I am sure Malcolm Lowe-Lauri's opinion column on management consultants must have struck a chord with PCT colleagues who have been subjected to the turnaround process in recent months (page 17, 5 October). Although the consultants input has been valuable in some areas the benefits were not apparent in many others.

I am sure Malcolm Lowe-Lauri's opinion column on management consultants must have struck a chord with PCT colleagues who have been subjected to the turnaround process in recent months (page 17, 5 October). Although the consultants input has been valuable in some areas the benefits were not apparent in many others.

The tools produced by these consultants churn out big numbers depicting how much could be saved if you do X or do not do Y. However they do not take in to account the prevailing clinical culture, patient and population expectations and other important local factors. Apart from using numerical data from initiatives such as payment by results (which are done by ex-NHS colleagues anyway), their tools may not be superior to what local teams can and have probably come up with already.

In the brave new world what we need is not 'turnaround consultants' but 'target-achieving consultants'. This new breed of consultants will not leave behind a hefty invoice and disappear after telling us what we already knew, but will devise an action plan, implement it and realise the savings they predicted. They will work closely with the PCT teams in this challenging venture.

In this win-win situation the consultants will retain a share of the gains and the rest will go towards the PCTs financial recovery funds. On a fellowship this summer I learnt that in the US they call this 'you eat what you kill'.

This should be the way forward to benefit our patients, the taxpayer and the wider NHS, but I am afraid not our new found friends at McKinsey, PWC, KPMG et al. PCT colleagues need to develop skills and expertise to work with these consultants. They also need to ensure that clinical quality is not compromised and be able to hold the consultants to account if they do not achieve the gains predicted, ie if they dont kill they go hungry. Let us look for the great hunters out there and let the hunting begin.

Dr Padmanabhan Badrinath,
consultant in Public Medicine,
Suffolk PCT.
Writing in a personal capacity