Consultancy firms make hospitals worse

By Chris Smith - The Times 21st February 2018

The hundreds of millions of pounds the NHS spends on management consultants actually make it less efficient, the first study of its kind has concluded.

Not only are hospitals wasting their money but the consultants appear to make finances marginally worse.

Researchers said that “inefficiency is the norm” in NHS consulting projects.

Health unions reacted furiously to the “scandalous” findings, urging ministers to divert money from management consultants to doctors and nurses. Hospitals and consultants insisted that external advice was needed, but conceded that the results underlined the need for clear measures of value for taxpayers’ money.

Andrew Sturdy, professor in management at Bristol University, who carried out the study, said: “Our research has clearly shown that management consultants are not only failing to improve efficiency in the NHS but, in most cases, making the situation worse . . . this is money which, many argue, could be better spent on medical services or internal management expertise.”

Despite consistent political criticism of management spending from both main parties, the cost to the NHS has increased under both, reaching £640 million in 2014 before falling to £263 million in 2016-17.

Professor Sturdy gathered data on 120 NHS hospitals over four years, comparing spending on consultancy with an efficiency measure recording how much it cost them to carry out standard procedures. Each £100,000 spent on management consultants led to extra costs of £880, he concluded in the journal Policy & Politics.

The average trust spent £1.2 million a year on management consultants and afterwards became less efficient by about £10,600 a year. Professor Sturdy said: “The big question is what that money could have been spent on instead.”

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HCT march prompts Trump tweet - and international coverage for NHS underfunding

On Saturday 3rd February veteran "professional" campaigners, families, OAPs, NHS professionals, trade unionists and people from every part of England and Wales joined in a march of about 60,000 from outside University College Hospital in Gower Street to Whitehall. This was a repeat of the much bigger march on 4th March 2017 along almost the exactly same route.

Amazingly 2 days later it has become an international news story - at last the severe underfunding and repeated wrongheaded reorganisations which protesters reject have hit the international news headlines following a comment by Nigel Farage on Fox News and a response by President Trump - which was based on his complete misunderstanding of our NHS.

In this news piece the BBC effectively advertised: "The US health system is crap".

If you google "Fox news NHS march" you find that the march is covered in major outlets:

(1) Fox News:

(2) The  Washington Post:

(3) Huffpost  (UK edition):

(4) Sky News:

(5) The Times:

  Save Our Hospitals demonstrators as part of the Health Campaigns Together and People's Assembly and NHS campaigners in general (ALL the groups) -  have broken through onto an international stage.

Thank you, Mr Farage, for banging on about your favourite topic of immigration and blaming that, wrongly, for the pressure on the NHS.

Thank you, Mr Trump, for misunderstanding Nigel Farage's comments.

Thank you, Mr Hunt, for saying that 28M Americans don't have health cover and that [in the UK] "all get care no matter the size of their bank balance"....

Two wrongs did make a right: I am referring to proper coverage of the HCT/PA march, of course.


Stephen Hawking and leading doctors to take Jeremy Hunt to court over 'back-door privatisation' of NHS

Full judicial review granted to determine the lawfulness of the Secretary of State's proposals to introduce Accountable Care Organisations 

By Shehab Khan - The Independent - 29th January 2018 21.30


Professor Stephen Hawking has won permission to take Jeremy Hunt and NHS England to court over controversial proposals to restructure the health service, The Independent can reveal. 

Mr Hunt has tabled a plan which could allow commercial companies to run health and social services across a whole region in what critics have described as allowing back-door privatisation. 

Leading healthcare professionals and Professor Hawking have argued an act of parliament is required, allowing MPs and Lords to scrutinise the proposals, before the policy is implemented and any changes to regulations are made. 


Lawyers from the Department of Health and NHS England have rejected these claims but a court has now ruled that a full judicial review will be granted to determine the lawfulness of Mr Hunt’s proposals. 

The news comes as pressure mounts on Mr Hunt after he faced a barrage of criticism during a record winter crisis for the NHS. One in five NHS hospital trusts ran out of beds in the first weeks of winter and adult patients were put on children’s wards as trusts struggled for space. 

Under Mr Hunt’s plans the boundaries between different parts of the NHS that pay for and provide care, such as hospitals, GPs and clinical commissioning groups, would be dissolved. 

Responsibility for patients in these areas would be held by new healthcare overseers called Accountable Care Organisations (ACOs) which could lead to newly merged NHS super-organisations or a non-NHS body being awarded contracts to manage and provide entire packages of care. 

These ACOs in turn could choose to either subcontract the service or provide it themselves.  

Campaigners say this would allow ACOs to control the allocation of NHS money but their accountability for spending it and their obligations to the public would be under commercial contracts, not parliamentary statutes. 

The ruling is the latest instalment in an on-going feud between Professor Hawking and Mr Hunt, with the scientist previously accusing the Health Secretary of cherry picking and misrepresenting research. 

The Department of Health described campaigners’ criticisms about ACOs as “misleading” and “irresponsible scaremongering”. 

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Hunt's secret NHS plan opens the door to further privatisation

By Dr Graham Winyard - published by on 15th January 2018.  Dr Graham Winyard is a former medical director of the NHS and deputy chief medical officer.

Brexit's dominance of media coverage and parliamentary time is providing the perfect cover for controversial reform of the NHS by stealth. 

Jeremy Hunt and NHS England's latest big idea is Accountable Care Organisations (ACOs). These bodies would be allowed to make most decisions about how to allocate resources and design care for people in certain areas.

At the moment, that's done by public bodies whose governance is regulated by statute, set up by parliament after wide consultation and sometimes fierce debate. ACOs, by contrast, can be private and for-profit bodies. They are not mentioned in any current legislation and would have no statutory functions. They are not subject to the statutory duties imposed on other parts of the NHS.

Although NHS England plan to get several ACOs up and running this year, no detailed policy proposals have been presented to parliament or the public. Indeed, details are so sparse that the House of Commons library briefing is forced to use definitions provided by the King's Fund, a health think tank.

Hunt is planning to lay a raft of secondary legislation - which doesn't require a full parliamentary vote - in February, so that the first ones can be up and running by April 1st.

The ACOs are going to be given long-term commercial contracts of between ten and 15 years. We know these are difficult to get right and expensive to get out of. Think of Virgin and the East Coast Main Line or the private finance initiative, which has left the NHS paying hundreds of millions to offshore finance companies for hospitals that cannot now be afforded. Warnings about risks of PFI were once brushed aside as alarmist, often by the same people who now dismiss criticism of ACOs in similar terms.

I'm working with four colleagues to challenge these proposals through judicial review. Our case is not concerned with whether ACOs are a good or bad idea. That's for parliament and the public to decide, not the courts. Our case is that such a radical and significant change cannot lawfully be introduced and implemented without public consultation, parliamentary scrutiny and primary legislation. The case was filed on December 11th and clearly struck a chord with the public. They've provided £176,000 through crowd funding in over 6,000 donations.

We are also deeply concerned that by using contracts instead of statute to allow ACOs to operate, the government is exposing the NHS to major risks.

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