Shouldn’t it have been highlighted in the risk assessment? How come the monitoring process didn’t highlight it?
No doubt there are many lessons to be learned from the failure of G4S, the company formerly known as Group 4 Security and Securicor, to find enough security staff for the Olympics, even in a depressed labour market.
Weary NHS managers will observe how handy it remains to have a public sector – in this case the army – to sweep up when big business fails. And they’ll wryly note that since G4S is a huge private firm, rather than a fairly large NHS body, the core problem clearly couldn’t have been poor management.
There’s an age-old axiom: don’t put all your eggs in one basket. If you must, at least check the wickerwork is sturdy and the person carrying the basket is sensible.
Reflect for a moment on how much of the “Nicholson challenge” is supposedly being delivered through back-office efficiencies, and the NHS’s reliance on shared business services as the route to serious savings. Now consider last week’s Commons public accounts committee report on the experience of five large shared service centres established since 2004, and the widening gap between hope and reality. The plan was to save £159m by 2011. The reality? One centre, operating for the Ministry of Justice, broke even.
Two, the Department for Work and Pensions and the Department for Environment, Food and Rural Affairs, could not track their total savings. And two, the Department for Transport and Research Councils UK, reported a net cost of £255m.
Meanwhile the five centres had cost £500m more than budgeted to build and operate.
By comparison, the Department of Health joint venture with Steria, which proudly presented a “royalties” cheque for £1.2m to the NHS last year, is a sparkling success story.
But there’s a big difference between £1.2m, which would barely buy a house in many London boroughs, and a savings aspiration of somewhere over £3bn. And issues highlighted by the public accounts committee report, including low take-up of shared services, are equally relevant to the NHS.
So where’s the risk assessment? And where’s the monitoring?