Secretive Sustainability and Transformation Plans are likely to have cost NHS over £16 million in management consultancy fees

Underfunded NHS clinical commissioning groups could be spending over £16 million between them, for advice from management consultants on the secretive shake-up of health and social care in England.

Unite, with 100,000 members in the NHS, said that health secretary Jeremy Hunt needs to come clean on the spending on management consultants in relation to the 44 Sustainability and Transformation Plans (STPs) for England.

Unite calculated that £15 million is the likely cost, after the media revealed that NHS chiefs in Coventry and Warwickshire had forked out £343,000 to PricewaterhouseCoopers (PwC) for advice on saving money in their local STP plan.

However this may well be a significant underestimate. The British Medical Association has just reported that health leaders drawing up the North Central London STP have paid £2.3m to eight different companies – including accountants Deloitte and management consultants McKinsey – for services stretching from ‘administrative support’ and ‘financial modelling’ to ‘communications support’.

Upper Calder Valley Plain Speaker reported in October last year that the 11 West Yorkshire and Harrogate Clinical Commissioning Groups had between them paid £378K to management consultancy company Attain  to set up and run the West Yorkshire Sustainability and Transformation Plan Programme Management Office.

At a February 2016 meeting, the 11 Clinical Commissioning Groups in West Yorkshire and Harrogate decided to commission Attain on an interim basis to work alongside NHS staff as part of the West Yorkshire Sustainability and Transformation plan – also known as the Healthy Futures programme.

Attain’s role between April and October 2016 was to give immediate, short term support following NHS England planning guidelines on STPs that was issued in December 2015.

Here is Attain’s case study description of what they did.

Management consultancy McKinsey is the author of the NHS underfunding crisis

If each of the 44 STPs spent a similar sum on management consultants, the figure could reach at least £15 million – money which could have helped deal with the NHS “winter crisis” – which is more the culmination of a six year underfunding crisis and as such is entirely a manufactured crisis.

When the Coalition government came to power in 2010, they enforced five years of  “efficiency” cuts which aimed to cut £30bn NHS spending. This so-called Nicholson challenge was itself the result of another management consultancy company’s advice.

The New Labour government brought in McKinsey to tell them how to cut £20bn from NHS spending, after they had emptied the Treasury coffers to bail out the criminal and feckless bankers in 2008.

The Coalition government not only enforced the McKinsey-inspired “efficiency cuts” on the NHS, they also gave the NHS less than 1%/year increase in funding  – far below the rising costs each year that are associated with population growth and inflation in the costs of drugs and medical technology.

The kiss of death leading to the current crisis in NHS hospitals and GP services has been the introduction in 2016-16 of Sustainability and Transformation Plan financial controls that are aimed at cutting the massive hospital deficits now, in order to eliminate them in the next financial year.

And devil take the NHS staff and patients.

Unite national officer for health Sarah Carpenter said:

“Unite is calling on Jeremy Hunt to come clean on how much management consultants are being paid for so-called advice on STPs.

“Any such funds would be much better spent on frontline services, such as under pressure A&E departments, rather than on jargon-filled reports.

“The NHS is reeling from a starvation of cash. The health service is at crisis point and we have not yet reached the worst of the winter weather.”

STPs aim to cut £22bn NHS spending by 2020/1 and open the NHS wide open to American health insurance companies

Simon Stevens, the head of NHS England, may have belatedly raised serious concerns at the government’s insufficient level of NHS funding – but it was his idea to impose the STPs, with the dual aim of:

  • cutting at least a further £22bn of NHS costs by 2020/1 (compared with what would need to be spent if current levels of spending were to continue until then), and
  • transforming the NHS in line with the American private health care “ecosystem” – the better to allow American health care companies, like his former employer United Health, to take over the NHS.

NHS England, and the Clinical Commissioning Groups it instructs, constantly blame  “an aging population with complex needs” for the manufactured NHS crisis, despite authoritative evidence that this is not the cause of greatly increased costs.

Beware any post-Brexit free trade deal with the USA

This false claim is basically a marketing ploy designed to lead to a demand for goods and services that can drive sales of American insurance, medical devices and record-keeping technology.

In 2011 Simon Stevens said that the worldwide need for health care in aging populations would do exactly this.

At the time he was president of global health at the American health insurance company UnitedHealth and a member of the Alliance for Healthcare Competitiveness (AHC), which was urging the U.S. government to build its foreign free-trade policy around the health care industry, noting that the sector has been a significant jobs creator since the recession began in 2008.

The Star Tribune reported that AHC leaders said that breaking down tariffs and other forms of international discrimination against America’s “health ecosystem” would allow U.S. companies to rescue the American economy by hiring more people.

Simon Stevens’ Five Year Forward View for the NHS 2015-2020 and the STPs that are to speed up the imposition of the 5 Year Forward View are all about replicating American’s “health ecosytem” in the NHS.

Meanwhile, the Tory government is wriggling off the hook of responsibility for the NHS by claiming that the 44 STPs are nothing to do with them, but are purely local matters.

Join the Howl against the STPs in Leeds on 28th January, 11am-12.30pm, outside BBC Leeds, 2 St Peter’s Square, Leeds LS9 8HA.

Updated 21 January 2017 with information from the BMA about  £2.3m paid to private companies for services ranging from ‘administrative support’ and ‘financial modelling’ to ‘communications support’ for drawing up the North Central London STP

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