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Stop wasting taxpayers’ money on management consultancy for the NHS

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g7243 (Published 10 December 2014) Cite this as: BMJ 2014;349:g7243
  1. David Oliver, visiting professor, School of Community and Health Sciences, City University, London EC1V OHB
  1. david.oliver.1{at}city.ac.uk

Despite promises to reduce spending, NHS leaders continue to pour money into consultancy. David Oliver asks why

After the 2010 UK general election, the health secretary for England, Andrew Lansley, pledged to “slash” the £313m (€400m; $490m) annual spending on management consultancy, saying he was “staggered by the scale of the expenditure.”1 NHS funding was to be flat, leaving a projected £30bn shortfall over the next decade.2 “We are all in this together,” cajoled the prime minister,3 imploring NHS staff to accept pay freezes and pension changes, and culminating in recent strikes.4

Service leaders spent most of this parliament preoccupied with structural reorganisation. Departing “bureaucrats” (often experienced and competent managers) left institutions rudderless and shorn of institutional skills and memory.

In times of war, arms dealers, rebuilders, and racketeers profit from the chaos. “Disruptive innovation” has led to similar spoils for management consultants, with taxpayers’ money diverted from already struggling health and care services.

Did Lansley keep his promise to halt consultancy spending? A Freedom of Information request showed a doubling of annual NHS spending on consultancy from £313m to …

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