Power restructuring in April.

They say if you make people redundant you must pay them and point out that it is harder to redeploy managers at the most senior levels, where jobs are more limited.

There are no national figures available and there appears to be no formal research into what happened to what sources claim was£100m put aside to fund redundancies. In practice, it seems the option of redundancy was available only to the most senior managers. And middle managers who are publicly tight-lipped on the subject are privately furious.

HSJ sources report that a large number of health authority, community trust and primary care group chief executives chose to leave the NHS.With redundancy payments and accelerated pension rights, typically they received over£300,000 each.

Others nearing the early retirement age of 50 moved to government agencies where they continue to receive protected salaries, sometimes well in excess of the advertised rate for the job.

Another wave of redundancies and early retirements is predicted as these people turn 50 and as the period of protected employment comes to an end in April 2003.

In contrast, middle managers were offered alternative jobs and told they could like it or lump it - if they didn't take the job on offer they would be deemed to have resigned.While that suited some, others have been downgraded or found themselves forced into what one source called 'non-jobs or special projects'.

Source after source says this picture is correct, but insist they would rather not say so in print.

A senior human resources manager said: 'I do know that there are middle managers who would prefer to go than to be recycled into another job. I can also understand that people in more senior jobs are more difficult to recycle.'

The First Division Association represents 1,100 senior NHS managers. Its health department head, Paul Whiteman, confirms the exodus: 'We do not have global figures, but certainly I have a feeling an awful lot of chief executives are exercising the choice to go.'

Nearly all chief executives are on personal contracts and had to negotiate their leaving packages individually.

The anger felt at lower levels is clear from a letter to prime minister Tony Blair copied to HSJ.

In it, an anonymous group of NHS managers write: 'We have become very disillusioned about how the reorganisation is affecting staff and the vindictive and discriminatory way we are being treated.'

When their old jobs disappeared, they took the new ones offered to them only to be downgraded at a salary review about which they were not forewarned.

Many are now doing jobs with less responsibility. Meanwhile, they claim, 'chief executives who took a handsome pay-off are working as consultants to the NHS at huge hourly rates'.

The writers ask: 'How can you possibly spout the rhetoric you do about treating staff equally and fairly when this sort of injustice is going on?'

In response, the DoH denies that it had set aside£100m for redundancies. In a statement, it added that the chief executive strategic health authority posts were the only ones subject to national competition, while 'ringfenced' arrangements were in place so there was limited competition for new posts at other levels.

News of large pay-offs for senior managers is always bad for public relations, regardless of the facts.

In November The Daily Express and The Sun reported 'fury' at payments totalling£1.4m for three NHS chief executives made redundant in a trust merger.

University of Birmingham health services management centre visiting senior fellow Andrew Wall says this illustrates why there is no research on the subject. He recognises the picture painted by HSJ: 'Most of it is anecdotal because there is no study into it, and one will not be funded because it does not look good for government.'

'It is a disgrace that so many able people with a lot to offer should be let go at 50, ' he says. 'It is a tremendous cost to the system and it cannot be justified.'

He adds: 'It is not surprising that middle managers are complaining as this is bound to cause envy. But if they were given the same accelerated pension rights the whole NHS would certainly collapse.

They hold the NHS together.'

And that seems to be the crux of the matter: whatever the political rhetoric about bureaucracy in the NHS, in reality the health service cannot afford to let middle managers go. l