Feature Health Politics

Behind closed doors: how much power does McKinsey wield?

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e2905 (Published 09 May 2012) Cite this as: BMJ 2012;344:e2905
  1. Peter Davies, freelance journalist
  1. petergdavies{at}ntlworld.com

It’s the most envied management consultancy in the world, and more than a third of its health consultants are medically qualified. But does the enigmatic McKinsey and Company have undue influence over UK health policymakers? Peter Davies reports

McKinsey's offices in London: could the company really have inspired the NHS changes?

CHRIS BATSON/ALAMY

A flurry of indignant questions from opposition peers briefly distracted the House of Lords earlier this year as the Health and Social Care Act was still wending its way through the upper chamber.1 They demanded to know, following a Sunday newspaper report,2 what influence the management consultants McKinsey and Company had had on the NHS reforms and whether any involvement gave rise to conflicts of interest. Were their lordships on to something, or had they succumbed to conspiracy theory?

McKinsey’s elite image is envied by other management consultancies. Established in the United States in 1926, it is renowned as the founding father of the industry, and its clients include the world’s biggest and most successful enterprises. Its staff, sometimes dubbed the “Jesuits of capitalism” for their perceived radical and zealous approach to corporate strategy advice, boast formidable intellectual firepower. McKinsey has a prestige and mystique that others lack. It is said that no one was ever sacked for hiring McKinsey.

Its global health practice comprises 400 consultants, including 150 with medical qualifications. The company’s first overseas office opened in London in 1959. Yet McKinsey remains an enigmatic, even secretive, organisation, keeping a determinedly low profile and rebuffing media intrusions. It claims that this helps maintain client confidentiality; critics say it prevents close public scrutiny. It refused BMJ requests to interview staff for this article.

NHS input

Could McKinsey really have inspired the controversial NHS reorganisation that seemed to emerge from nowhere so soon after the election? Health minister Earl …

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