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Jon Kennard

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News: NHS consultancies thrive as management positions axed

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NHS London has reportedly paid consultants as much as £7m to train GPs in management skills after losing up to 2,000 bosses during 2010/11 as part of a Government-backed drive to axe managerial positions.
The Guardian said it had seen an internal NHS London document, which showed that, as of 28 November 2011, contracts worth £6.3m of a total £7m had been agreed.
The highest-earning firms were PricewaterhouseCoopers, which signed a deal worth £1.61m, KPMG (£1.47m) and McKinsey & Co (£1.27m). Ernst & Young earned the least at £332.650.
The biggest individual contracts were awarded to PwC (£852,875) for its work with six clinical commissioning groups in outer north-east London and McKinsey (£736,500) for training personnel in five CCGs in inner north-east London, the document revealed.
A total of eight firms are advising the 38 GP-led CCGs that have been set up across London and which will replace Primary Care Trusts in April 2013, taking on responsibility for patient treatment budgets that are worth billions of pounds.
But in hiring the consultancies, NHS London said it was helping ensure the nascent CCGs "have the business management and leadership expertise need to manage health budgets and meet the health needs of Londoners, working with their partners such as social services".
The British Medical Association condemned the situation, saying that  the money was going "unnecessarily" to private companies, even though the current generation of primary care trusts already had these skills in place.
Apparent contradiction
Laurence Buckman, chairman of the union’s GPs committee, told the newspaper: "NHS funding is incredibly tight at the moment and this is £7m that's been spent unnecessarily due to the restructure. There is sufficient expertise within the NHS in London for them not to have needed to use external companies to do this and then this money could have been spent elsewhere, ideally on patient care."
Critics also point out the apparent contradiction in a Government that came in making loud noises about curbing use of external consultants in the NHS, but which is now turning them as part of moves to make its controversial NHS reforms workable.
But an an NHS London spokesman said: "It was decided just to use external organisations for this. The eight firms chosen are in a roster to help CCGs prepare for the new era. They are, in effect, preferred suppliers. We want CCGs to learn how to manage budgets so that, when PCTs have ceased to exist, CCGs are up to speed as organisations in their own right and ready to take on their new responsibilities."
But private firms were offered the work partly because of concern that PCTs across the capital would not be able to do it after losing up to 2,000 managers during 2010-11 as part of an NHS-wide drive to reduce their posts, the report said.
NHS London indicated that the £7m represented just 0.6% of its annual £1.2bn "multi-professional education and training budget," used for training clinicians, including GPs and the expenditure would not affect the delivery of frontline NHS service.
“Putting NHS doctors in charge of their own services means they need the right skills and training to manage taxpayer's money responsibly. But in making arrangements for that training we would always urge the NHS to make sure funds were being spent as effectively as possible,” a DoH spokesperson said.

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Jon Kennard

Freelance writer

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