Wednesday, November 9, 2011
NHS & Regulators: McKinsey & COI
Not too long ago in Iceland
Governments never seem to learn: In Health Care Death is Irreversible!!!
The Guardian:
A global consultancy firm seeking to profit out of the fallout from the shake-up to the NHS is being paid £250,000 a year by the government for advice on the transition towards health secretary Andrew Lansley's vision of the service.
The American firm, McKinsey Inc, with estimated revenues of £4.1bn a year, has been advising the Department of Health on how best to manage the radical changes since March. McKinsey is also one of a group of private consultants that have united to provide paid-for advice to GPs as they prepare for life after the reforms.
Family doctors need help from private companies because of the government's decision to abolish primary care trusts as part of their controversial changes to the health service, a move criticised as a step towards privatisation.
An earlier post:
There is much talk of the role of the regulator Monitor in safeguarding our health care.
Perhaps we should look at our most famous regulator: FSA. (Financial Services Authority).
The FSA was dragged into the news recently as its first head Sir Howard Davies, resigned as director of London School of Economics for eight years over "a mistake". The "mistake" was to advise the LSE's council to accept £1.5m research funding from a foundation controlled by Colonel Muammar Gaddafi's son, Saif. More>>>>>>>>>
So, were there any other "mistakes" when he was head of FSA?
Independent:
17 July 2008
The Financial Services Authority will be dealt yet another hefty blow to its credibility today, as the Parliamentary Ombudsman, Ann Abraham, reverses her decision of five years ago and accuses it of maladministration for its role in the collapse of Equitable Life eight years ago.
"The case of Equitable Life, which echoes earlier cases such as Vehicle & General in the 1970s and shares some similarities with the current example of Northern Rock, illustrates the need for absolute clarity as to what can and cannot be expected from financial regulation and the development of shared understandings as to the limits to the protection that such regulation offers to investors both before and after problems arise, as they inevitably will," said Ms Abraham.
"Key, however, is that those responsible for undertaking financial regulation should act in a way that is compatible with the duties and powers which Parliament has conferred on them. Those responsible for the prudential regulation of Equitable Life failed to do so throughout the period covered in my report."
Sir Howard Davies was previously employed by McKinsey and Company and was Special Advisor to the Chancellor of the Exchequer.
I was reading a book by Philip Delves Broughton on Harvard Business School
From Royal Bank of Scotland to Merrill Lynch, from HBOS to Lehman Brothers, the Masters of Disaster have their fingerprints on every recent financial fiasco.
Mediocre But Arrogant, Mighty Big Attitude, Me Before Anyone and Management By Accident.
For today’s purposes, perhaps it should be Masters of the Business Apocalypse.
On RBS (Royal Bank of Scotland)
When I was a student at Harvard Business School, between 2004 and 2006, I recall a distinguished professor of organisational behaviour, Joel Podolny, telling us proudly of his work with Fred Goodwin at RBS. At the time, RBS looked like a corporate supermodel and Podolny was keen to trumpet his role in its transformation. A Harvard Business School case study of the firm entitled The Royal Bank of Scotland: Masters of Integration, written in 2003, began with a quote from the man we now know as Fred the Shred or the World’s Worst Banker: “Hard work, focus, discipline and concentrating on what our customers need. It’s quite a simple formula really, but we’ve just been very, very consistent with it.”
When I was a student at Harvard Business School, between 2004 and 2006, I recall a distinguished professor of organisational behaviour, Joel Podolny, telling us proudly of his work with Fred Goodwin at RBS. At the time, RBS looked like a corporate supermodel and Podolny was keen to trumpet his role in its transformation. A Harvard Business School case study of the firm entitled The Royal Bank of Scotland: Masters of Integration, written in 2003, began with a quote from the man we now know as Fred the Shred or the World’s Worst Banker: “Hard work, focus, discipline and concentrating on what our customers need. It’s quite a simple formula really, but we’ve just been very, very consistent with it.”
