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Mark Britnell quits NHS for private sector

HSJ has learned Mark Britnell, NHS director general for commissioning and system management, is to join consultancy KPMG.

He is on gardening leave from the Department of Health.

He is expected to play a leading role in KPMG’s European health practice.

Mr Britnell has been the leading reformer in the NHS management team. He launched the world class commissioning drive, and has always been a staunch advocate of private sector involvement in the NHS.

He recently established the co-operation and competition panel to ensure fair access to the healthcare market.

Academic Chris Ham said the panel’s draft interim guidance read as if it had been written “by a neo-liberal economist on speed”.

Mr Britnell also established the framework for securing external support for commissioners (FESC) to encourage private sector involvement in world class commissioning.

He was unavailable for comment.

Read more about Mark Britnell

Mark Britnell announces changes to commissioning framework

Mark Britnell confirms DH is still mulling over PCT freedoms

Mark Britnell on world class commissioning so far

Commissioning reforms were ‘right thing at the wrong time’

Britnell moots PCT rebrand

Lookey-likey: Mark Britnell and Sean Penn

See www.hsj.co.uk/confed for more news

Readers' comments (28)

  • If you put 2 and 2 together there's a fair chance you can see the general direction of the NHS in the future - a mixed economy!

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  • Tenders are out, responses coming in as we watch. The NHS will be largely privatised before the end of 2010

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  • He really is not stupid! I would say cunning rather than clever or smart. He knows very well Andrew Lansley would give him short shrift when the Conservatives come to power. Another rat leaving the sinking Nu Labour project.
    Embodies everything that is wrong with the NHS. A 'high-flyer' who has risen with meteoric speed through the NHS 'fast-track' management scheme. Has no experience of anything except the Alice in Wonderland of NHS finances and organisation. He figured out right at the beginning that there were 2 paths in life: the honest hard graft and the sheltered, cosseted life of an NHS mandarin. Actually - maybe I am just a bit envious.........

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  • Clive Peedell

    Congratulations to Mr Britnell's "World Class" move to KPMG.
    I now finally understand what he meant by "life to years and years to life"

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  • "He is on gardening leave from the Department of Health."
    Is this a slur?
    "gardening leave" as applied to consultants appears to be a situation where the employing authority is looking for an excuse for dismissal - but doesn't have any supportive evidence: not sure how it applies in NHS management.
    Goggling "Mark Britnell" doesn't reveal any suggestion o gardening leave: and I would have thought that any senior manager in DH - or any other department - would be looking for alternative employment ;-<

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  • Clive Peedell

    Mary Hawking makes an interesting point. However, it is rather galling that KPMG is one of the companies involved in FESC. In addition, we have recently had a report suggesting that too much money is being wasted on management consultancy.
    He hasn't broken any rules, but I think we must think harder about what to do with the "revolving doors" culture. I think it has been hugely damaging to the NHS and our public services.

    Other recent examples include:
    1. Simon Stevens (No 10 Health Advisor, CEO of United Health (Europe)
    2. Alan Milburn (SoS Health, Alliance Medical)
    3. Patricia Hewitt (SoS Health, Boots)
    4. Lord Warner (Health Minister, UK Health Gateway)
    5. Baroness Jay (Health minister, became senior advisor to Currie and Brown, construction consultants active in PFI)
    6. Lord Barnett: Labour Peer, became Charmain Atos Origin

    and in the other direction:
    1. Richard Abadie: former Price Waterhouse Coopers (PwC), now Head of PFI policy HM treasury (excellent name by the way!)
    2. Liame Byrne: former Anderson Consulting, Labour MP and Health minister
    3. Paul Corrigan: former indepedant consultant managing public service change, became Special Advisor to health secretary (architect of ISTCs and Foundation Trusts)
    4. Dr Penelope Dash: former McKinsey consultant, became director of Monitor (independent regulator of Foundation Trusts)
    5. Richard Grainger: Deloitte partner, became head of NHS IT programme
    6. Patricia Hewitt: Director Anderson Consulting, became SoS for Health!!
    7. Paul Jones: Director Atos Origin, became Chief technology officer for CfH
    8. Simon Leary: Consultant PwC, became head of DH strategy unit
    9. Adrian Masters: Consultant with IBM and PwC, became director of health team in PMs delivery unit, then head of strategy at Monitor
    10. Sheila Masters: KPMG partner, appointed to public services productivity panel looking at performance, estates and IT in NHS
    11. Dr Timothy Stone : Chairman KPMG PFI advisory services, became member of the DH commercial directorate advisory panel amongst other HMG advisory roles in health, farming and MoD

