Well Don't Say I Didn't Warn You!

Under the Blair and Brown Governments 'watch', over the NHS, more services both for Health care and for Government generally, were outsourced. A revolving door, between the DofH and many of the 'Big Four' accountants and consultants, was established with ex NHS Commissioning czar, Mark Britnell, becoming a KPMG Partner in October 2009.

We now hear, that KMPG Health  has won a contract with NHS London, worth.... well who knows? You see, even though, some of that cash, is mine (and yours), it is now a commercial 'secret', between the new 'pathfinder' consortia, and those with whom they contract, for services. If I believed for one moment that this would be a helpful development, or one that would yield cost savings, or efficiencies, I would be applauding. But I am not.

The involvement of management accountants, in Health care (or anything, if it comes to that)  has done little or nothing, to make it better, or save money. The converse is true. The expansion of 'the management', in the NHS, was almost always preceded, by some Consultant report, demonstrating it's need. Then of course, offering to recruit the needed 'management', or often providing it, as a service. A very large proportion of the ever burgeoning budget in the NHS, was consumed by these pariahs.They were responsible, in the main, for the stupid and expensive, PFI and PPI Projects, that delivered, less. Less beds, nurses, care (fill the rest in yourselves); all for more than it cost before.

The concept, that involving 'any willing provider' and invoking the profit motive, will drive down costs is highly flawed. Witness the view from 2006 of Allyson Pollock of the huge cost of PFI projects in the NHS, which has driven up costs for Trusts out of all proportion to the benefits involved. Or indeed the £12.4 billion squandered on the NHS IT project that never worked, and likely will be entirely cancelled. The 'big four' were heavily involved in the design and execution of all of these failed policies, reaping enormous fees for them and 'bugger all' for the NHS and the taxpayer. Only last June, Gary Belfield, Mark Britnells successor at the DofH also left to join KPMG, no doubt rubbing his hands with anticipation of Lansleys plans and how he might ' turn a dollar' from the opportunities that were now available to commercial providers, in the 'new dawn' of GP Commissioning.

This is just one of the 'buzzards' circling, to see that which they can pick off from the, dying carcase of the NHS, to their own advantage of course. Serco, the company that provides services for Government and the Military, formed a partnership only last year, with Guys and St Thomas' Hospital, to undertake pathology work for itself and other Hospitals. A year down the line, concerns are being voiced about governance, security, and other problems, especially one of cost increases, that had to be paid to the new body as a result of increased demand, amounting to some £2 million (as reported by Private Eye). Increased demand, is endemic in hospital laboratory testing, simply due to the nature of the beast. So long as the NHS, continues to treat for prevention, with surrogate end points and markers, it's patient cohort, it will have to test to prove they are being achieved. It's the climate that surrounds QOF protocols, that drives this. A sort of convoluted, payment by results system, that eats money and will continue to do so, for as long as health care is tied to this barmy concept.

Only yesterday, it was revealed that the estimated cost of overhauling the NHS, to favour GP Commissioning, over that which exists, will be £1.5 billion. This vast sum, will no doubt go to largely to the 'big four' because it always seems to. They will be heavily involved, without doubt. The revolving door between Government and them will see to that. Oh, and of course, we should not lose sight of the fact, that the 'big four' were complicit in the Banking crash, we are all paying for. They helped to design some of the models of profligate lending, and audited the results without demur.