Prescription for the NHS

Grand and vague promises from all the main political parties have made voters sceptical about how much of Britain's essential spending savings can really be wrought from reducing paperwork, duplication and layers of management, particularly in the sprawling empire of the NHS. Billions can be saved, however, and there is conclusive proof of this in Yorkshire.

Mismanagement at Scarborough and North East Yorkshire Healthcare NHS Trust (SNEY) created a chaotic financial environment where top-up funding of nearly 8m was required and vacancies were left unfilled while millions more were splurged on temporary staff.

A report, by PricewaterhouseCoopers, which accuses the trust of failing to recognise it is in a "crisis turnaround" situation, makes damning reading. It paints a picture of poor decision-making, one example of which being that it spent 3.8m on agency staff in the 12 months to March while it had 10 fewer consultants than were needed.

The trust is right to highlight its success in achieving a 2m surplus for 2009-10 but its turnaround requires a long haul. It is still unclear just how much money the NHS will have over the next decade and it is only once the winner of the General Election has spelt out its plans that the NHS will know how it must change. So far, Labour and the Conservatives' pledges to "protect" the health service have not told us anywhere near enough.

In the meantime, a close look at what has been going on in North East Yorkshire, aided by the PwC report, can tell us what changes should be made. Spending on agency staff, which leaves trusts liable to pay hefty fees to recruitment firms, must be cut, vacancies for nurses and consultancies must be filled and the managers already in post must justify their existence by delivering larger, cross-directorate savings schemes.

What the report does not cover at length, but must be seen across the entire NHS, is a reduction in the largesse afforded to senior managers. There is a need for such individuals, because they can drive through the efficiencies needed and bring departments together, but their pay rises – or lack of them – must reflect the age of austerity in which we live.