New figures uncovered today (March 21) by the Press Association (PA) have sparked outrage, as it was revealed that controversial sustainability and transformation plans (STPs) to reorganise the NHS are wasting millions of pounds on management consultants hired to cut services.
Freedom of information requests made by the PA found that more than £17m – at the very least – has been paid out to big consulting firms such as KPMG, PricewaterhouseCoopers (PwC) and McKinsey among others.
Unite was among the first organisations to highlight the dangers of STPs which have divided England into 44 separate regions for the purpose of achieving £22bn in savings the NHS is being forced to carry out as it suffers from severe government underfunding.
The PA found that London STPs in particular spent a significant amount on consultants. In southwest London, where services across five hospitals are being reviewed, more than £4m has been spent on management consultants, including £1,807,340 to PwC for “programme support.”
In north central London, the STP there has spent £2,235,204 on management consultants, including £360,000 to McKinsey for “mental health modelling” – all while STP bosses are seeking to review maternity and emergency surgery as they plan to “consolidate” services.
In north east London, nearly £400,000 was paid to PwC consultancy, while Carnall Farrar received £150,000.
McKinsey consulting firm was paid half a million by the Northamptonshire STP for “support for development of STP care models” and was also paid £195,000 for management support. They also paid the PR firm People, Words and Pictures nearly £60,000 for “strategic and editorial communications support”.
Cloaked in secrecy
This was not the first time it has been revealed that STPs are spending money on public relations in an ostensible attempt to divert public attention from the dark side of STPs, which have been cloaked in secrecy since their creation.
Last month, Unite discovered that the Humber, Coast and Vale STP had asked marketing and communications firms to “express an interest” in a £10,000 nine-month contract to carry out a marketing campaign that aimed to downplay cuts to NHS services.
The expression of interest stated, “Social media and ‘guerrilla marketing’ campaign to link the work of the Humber Coast and Vale Sustainability and Transformation Plan (HCV STP) with real life patient and service user experience.
“We want to turn down the noise about cuts to services and risks to the NHS, and be able to demonstrate that our population understands that a focus on quality and prevention will sustain services into the future.”
A King’s Fund report, in which STP leaders were interviewed, revealed that some leaders felt under pressure to spend money on management consultants.
“Some leaders felt that STPs had ‘created an industry’ for management consultants – and questions were raised about why money is being invested in advice from private companies instead of in frontline services,” the report noted.
“In one area, STP leaders even felt under pressure from NHS England’s regional team to increase the amount of money they were spending on management and consultancy support. One leader told us they were ‘picked out’ for not spending enough on their STP programme, compared with other STP areas in the region.”
Gravy train ‘out of control’
Unite national officer for health Sarah Carpenter said the latest findings from the PA show “a management consultancy gravy train that is completely out of control, at a time when frontline services, such as A&E departments, are stretched to breaking point.”
“Unite has been raising the alarm since last year that the highly secretive STPs in England are a Trojan Horse designed to push through an agenda of cuts and privatisation of NHS services.
“Harry Potter would need all his wizard powers to cut through the obfuscation and lack of transparency surrounding the STPs which appear to have been structured so that the public knows as little as possible about what’s happening to their beloved NHS,” she added.
“Health secretary Jeremy Hunt and NHS England chief executive Simon Stevens need to come clean as to exactly what STPs mean for millions of patients facing lengthening waiting lists for operations and to have an appointment with their GP.
“A first step would be to pull the plug on this wasteful expenditure on these very expensive management consultants and to fight for ‘real’ increases in the NHS budget. Reports that local health managers felt under pressure by NHS England to employ these firms highlight this obsession with management consultants.
“What the public wants is more doctors, nurses and paramedics, not management ‘whizz kids’ brandishing flip charts and PowerPoint presentations.”
Privatisation by stealth
Unite is especially fearful that STPs – which the union has dubbed “Slash, Trash and Privatise” plans – are a smokescreen for further privatisation of the health service by stealth.
Even NHS England Director of Strategy Michael McDonnell told the Health Service Journal last year that STPs were “very much going to be how we think about the future”, and that they offered private and third sector organisations an “enormous amount of opportunity.”
This privatisation threatens to be turbocharged after chancellor Phillip Hammond announced in his latest budget an additional £325m in funding set aside specifically for STPs.
Carpenter said that such privatisation must be challenged.
“We need to step up our campaign to roll-back the tide of the profit-hungry private providers that are gaining an increasing foothold in the NHS – where the profit motive trumps patient care,” she said. “The STPs are a Trojan Horse designed to promote that perfidious agenda – they need to be fought tooth-and-claw.”
Carpenter pledged too that Unite will be lead in the campaign “to raise awareness as to the real impact for people in their local communities and the adverse impact on much-valued NHS services, such as the possible closure of A&E units.”
Find out more about Unite’s campaign against STPs here.