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  • Mark Britnell was due to present at a conference in Hull on Tuesday on membership schemes. He didn't turn up and we were told it was because his daughter had injured her ankle. If the man is as creative in his work with KPMG as he is in his excuses we have much to look forward to.

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  • Surely it is good for public sector employees to move into the private sector and bring their skills with them and vice versa. And let's stop pretending that the NHS is a 'universal service' that delivers equally to all - 'postcode lottery' sound familiar? Anyone managed to register with a NHS dentist lately?
    Let's accept that we already have a mixed economy of care (and always have), we don't have the resources to deliver everything to everyone and we're just all trying to do the best we can.

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  • I agree in principle with the benefits of cross-fertilising skills etc. However after 25yrs in the consulting game, I remain deeply suspicious of snr consultants taking leadership positions in client organisations and vice versa. It is just as insidious as the non-exec director's club. Skills transfer needs to happen in the engine room where the real work is done.

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  • This has made into the HSJ's top 5 most popular...must be a first for Mr Britnell

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  • Mr Britnell is a passionate, self motivated individual who cares deeply about the health and well-being of the public! He has no doubt made a difficult decision to move into the private sector, putting his family first!
    He will be missed immensely in the DH as he is a character with a drive and enthusiasm that is limited.
    Good luck to him and let's hope we see him back one day!

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  • Will anyone take the bet that Mr Britnell will reappear post election at the helm of the NHS? The tension in the Department has been palpable recently. A view from the private sector for a period would not look bad on a CV.

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  • KPMG! The epitome of the command and control consultancy will sit well with this man.

    They share the same shared services, introduce the market and introduce choice mentality.

    Now there is an opportunity to do the same to many more public sector organisations.

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  • I am an entrepreneur from the private sector and have been reviewing the complexity and subsequent inefficiencies of service delivery throughout the nhs and particularly at PCT level in recent years, it is no wonder that the nhs has a forecast defecit of c£12bn in 3 years time.

    Many of the comments made here are shamefully petty and small minded, from the private sector I have observed the refreshing changes that Mr Britnall has introduced towards improving overall efficiences in service delivery & design, in giving PCTs more freedom and flexibility to think out of the box, in reinvigorating PBC and putting commissioning in the hands of where it is most appropriate. He is not voted by your industry as the 4th most prominent and impacting figure in the health service for a consecutive year running for nothing!

    It is a very sad day for the health service and the public to lose such a bright & refreshing intelligent innovator to the private sector, it is your sector that needs more creative players like him and not to lose them.

    In our own recent engagement with PCTs throughout the country, as a provider we are witnessing greater efficiences and more positive responses to the practicle principles and the foundations that he has laid in WCC along with a far greater motivation from GPs and front line clinicians in PBC to work more closely together and taking responsibility for budget savings which is ultimatly enhancing and appropriatly commissioning patient care and saving substantial tax payer funds and making them go further which is now clearly a priority on the sectors agenda, as an outside observer I see that he has laid down some firm and concise systems that if implemented properly should pave the way for slashing the forecast defecit, all of those of you who have fired negatives and speculation, I urge you to step back and do a simple search on the HSJ site and note all of the marvellous practical differences this man has made, he has implementaed phenomenal practical shifts in the service which I am confident will pave the way for enhanced and more effective patient care without the excessive cost defecits that are currently forecast, its a shame you have lost him to the private sector, however he has left you a legacy with new systems that will ultimatly serve to deliver more positive patient outputs at a more cost effective price to the tax payer going forward in these forthcoming difficult years.

