THE Health Service Journal reports that in a survey used to oppose recent calls for a pay freeze, a quarter of NHS senior managers say they think they are underpaid.

If this is correct, and they oppose a proposed pay freeze, then frankly this news couldn’t come at a worse time, when the rest of the country is having to face up to the harsh realities of the current economic climate.

Many people employed in the private sector are now losing their jobs or having to face cuts in pay and would welcome the luxury of a pay freeze.

It used to be the case that pay in the public sector did not match that of the private sector, now the opposite seems to be true when the whole package is taken into consideration.

NHS chief executives routinely receive six-figure salaries, bonuses, pension schemes and cars.

In the same publication there are many job adverts for managers, which include, various temporary six-month contracts at £600 per day, a primary care trust chairman (3.5 days a week) at £62,000 a year, and PCT finance directors on £100,000 a year.

So, all things considered, they don’t appear to have it so bad.

Regular readers will know I am a passionate believer in our NHS and all it stands for. However, there is much to do to improve efficiency and reduce waste.

Some believe this can only be achieved by a restructure, to include a full review of inefficient and outdated processes, unnecessary job duplication, and a reduction in the numbers of PCTs and strategic health authorities.

Huge savings in overheads, as well as an end to the ‘postcode lottery’, could be made by centralising most of the functions of management and control, as has been the norm in the private sector for many years.

At the very least, consideration should be given for financial management, human resources and drug procurement to be centralised.

This should lead to lower prices being paid for drugs by virtue of the enormous centralised economies of scale.

I will be the first to admit it is not easy to see exactly what is going on. Nationally, the NHS made a surplus of £1.75bn last year, and yet still denied drugs to many cancer patients.

We are now told our local hospitals are having to make substantial cost savings, and yet I have just read the South Central SHA Performance, Quality and Finance report for June, which states that the overall year to date financial position is in surplus of £8.1m, with a year-end forecast of £50m!

Indeed, Oxfordshire PCT is in surplus to the tune of £2.5m. I can only assume that the “surplus” represents the budgeted “savings” they are required to make.

Perhaps someone can help me out here, as I would hate to think that patient care has again been compromised when all the time cash has been available.