THE NHS in England spent an estimated é1 billion last year on management consultants - a figure that would "dwarf" the funding deficit in the health service, the leader of the UK's hospital consultants said today.
Dr Paul Miller, chairman of the British Medical Association's consultants committee, has called for a halt on the use of external management consultants in the NHS and blames funding deficits on "bad policies" and "shocking incompetence" inflicted on the service by Whitehall.
In a speech to the hospital consultants' annual conference in London he warned that the Government risked destroying the NHS if it continued to waste money through misguided NHS reforms and schemes such as the public finance initiative (PFI).
He said: "Care is suffering, jobs are disappearing, patients and staff are paying the price. If a patient gets worse instead of better with treatment, then it's time to figure out whether the diagnosis is wrong.
"Something is going very badly wrong with these health policies. It is time to call a halt."
In his speech he denied that the funding deficit in England was caused by the new contracts for consultants. He said the deficits were clustered in a few areas and were caused by "local service management and strategic planning failure" often caused by political interference with proper local service planning.
Dr Miller called for managers and politicians to give up some of their power and control and to understand that the health system would never be as good as it should be until NHS consultants were running the organisations in partnership with managers for the "good of patients".
He said there should be no more external management consultants brought in to tell clinicians and managers how to run their services.
"They have no special knowledge, they don't know better," he said.
'Depoliticise'
He called for the NHS to be run by an independent body in order to "depoliticise" it. There should also be a halt to signing off any more contracts for further Independent Sector Treatment Centres (ISTCs) with the existing centres integrated "properly" with NHS patient services, he said.
Dr Miler cited a number of examples of where money had gone.
They included:
* Surrey and Sussex, a trust with "big debts", which paid more than é52,000 for less than two months' work from an interim chief executive from a management consultancy in February and March 2005. According to Dr Miller, the finances remained dire, so the strategic health authority brought in more management consultants, McKinsey, for é500,000.
* A chief executive on an NHS trust in North West England left after a critical external report, yet received a é475,000 pay-off.
* At the start of the year, the Health Secretary sent "turnaround teams" from management consultancies into 18 trusts with financial difficulties. Dr Miller wrote to the health secretary asking for the cost of these teams and received no reply.
But the figures leaked out anyway, he said, showing a é100,000 cost per month at Leeds, and é700,000 in three months at Surrey and Sussex trust, which still finished the last financial year with an operating deficit of é28 million and accumulated deficit of over é57 million before bail out money.
* Trusts already paid "handsomely" for their managers, with the annual report for 2004-2005 showing one trust paid its executive directors é1.2 million that year.
Dr Miller said there had been a "huge waste" of NHS money through PFI schemes. The Paddington Basin PFI ran up é14.9 million in costs before being abandoned, he said.
A two month "ministerial" delay to the private finance initiative to develop Bart's Hospital in central London was said to have cost é35 million.
Dr Miller said he understood that PFIs had been used to get large amounts of capital investment into the health service quickly. But he warned the Government could not bring NHS spending up to the EU average for just a couple of years and expect to have corrected "decades of underspending amounting to hundreds of billions of pounds".
"The good levels of NHS funding must continue permanently to bear fruit," he said.
SHOULD government call a halt on external management consultants for the NHS? Have your say.
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On top of all of the above,health tourism is also a huge drain on NHS resources.For example,anyone who wished to,including police,could go to Manchester Airport Terminal 2 any Tuesday morning and watch the PIA flight arriving.
They would see that approx.half of the passengers are heavily pregnant ladies.They would also observe that the departure queue for the return flight contains an unusually high proportion of new born babies.Coincidence or what? I know where they have been;my wife used to work in maternity at a Manchester hospital!
It is not as black and white as simply saying, call a halt to external consultants. There is a place for them but only when accredited and experienced consultants with an impressive track record are used. Contracting an 'independent' solo consultant who just happens to be Joe Bloggs who used to work for the trust and has now been brought back in is not the answer. The second and most important point is that many valid and acceptable consultancy reports that are commissioned, in my experience in the NHS, end up being disregarded for whever reason and placed into a cupboard and forgotten about. They invariably demonstrate that if their recommedations are put effectively into practice then short, medium and long term operational, clinical, strategic and financial benefits will be realised. The problem is 'it all seems too much trouble'. The consultants get paid, the report gets shelved and then the trust gets the blame for wasting money on consultants and not showing any results! If you take your car to a garage and the mechanic carries out an examination and says that if you do not implement his recommendations for repairs, your call will fall apart and you will probably crash and you subsequently pay him his examination fee and then ignore his advice, guess what, your car will eventually crash and fall apart!
Should we call a halt to the management consultants' gravy train? Difficult question that. perhaps we should pay some management consultants to advise us on the answer?