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  • I do not know Mr Britnell, nor have i had the pleasure of meeting him. i suspect that for the vast majority of those submitting comments, this is equally true. What does appear to be true is that he is clearly a gifted man with a considerable experience of succesful managment of healthcare. As with Man Utd's Ronaldo, the good will always be in demand and i wonder how many of the critics would have turned down an inviting transfer offer if they had received the same from KPMG. I can only assume it is sour grapes.

    Good luck to Mr Britnell. If he is as good as some surmize, we can be sure that he will return either with a KPMG hat, or new NHS hat, to help us in the future.

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  • "Mr Britnell is a passionate, self motivated individual who cares deeply about the health and well-being of the public!"

    What a load of cobblers! Mark Britnell is only passionate about one thing: Mark Britnell. And yes, I have met him and listened to him speak.

    As for the long eulogy from Peter Mahoney - yes, I am sure Mark Britnell was exactly what the private sector needed in the NHS. Read 'Plundering the Public Purse' by Patrick Wood or 'NHS Plc' by Allyson Pollock. WCC is, I assume 'World Class Commissioning' - another management-speak load of bollocks. A catch phrase to propel Britnell to the 'top 10' of movers and shakers in the NHS. It means absolutely nothing yet we have hordes of breathless middle-aged ex-nurses spouting this rubbish as if it is the salvation of the NHS. PCTs have entire webpages devoted to WCC. The sheer banality. It makes me want to throw up.

    It would help; Mr Mahoney; to take you seriously if you could spell words like deficit, principles and ultimately.

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  • Mr Mahoney clealry needs to be reminded of some factual information regarding NHS funding:
    1. Wanless estimated that the NHS was underfunded to the tune of £267 billion over 25 years (1998 prices) and UK spending was well below the European average
    2. The projected £12 billion deficit has resulted from predicted and necessary public spending cuts due to massive public debt. This has mainly resulted from bailing out the banks. However, the PFI was already about to take Mr Brown well above the 40% GDP Golden rule because the international financial reporting standards (IFRS) have now put PFI on the public borrowing books. Interestingly the banking crisis has masked this and let off the PFI yet again!
    3. Yes, there were and still are inefficiencies in the system, but the healthcare market and private sector will add to this, not reduce it. There is no evidence that choice and competition improve healthcare systems. Most of the published, peer reviewed data suggest the opposite. Would Mr Mahoney like to cite evidence to the contrary?

    A few other points for Mr Mahoney to consider:
    1. Mr Britnell was voted 4th most prominent figure in the NHS because he was a very senior member of the DH with a major remit to deliver WCC. These rankings are about levels of power and influence, not success.
    2. Britnell was keen to expand the market, so it is not surprising that entrepreneurs from the private sector liked him. As a taxpayer and not a shareholder of a multinational healthcare company or managemnt consultantcy, I was less keen on him!
    3. WCC and PBC is a key area where policy is currently failing. lots of criticism in the literature at present
    4. Where is the hard evidence that money is being saved by commissioning? What about the costs involved in delivering it?
    5. I agree with him that we should all search the HSJ site for examples of policy that is working. I'm afraid that this Journal is an evidence free zone. It is full of opinion formers that are given a significant platform to promote their ideological fads with no referencing to any academic policy literature. It nicely sums up what is wrong with the NHS.
    6. As for losing "creative talents", we have more than enough of them delivering their "creative destruction" on the NHS.
    7. Finally, he suggests that the systems Mr Britnell has put in place will be beneficial for patients and the taxpayer. Where is the indepedent peer reviewed evidence for this?

    As a clinician, I am used to critically appraising the academic literature in order to deliver the highest quality and most cost effective care to patients. Current health policy is based on political ideology, not evidence. Unfortunately, NHS managers will continue to deliver on it, because their jobs depend on it. I don't blame them, especially in the current economic climate, but it would be nice to see some honest evidence based analysis of current policy in this journal.