Harvard Business School alumni include Stan O’Neal and John Thain, the last two heads of Merrill Lynch, plus Andy Hornby, former chief executive of HBOS, who graduated top of his class. And then of course, there’s George W Bush, Hank Paulson, the former US Treasury secretary, and Christopher Cox, the former chairman of the Securities and Exchange Commission (SEC), a remarkable trinity who more than fulfilled the mission of their alma mater: “To educate leaders who make a difference in the world.”
Q 195 Jeremy Lefroy (Stafford ) (Con): I have a couple of questions about the role of Monitor. The first is about the Mid Staffordshire trust into which the Francis inquiry is looking at the moment. It seems to me as the local Member of Parliament that Monitor approved the foundation trust status without going into sufficient detail as to the status of that trust, particularly the quality of care at the time. What assurances can you give us that Monitor’s approval of foundation trusts will be more rigorous in the future than it was in the case of Mid Staffordshire?
David Bennett: Yes. I was not around at the time, but looking at the evidence, the trust was approved at a time when it was not delivering appropriate care to its patients, and that was wrong. Monitor has done three core things in the light of that, all based on an external review of what happened and why, and therefore what lessons can be learned. First, it has set a clear quality bar. That did not exist before—there was no clear definition of what was an adequate level of safe care for any trust to be providing to be authorised. In conjunction with the CQC and the Department of Health, there is now a clear definition of what the quality bar should be.
Q 196 Jeremy Lefroy: Sorry, are we saying that there was not a clear quality bar for approval of foundation trusts up till now?
David Bennett is the current head of Monitor (a sort of health FSA!)
David was a Director at McKinsey & Co. In his 18 years with McKinsey he served a wide range of companies in most industry sectors, but with a particular focus on regulated, technology-intensive industries.
There were more:
ISTC
Q 203 Mr Barron: I was on the Health Committee during the previous Parliament, when it looked into the independent sector treatment centre programme. I had conversations with more than one company running the programme that said they felt threatened by the pensions implications, with the work force working in the independent sector while keeping the NHS rewards such as pensions. I call them distortions, but most of us have one. By implication, what does that mean?
David Bennett: I think again of Sonia’s point. There are lots of considerations. Yes, pensions are an issue, but as someone said there is an issue around the complexity of the cases that we have dealt with.
Q 204 Mr Barron: I accept that. ISTCs were contracted for cases that were not likely to go wrong in surgery, because there was no back-up in the hospitals or institutions if someone needed to go into ITU, and so on. I understand that exactly.
Sue Slipman: The only thing I would add is that it is clearly the public sector that is carrying the responsibility for the education and training of people across the system as a whole. There are balances here in those imbalances, and we would certainly be pressurising Monitor very hard to take them into account.
Trust!
Emily Thornberry: I am tempted to press you further, David, given the profound implications of what you said in relation to work force pensions. We are about to pass this legislation and you are saying, “Take it on trust, as it will all be sorted out.” But we are talking about millions of people’s pensions here, and it is difficult not to push you at this stage.
Worse than that, you said in an incomplete answer earlier that there were other obvious distortions and advantages that the NHS had over the private sector. I wonder whether you could list anything else, on top of pensions, that you might think might of?
David Bennett: I said that obvious distortions are creating advantage within the NHS. I was also saying that there are other distortions in the market, and Sue has just pointed out two of them. At the moment, it is the public sector that has to pay for R and D, and it is the public sector that pays for training. That places the public sector at a disadvantage. That needs to be taken into account.
Related:
NHS & Market Forces: Uncomfortable Readings!!!
Labels: NHS
Tuesday, November 1, 2011
Greek Gods & Euro: Bevan Curse & McKinsey
© Am Ang Zhang 2011
It is interesting to be revisiting Athens
The question is:
Should you be holding Euros, you may wish to exchange those whose serial numbers begin with a Y, M or T for those whose numbers start with an X.
Why? Well, in doing so you will swap euros issued by, respectively, Greece, Portugal and Ireland – the three most troubled members of the eurozone – and get in return euros issued by the Continent's economic powerhouse, Germany.
