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Even the DH likes to bash consultants now

Health ministers are busy disowning their previous pronouncements on competition and consultancy to create a gulf with the Tories

By Richard Hoey

Health ministers are busy disowning their previous pronouncements on competition and consultancy to create a gulf with the Tories



Professor Steve Field, the RCGP's genial chair, was in unusually feisty mood at the college's annual conference last week.

The millions spent by the NHS on management consultancy fees was, he declared, a ‘scandal'.

You won't get much disagreement from most GPs there, but the interesting question would be whether you would get much disagreement from the Government these days either.

You would have once – say a year ago, for instance, when the Department of Health was announcing new external consultancy schemes on what seemed a weekly basis.

First you had FESC – the Framework for External Support for Commissioners, as it was sexily called – which used companies such as BUPA to advise PCTs how they should spend their cash.

Then a second scheme was launched specifically to support practice-based commissioning, because the involvement of shiny-suited consultants was just what was needed to warm GPs to PBC.

And then McKinsey, the daddy of consultancy firms where the NHS is concerned, was drafted in to draw up a national balanced scorecard (which still hasn't seen the light of day), much to the disapproval of leading GPs.

But that was then, and these days the DH doesn't seem half so keen. Just a few weeks ago, health minister Mike O'Brien had PCT bosses breaking out in a hot sweat after laying into those who were spending on consultants as a way of ‘covering their backs'.

‘The NHS must be resolute in its pursuit of value for money, making full use of its own expertise before seeking often expensive external support,' he said.

Meanwhile his boss, Andy Burnham, has been busy rewriting the Government's approach to competition and performance management, making clear he wants NHS providers to be given two separate chances to improve before PCTs look to alternative providers.

That's been seen by some as three strikes and you're out, and in a sense it is. But it's still a good deal less scary than the Government's previous approach, which under World Class Commissioning had come worryingly close to one strike and you're out.

Feeling sorry for PCTs doesn't normally come naturally, but I must admit to just a spot of compassion for those poor trusts who must now shred six months' of WCC planning and stoically start over.

So why the change of heart? What, after 12 years of merrily playing the bad guy, has suddenly made the DH come over all fluffy?

It's unlikely to be sudden empathy with GPs, particularly since – as our poll last week demonstrated – not too many are likely be sending their votes Labour's way.

But votes do have everything to do with it, all the same. Labour always used to calculate that as long as the Tories were bog-eyed and scary, it could win elections on personality without there being much policy difference between the parties.

With Gordon Brown in charge, winning on personality isn't an option.

Which is why Labour are scrambling around for ways of opening up a policy divide between them and the Tories.

Management consultants, like bankers, are ripe for bashing.

By Richard Hoey, Pulse editor

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