Imagine, if you will, that the NHS’s vast army of managers simultaneously took today as a sickie.

Perhaps to watch endless re-runs of The Apprentice and hone their gladiatorial boardroom skills. (Off topic: Is it just me or is everyone watching The Wire at the moment?)

Would patient care diminish? Would forms go unfilled? Would anyone really notice?

I ask because HCR reports today that in the last 5 years spending on NHS administration has doubled.

Last year’s Valuing General Practice campaign was all about highlighting the fantastic work that practices do on a limited budget.

The Tories are asking whether the same value-for-money test can be applied to NHS management.

I’ve no idea whether the figures quoted are correct but the DoH response neatly sidesteps this issue to focus instead on the increase in medical workforce.

However, £12.6 billion on NHS administration is an incredible amount. Especially when compared with the £7 billion spent on general practice. Imagine what your practice could have achieved with almost double its budget.

My alarm bells really should have started ringing when the outgoing GMC president complained to GP about the dangers of over regulation of the profession.

The more patients/voters learn about how the health service works and how it is funded, the more they are likely to recognise the value of those who provide their care and question the amount spent on those who administer it. After all, would sick people rather see a clinician or a manager?

Health minister Lord Darzi is all about a quality NHS but perhaps that is because, given the vast sums Labour has lavished on the NHS, to emphasise anything else at this stage would be political suicide. 

Perhaps this is why the NHS is so keen to encourage clinicians into management to lead the NHS.

One thing is clear to me: the deeper we go into recession, the more patients will question how money is spent on their behalf.

Could the NHS manage without its managers? Probably not – but perhaps we need an investigation into the quality they offer and value they provide.

Perhaps bloggers like Guido Fawkes, who claimed his first scalp at the weekend, should set their sights on a new target.