Intended for healthcare professionals

Observations Body Politic

Why the NHS needs management consultants

BMJ 2010; 341 doi: (Published 01 September 2010) Cite this as: BMJ 2010;341:c4729
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}

    To become commissioners, general practitioners will need all the help they can get from whatever source

    Consultants in the NHS come in two flavours. Both are well rewarded; but while hospital consultants are more or less immune from criticism, management consultants get it in the neck from every point of the compass. If you are looking for easy applause, denounce the money wasted on management consultants.

    That’s exactly what England’s health secretary, Andrew Lansley, did recently, declaring that he was “staggered” by the amount the NHS had spent on consultancy services in 2009-10. Given his background as a former deputy director general of the British Chambers of Commerce (1987-90), he seems easily staggered, if he really means us to take this remark seriously. He must, after all, have some idea what private companies spend on consultancy services—which include, in the definition used, lawyers, surveyors, engineers, architects, human resources advisers, and marketing and communications experts, as well as management consultants.

    The NHS bill for these services in 2009-10 was £313 891 000 (€392 970 000; $487 000 000), “new figures reveal,” as the press release from Mr Lansley’s office (not the Department of Health’s media centre) puts it. Always beware of exact figures; they are there because journalists love to convey …

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