"Lord Carter's plans for saving the NHS £5bn a year"

From the BBC:

Lord Patrick Carter, a Labour peer as it happens, is advising Health Secretary Jeremy Hunt on how hospital budgets can be better spent.

In June he said up to £5bn a year could be saved annually by 2020. In his first report then he argued that some of it could be delivered by smarter procurement of hospital supplies and some by better management of staff rosters.

Now he has attempted to put more flesh on the bone, outlining other areas which could contribute to that £5bn figure.

All sounds lovely, but that reminds me of another topic, the notion that organisations have to pay their more senior employees "competitive salaries".

Clearly, at lower and middle levels, you have to pay people roughly the same as the competition would pay them or as much as they could earn in similar level jobs in a different kind of business.

But I'm not sure that applies to the higher echelons.

When deciding the salary of all these NHS senior managers on six and seven figure salaries, the only real comparative is how much they - with their particular skills - could earn by doing something else, which in most cases would be four or five figures.

As to doctors, there is no particular need to pay as well as in other countries. Let's assume 3 million qualify worldwide as doctors each year; America wants to take on 1 million new doctors for $200,000 each. Is there any particular need for all other countries to offer $200,000?

Of course not; once those 1 million jobs are taken, the other 2 million will have to take whatever is left. As long as the lowest paying country is still paying enough to make seven years of medical school (or however many years it is) worthwhile, then that is enough. Many European countries recruit doctors and nurses from low-income countries - all they have to offer such people is enough to make sure that they end up slightly better off than they would have been working as a doctor in their own country.

Compare and contrast with footballers' salaries; the top teams have to attract the top players to remain top teams, so wages get bid up in the Premier League, the top football players can thus soak up all the super-profits which top clubs make (i.e. they collect rent). Does that affect wages in the Championship where the super-profits are much lower? No, not really. Why would it? Salaries in the Championship are based on those lower super-profits.

Furthermore, football teams in the same league are directly competing with each other - so Chelsea has to try and outbid Arsenal etc. But one hospital is not really competing against other hospitals in any meaningful sense, and they are certainly not competing across borders.

Just sayin', is all.