Doctors 'spending money they don't have' on NHS

MIDDLE managers in NHS Lothian are not getting the message about budget cuts and ordering equipment they cannot afford, health chiefs have warned.

While the organisation's top managers are counting every penny, the fear is the message is not being passed further down the chain to doctors and consultants, putting the health board's goal of saving 31 million in jeopardy.

It comes a day after the Evening News revealed the latest cash crisis to hit NHS Lothian. The board is being forced to swallow a 38 per cent rise in its business rates bill, costing an extra 5m a year at a time when it is already battling a 70m black hole.

Eddie Egan, the board's vice-chairman, said the problem of free-spending managers was not a new one but that it had become more critical because of the financial situation.

He said: "I still have concerns that there are those who do not understand this (the need for savings]. Somewhere down the machine, the message comes to a shuddering halt and there are people out there who are not getting it.

"They are still spending money they don't have."

NHS Lothian is facing financial difficulties on several fronts, not least the need to scrap 2000 jobs in the next two years. Bosses are determined to make the necessary savings, but said they needed the support of managers further down the organisation to make it a reality.

Some senior figures suggested a "walkaround" of departments may help reduce the problem, similar to the initiative which has been so successful in cutting superbug rates.

Medical director Dr Charles Swainson said: "We do come across some of the most surprising ignorance and unwillingness to engage with these problems.

"Doctors understand the personal circumstances but fail to relate this to the NHS in their work. However, I have no doubt that we are committed to this because we've had recent positive discussions."

NHS Lothian is being hit harder than most health boards financially, despite contributing so much to the healthcare system through research, tuition and complex cases other areas can't handle.

The NRAC funding formula used by the Scottish Government to support health boards is weighed heavily in favour of Glasgow because of its high rates of deprivation.

Margaret Watt, chairwoman of the Scotland Patients Association, said: "If you don't have money for something you don't buy it. If managers don't know how to control their budgets then they shouldn't be in the job and we can save on their salary instead."