PCT spending on external consultants triples in just two years
By Steve Nowottny
PCT spending on management consultants has more than tripled in the past two years as NHS chiefs throw millions at the private sector, a Pulse investigation has revealed.
Our analysis of figures from 62 PCTs obtained under the Freedom of Information Act found that each PCT is now spending an average of £1.217m on external consultants – up from £361,000 since 2006/7.
The cost of legal and professional fees has also risen dramatically, bringing the total paid to external companies to an average of £1.568m per PCT.
The revelation comes a month after PCTs were ordered to cut referrals and follow-up outpatient appointments to save money.
Individual PCTs have paid consultants hundreds of thousands of pounds for support with the Government's flagship World Class Commissioning project, while GP-led health centre procurements, polyclinics and local access initiatives have added to the enormous costs.
NHS Tower Hamlets, hailed by ministers as a trailblazing PCT, reported the heaviest use of external consultants. It spent £5.682m on various projects last year, an eightfold increase since 2006/7, claiming there were ‘clear benefits' for patients.
Dr Anna Livingstone, a GP in Tower Hamlets, said: ‘I'm concerned about these vast levels of expenditure on consultancies – out of all proportion to NHS pay – and the lack of transparency. Many of us are concerned that this is part of the marketisation of care.'
McKinsey, PriceWaterhouseCoopers, Tribal Consulting and Finnamore Management Consultants were among those employed by multiple trusts across the country.
McKinsey – a company that Pulse revealed last week has been hired by the Department of Health for an undisclosed fee to develop a model balanced scorecard for PCTs – last year was paid more than £4m by Tower Hamlets alone.
The BMA reacted furiously to the findings, warning that a ‘huge sum of money' had been taken away from patient care.
GPC negotiator Dr Chaand Nagpaul said: ‘It is extremely concerning that such large sums are being spent on management consultants, in the absence of any evidence of their effectiveness. It's ironic that at a time when GPs are unable to receive the resources they need to make PBC work, we're seeing money thrown at the private sector to advise PCTs.'
Although some of the consultancy contracts related to clinical work, a clear majority were for business advice, many linked to the World Class Commissioning drive.
NHS South West Essex, which saw its spending on consultants rise by more than £3m last year, blamed the rise on filling staff vacancies, organisational changes resulting from World Class Commissioning and the separation of its PCT provider arm.
NHS Richmond spent £243,276 on World Class Commissioning in 2008/9, while NHS Great Yarmouth and Waveney spent £150,000 on the same strategy and a further £48,578 on ‘the development of a World Class Communications and Engagement Strategy'.
Dr Nigel Watson, chief executive of Wessex LMCs, said private companies were ‘champing at the bit' to take a greater role in commissioning: ‘If you want 16-year-old spotty accountants running the health service, that's where some people in Government see us going next.'Dr Nigel Watson: 16-year-old spotty accountants running the health service Dr Nigel Watson: 16-year-old spotty accountants running the health service