Nearer home, we have the Bevan Curse:
Poor old McKinsey, how long can it last now that it has invoked the Curse of Nye Bevan? The cult management consultancy was a prestigious global brand until this morning when it was revealed to have urged the NHS to sack one in 10 of its staff to help balance the bankers' budgets.
As a result of the Health Service Journal's scoop (I write a politics column for HSJ) the politicians have already been rushing into the TV studios to declare their undying ardour for the British way of health.
All they dare admit by way of criticism is that it must become more efficient, which indeed it must. So must we all. But what about McKinsey & Company, now that it has provoked the ghost of Nye, founder of the NHS and the swashbuckling Churchill of the left?
Nah, no way, this is the 21st Century.
But hang on:
It took care of Daniel Hannan & Sarah Palin.
Looks like one of their most famous sons is now in trouble:
On Wednesday, a federal grand jury in Manhattan charged Mr. Gupta, 62, with one count of conspiracy to commit securities fraud and five counts of securities fraud. He is accused of sharing corporate secrets about Goldman and Procter & Gamble with Raj Rajaratnam, the co-founder of the Galleon Group who was sentenced to 11 years in prison earlier this month for insider trading.
…….The government has taken aggressive action against insider trading. In the last two years, the government has charged 56 people with swapping illegal tips, including Mr. Gupta; of those, 51 have pleaded guilty or have been convicted.
With Mr. Gupta, the campaign has moved beyond financial professionals. As the head of McKinsey & Company, the prominent consulting firm, Mr. Gupta advised some of the world’s most influential people, rubbing elbows with the chief executive of General Electric, Jeffrey R. Immelt, and the former President Bill Clinton.
"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan
Greece again:
(CNN) -- As the dust settled after the latest agreement was struck to solve the Eurozone debt crisis, French President Nicolas Sarkozy admitted it had been a "mistake" to admit the stricken Greeks into the monetary union.
"Let's be clear; it was a mistake," Sarkozy told French television.
"Greece
Related:
Friday, May 13, 2011
McKinsey: Galleon, Railtrack & The NHS
McKinsey does not make many mistakes when promoting someone to the partner level: not normally? They never make a mistake when promoting to Director level. Well, maybe not until now.
The Galleon Case
The trial of billionaire hedge fund manager Raj Rajaratnam on securities fraud charges was being watched closely both in the United States and abroad – and not just because prosecutors went after one of the top hedge fund managers in the world, but because it represented the potential for a new wave of prosecutions aimed at curtailing what many believe is a widespread practice of trading on insider information through a secret network of well-placed sources. Now that prosecutors gained convictions on all counts against Rajaratnam, expect more of these cases to come.
Mr. Kumar earned several million dollars a year as a senior executive at McKinsey. He had a gruelling work schedule, travelling some 30,000 miles a month, consulting for corporate clients across the globe.
Underpaid
In 2003, Mr. Rajaratnam, who was fast on his way to becoming a billionaire, told his business school classmate that he was underpaid.
“You work hard, travel a lot; people made fortunes while you were away and you deserve more,” he said he was told by Mr. Rajaratnam.
Mr. Kumar would later depict himself as a reluctant felon, initially rejecting Mr. Rajaratnam’s offer. But after they devised an elaborate scheme to hide the payments — opening a Swiss bank account and then transferring funds from it into a Galleon account in the name of Mr. Kumar’s housekeeper — he began moonlighting as a private consultant to Mr. Rajaratnam.
Mr. Kumar pleaded guilty to providing inside information to Mr. Rajaratnam in exchange for cash payments of at least $1.75 million from 2004 through 2009.
In the late 1990s Mr Corbett commissioned McKinsey to devise a blueprint for the company. The central recommendation that came out was that Railtrack should "sweat" its assets. This meant replacing its cyclical system of rail maintenance with a programme where infrastructure was mended on an as-and-when basis. "The theme was very much that we should get the most out of the assets before we renewed them," says a Railtrack insider.