    The number of anonymous comments speaks volumes to me.

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  • Mr Britnell’s obituary as set out above says it all; it’s a bit of love hate thing going on with him, always has been. Some think he’s great most have an opinion. Britnell always knew when to get out and he knows now that the current DoH team is dead in the water, Nicholson included. He will not want a new government dumping the blame on him in the way he has done to so many people on his journey up the greasy pole of the NHS! He will want to distance himself from the mistakes in the vein hope that his ambition to make it to the top job will still be in his grasp by shifting the blame to others.
    It is now becoming increasingly clear, the level of wasteful bureaucracy the current team have presided over and created under the banner of reform and innovation beggars’ belief. This has placed the NHS into the super league for regulation, management and system bureaucracy whilst patient outcomes languish behind Europe and Australia. The NHS is going to really struggle with the Economic downturn because they had taught it to spend money on frippery.
    They have created a situation where stunning fees are paid to the consultancy firms as the norm and created a situation where the service is totally dependent on and frankly addicted to multimillion pound consulting contracts. If nothing else this addiction will make life in consultancy pretty lucrative for Mr Britnell.
    The reality is however, he does not leave the DoH in a better state than he arrived. For all the publicity and pomp that the DoH portrays the NHS is in for a hell of a rocky ride over the next few years and it is not as Britnell and Nicholson portray in a good state to tackle this.
    For Britnell this is a good bet, and he does make good bets, he can sit out the political white water over the next 18 months allowing the blood bath to drain away and then see what happens. Either way the DoH is going to spend lots on consultancies, keeping a sinking bureaucracy going, well into the next Government.
    The thing is Britnell is no longer the man he used to be, and for those that have experienced Britnell’s ability to put himself first will recognise that this is exactly what this is about. He will of course be joining friends past and present, making that transition to the private sector all that much easier. We should all wish him the very best of health.

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  • I find the comments posted typical of the current nature of people working in the NHS. As usual they will have been made by people who wont have actually worked with Mark - but feel able to comment without knowing the facts. He has only joined KPMG - not gone over to the dark side.

    The reality is that Mark has done more for the NHS than many people. Yes, challenging, yes, unconventional, yes flamboyant - but most of all - deeply committed to the NHS, public sector and at the heart of it, patient care. As an individual he is passionate about improving what we provide. If that takes us out of our comfort zone - then even better. An inspirational leader who motivates & stimulates the type of different thinking we need to really bring about change. For those of you who winge and moan about people like Mark - realise the world is changing - & the NHS needs to change with it.
    There should be more of him - and I hope he comes back.

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  • I do not know how many people commenting on Mark Britnell's contribution to the NHS have actually worked with him or not and I respect that everyone is entitled to their opinion.

    I had the privilege of working for Mark for over four years as I made the transition from a clinical role into a managerial one. Mark challenged himself and everyone around him to look at different ways we could improve the NHS, making it more effective and efficient with the ultimate aim of providing the patient care that anyone of us would want for our own family.

    His provocative style didn't always make people feel comfortable as none of us like having a mirror held up to us but hold up the mirror he did.

    One of the commentators made the point about evidence based interventions and I wanted to draw everyone's attention to the evidence in the social sciences around the psychology of human behaviour and lessons we learn from research in ethnographic studies around organisational culture. I wonder how each and everyone of us who has commented here thinks about our own contribution to the culture in the NHS?

    Through the development of the NHS Constitution, we have been challenged by those who rely on us to deliver and manage heatlh care to do so in a more compassionate way. I wonder how we can do this if we are unable to show compassion to each other?

    You may not agree with the policies Mark Britnell has put in place, you may not like him as a person but if you want to work in an NHS that values its workforce (as I do) I offer you some advice:

    "Words have the power to both destroy and heal. When words are both true and kind they can change our world."

    Mark - It has been a privilege to work for you and I wish you well in your future role. I have no doubt you will continue to identify and offer ways that the NHS can meet some of its biggest challenges yet.

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