It's raining money

You might remember the "shock/horror" headlines of a couple of years ago when many NHS organisations were finally forced to declare their hidden deficits. Our then illustrious leader, the glorious Patsy Hewitt, forced trusts to do all the unpleasant things they had tried to avoid such as getting rid of surplus staff, becoming more efficient, etc. However, the knee-jerk actions of the NHS bureaucracy reached all the dark corners of the service and we had "realignment of services" (ward closures); "streamlining" (nursing staff were made redundant); and "financial re-focus"(budgets were suddenly reduced). Our own primary care trust was one of the few that had stayed within budget up until then. Suddenly, their budgets were "top sliced" and abracadbra - we were £30,000,000 in the red.

That's the good bit! Next, because the trust couldn't work out how to recover all this "overspend" a pack of management consultants was forced upon us (at our trust's expense) to tell us how to run more efficiently. (I don't know why but it reminds me of the old army joke: "all leave is cancelled until morale improves".

Life has moved on. Our trust has now had much of that top-sliced money suddenly returned. It is falling out of trust headquarters by the day. On my desk are three new incentive schemes that seem amazingly generous after the recent sparse past. I am trying to work out how to recruit (expensive) agency staff so I can grab this dosh before the meter stops (March 2009). My primary care management team was reduced to two people during the lean times. There are now at least ten of them floating around, some of whom are tasked specifically to help me spend money.

Meanwhile, back in the real world, we are hurtling towards a recession. This government is forecast to borrow £100,000,000,000 next year. somehow, I don't think that the next cuts are likely to be another unpleasant top slice. They are more likely to be financial castration.

I'm keeping everything crossed.