NHS spending debate focuses on the wrong type of consultant
Why is health secretary Andrew Lansley still acting like an opposition politician? That is the question raised by the government’s haranguing of primary care trusts for their use of management consultants.
There is an important debate to be had about the use of external management support in the NHS, most notably to deliver Mr Lansley’s reforms, but the health secretary did not seem interested in having it. Thank heaven, as ever, for the sane and wise words of NHS Confederation acting chief executive Nigel Edwards, whose ubiquitous media presence meant that some of the context was explained.
At almost the same time as the government was trying to whip up a frenzy over management consultancy spending, it announced a review of the clinical excellence and distinction awards
The government’s announcement of the findings read exactly like the kind of bulletin released by opposition parties during the dog days of August and designed to bring the relevant minister scuttling back from their summer holiday to combat the press furore. As with other politically led announcements made over the summer, the tone and content had many DH officials cringing with embarrassment.
So why do it? The most likely reason seems to be as a diversionary tactic. It is better for the government for attention to be focused on the record of the last administration than the challenges to come.
At almost the same time as the government was trying to whip up a frenzy over management consultancy spending, it announced a review of the clinical excellence and distinction awards given to medical consultants. The news received a tiny proportion of the coverage given to the management consultancy story. But, as a marker to future action on NHS spending, it is of much greater significance.
There is a growing awareness in the NHS that getting a tighter grip on the additional and incremental aspects of NHS pay is the main ingredient of delivering the £15bn of savings likely to be required by March 2014. This review of existing contractual entitlements is likely to be wide ranging and affect most staff. It is also likely to be the biggest cause of strife in the service over the next three years - and no diversionary tactic will disguise that.
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Readers' comments (4)
A Harris | 26-Aug-2010 11:41 am
Very well said Alastair. There has been a lot of exaggerated negative comments from this Secretary of state intent on causing anxiety. Any leader should know that a nervous workforce is unhealthy.
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Anonymous | 26-Aug-2010 7:28 pm
NHS spending debate focuses on the right type of consultant. The difference between management consultants and medical consultants is that if management consultants did not turn up for work, no patient would notice any difference. The only people who would be worse off is PCT and SHA board directors who would now have to do the work themselves. The latter would not be possible because they don’t have the skill or capability, despite receiving vast salaries and huge pensions.
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Anonymous | 26-Aug-2010 8:00 pm
As a GP myself, I wholeheartedly support the argument proposed by this editorial. The amount of management consultancy spend in the NHS is a drop in the ocean compared to the largesse of NHS Consultant salaries/pension arrangements (and for that matter, GP 'profits'). By the way the Secretary of State speaks, anyone would have thought that the management consultancy spend was half of the NHS budget, not less than 0.5%. This is a huge diversionary tactic which everyone is falling for. Unless dysfunctional and unproductive clinical behaviour is challenged, we will get absolutely nowhere with the huge task ahead of us in the coming years.
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Palladian | 27-Aug-2010 8:53 am
A differentiation between management consultant and IT consultant would also be helpful. Beyond the wit of any politician regrettably. Further refinement still would separate Big Four 'lean' programmes with their Six Sigma bells and whistles and the smaller specialists who can make a real difference - even if it's simply doing a piece of work that no one else wants to touch with a barge pole.
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