| Mick James examines the notion that the consulting profession is the root cause of the financial malaise currently engulfing the NHS... |
| Are management consultants poisoning the NHS? |
| |
|
| | I’m becoming quite a fan
of the Daily Telegraph
and its way with
figures. Recently a
dinner table argument
over the increase in the
murder rate since the
abolition of capital
punishment led to a
trawl through the
Telegraph archives in
search of some stats.
We learned that in 1964
there were “fewer than
300” murders, whereas
last year there were
850. In the (clearly
frothing) mouth of
columnist Simon Heffer
this became
“quadrupled”.
If that’s how the
Telegraph treats
murderers, what mercy
can we expect for
management consultants?
Here’s the first line of
a recent Telegraph
article:
“The Government has
spent £52.5m in six
years on management
consultants for the
health service”. In the
headline this became
“more than £200m”. I
know people suspect that
real inflation is more
than Gordon Brown is
letting on, but this is
ridiculous. How did
they justify such a
claim?
It was made on the | |
| |
| | can’t all be attributed
to rash spending on
consultants as the
figure dwarfs any amount
of consultancy spending.
What could possibly
have caused a sector
which has had funding
hiked more under New
Labour than under any
previous government to
be in such financial
difficulties?
Some clues might come
from an article found
elsewhere in the paper
by a bemused but
grateful GP who pointed
out that revisions to GP
rewards schemes meant
that the average GP
remuneration had risen
from around £70k to over
£120k, with no increase
in productivity received
or even asked for. In
fact the overall wage
inflation rate in the
public sector is
estimated to be double
that in the private
sector, while growth in
productivity lags far
behind.
Could these problems
possibly be helped by a
bit of consultancy,
possibly from a
remuneration and rewards
specialist. Let’s ask
Dr Paul Miller, of the
British Medical
Association, also quoted
in the article and also | |
|
| | blessed with Frank’s
all-seeing vision into
every consultancy
project taking place in
the NHS:
"I don't believe that
the health service gets
good value for money
from these consultants,
who have no background
in health,” he said.
(This is quite rich.
Anyone who’s tried to
climb on the NHS IT
gravy train recently
will tell you that it’s
pretty much a closed
shop unless you have
prior NHS experience)
"They do not seem to
come up with any new
ideas. Every trust has
its own chief executive
and finance director. I
see no evidence that
consultants are giving
trusts any solution they
were not aware of
already. We know that
if you want to save a
lot of money you can get
rid of a lot of staff."
Yes, but you didn’t
did you? You just went
out and hired and hired
and gave pay rise after
pay rise until now all
the money’s gone and you
still haven’t got a clue
how to cut the deficit
or treat any more
patients. That’s why
the KPMGs and the Ernst
& Youngs of this world | |
|
| | are crawling all over
the NHS trying to pull
the chestnuts of those
chief executives and
finance directors out of
the fire. And watch
carefully as the efforts
of these turnaround
teams are added to
whatever “shocking”
total the consultancy
spend for 2006 comes to.
In case anyone has
forgotten who Mr Dobson
was, he was the first
health secretary under
the incoming New Labour
regime in 1997, but
unlike his successors he
was unable to hose the
medical profession down
with money because at
that time our Iron
Chancellor had insisted
that he live within
Conservative spending
limits.
So well done Mr
Dobson, for your
sterling performance as
John Major’s last Health
Secretary. In the
meantime if you have any
suggestions for how the
NHS could be run any
better, I’m sure they’d
be glad to hear from
you. Oh, but hang on —
that would make you a
consultant wouldn’t it?
| |
|
| | authority of former
health secretary Frank
Dobson, who claimed that
the sum was "the tip of
the iceberg" because
this was just Department
of Health spending and
did not include
individual hospital
trusts and other health
service bodies.
Given the diffuse
nature of the spend and
the multiplicity of
projects involved, you
might think that Mr
Dobson would hesitate to
speculate on whether it
was money well-spent.
Not at all. Reminiscing
that in his day, all
consultancy contracts
over £25,000 had to have
his personal approval,
he opined that
management consultants
were "seldom value for
money" and added that
patients would much
prefer the money to be
spent on reducing
hospitals' deficits.
Ah, those hospital
deficits. Sadly, these | |
|
|
