Spare a thought for our ex-junior health minister, Ivan Lewis.
In the row over the release of Mr Megrahi, the convicted Lockerbie bomber, I noticed that a letter he wrote in his new job at the Foreign Office was being blamed for encouraging Scotland’s decision.
The NHS spent £600m on management consultants in 2005-06, according to the National Audit Office’s estimate
I thought I detected similar scapegoating when I read this week that both the General Medical Council and the Royal College of GPs want EU doctors to undergo fitness-to-practise tests before working as locums etc in Britain.
This came off the back of the unfortunate Daniel Ubani, the tired Nigerian-German who accidentally killed an elderly patient while weekend moonlighting in Cambridgeshire. Surely it is the system that allows such practices that is primarily at fault?
But scapegoating is always an aspect of human affairs. So was The Sunday Telegraph right to take a poke at the Department of Health’s use of management consultants? If we include NHS IT and purchasing, it bought £470m worth of consultancy in the three years from 2005-06 to 2007-08, according to freedom of information inquiries.
The figures are incomplete - they are too low but also appear to suggest declining use. As Commons health select committee chair Kevin Barron (Lab) was quick to point out when I rang, his team issued a sceptical report on this problem as recently as June.
Its starting point was that the NHS spent £600m on management consultants in 2005-06, according to the National Audit Office’s estimate - one fifth of the Whitehall total and a rising share, too. Officials had aroused suspicion by avoiding answering this kind of question, though since 2007-08 they have been required to specify such spending rather than bury it.
The result is that £43.4m was spent that year by strategic health authorities; £132.6m by primary care trusts; and £132.4m by NHS trusts, a total of £308.5m. The consolidated accounts of NHS foundation trusts did not separately identify consultancy costs in 2007-08.
Quite a lot of money then, but less than in 2005-06. The MPs complained that there should be a better grip on such spending from the centre, including daily pay rates of £1,000 a head or more. They did not accept Mr Nicholson’s fear that this would amount to micromanaging.
His justification was that in matters like the NHS Connecting for Health IT programme, outside expertise was needed; likewise with former health secretary Patricia Hewitt’s financial “turnaround” drive where, interestingly, the ideas for better performance came from NHS staff.
“What the consultancies gave us was the ability to execute some of these much better,” he told the MPs.
The Telegraph report focused on a different angle: the notion that a Labour government hands out such contracts to “cronies” and that insiders like Lord “Stormin’ Norman” Warner and Matthew Swindells, ex-adviser to Ms Hewitt, then leave Whitehall to work for such firms at great expense.
All involved insisted that they had abided by the rules and, at the risk of sounding naive, I believe them. Bad things do happen, but not as often as the press suggests. It is expertise they are buying, not influence-peddling.
I ran my thoughts past Professor Julian Le Grand, ex-No 10 public service adviser, who says what a good job management consultants do when you give them a policy to implement as opposed to just getting their twentysomethings to dream one up.
His complaint is that civil servants are moved too often nowadays and lack expertise or confidence; hence the resort of consultants. It’s an old pre-Labour complaint that ministers don’t rate their officials. It’s a sentiment they sometimes reciprocate.