The Independent: The might of the McKinsey mob
Network Rail: Potters Bar
Judge Bright and some of the bereaved families highlighted the fact that, as NR is a not-for-dividend company with no shareholders, any fine for NR would have to be paid from what the judge said was "an income which is substantially derived from public funds".
Perdita Kark, the daughter of Austen Kark, one of the passengers who died in the crash: said: "It's offensive that I pay a fine for something that killed my father."
Train drivers' union Aslef said it was "ludicrous that managers responsible for rail safety walked away unscathed while the public picks up a £3 million bill".
NR said it accepted the fine "as we accept the liabilities inherited from Railtrack".
NR's predecessor Railtrack was the infrastructure company in charge at the time of the crash but NR has shouldered the responsibility.
.
And now: The NHS.
David Bennett is now Chairman of Monitor and he was a Director at McKinsey & Co. In his 18 years with McKinsey he served a wide range of companies in most industry sectors, but with a particular focus on regulated, technology-intensive industries.
As hospitals face fines by Monitor and even closure, whose money would that be!!!
Dr Sarah Wollaston
Dr Sarah Wollaston
“It is not Greeks that could destroy the NHS, but if Monitor, the new economic regulator, is filled with competition economists with a zeal for imposing competition at every opportunity, then the NHS could be changed beyond recognition.
It is no use "liberating" the NHS from top down political control only to shackle it to an unelected economic regulator.”
Links:
Jobbing Doctor: Cracks appearing
Thank you to the Nurses, who savaged Andrew Lansley's proposals at their conference. To Colin Leys and Stewart Player for their book "the Plot against the NHS". To Allyson Pollock for all her work in exposing the marketisation of the NHS. To the bloggers (especially Jon Tomlinson at a betternhsblog, richard blogger at conservative policies dissected, Dr Grumble at Dr Grumble and there are others as well including Witch Doctor, Cockroach Catcher and Dr No) who have been pointing out the threats and absurdities. To Clare Gerada at the RCGP for a timely and vital critique.
Witch Dotor: Big Data : The next frontier
Labels: NHS
Wednesday, March 9, 2011
NHS & McKinsey: Barracuda & Nye Bevan Curse
The Guardian:
“But what about McKinsey & Company, now that it has provoked the ghost of Nye, founder of the NHS and the swashbuckling Churchill of the left?
I envisage an outbreak of hospital-inquired infection sweeping through its 94 offices in 52 countries, a mysterious fire gutting its London HQ in Jermyn Street, its senior executives caught in compromising positions with choirboys and bankers.”
The Jobbing Doctor: It's begun.......
The ultimate corporate firm McKinsey (for whom the Foreign Secretary used to work) is now getting its management teeth into the NHS.
The curse extends to anyone that has worked at McKinsey too!
Really?
I need to re-post:
McKinsey: NHS & Vogue Saturday, September 19, 2009
Great Barracuda, BVI/ ©2009 Am Ang Zhang
Snorkelling can be very inspirational. I have often wondered why so many fishes stay around the Great Barracuda, running the risk of being gobbled up before the end of the day. Perhaps these fishes have not been warned. The NHS certainly has.
I read that McKinsey, one of the leading Management Consultancy firms is expected to recommend 25% cost cuts at Vogue. They have already advised a 10% staffing cut in The NHS to achieve a saving of £20 billion by 2014.
In actual fact the NHS could have saved even more money by doing away with the likes of McKinsey. A new book was published by one insider Matthew Stewart on management consultants. The Independent had the details:
Thursday, 17 September 2009
I will just pick out a few points that may be of interest.
The truth:
“Wherever I was in the world, at the beginning of every consulting project, one thing was certain: I would know less about the business at hand than the people I was supposed to be advising.”
How to impress:
“Firstly, they constructed a database of the client's customers, detailing each customer's product and transaction activity over the preceding year. Next they established a clean profit and loss statement for the whole business, including all overheads but excluding extraordinary items. Then, to allocate the revenues and costs of the business to each customer, they devised algorithms based on detailed models of each kind of product and transaction. The complexity of these algorithms, naturally, was such that they were far beyond the powers of most clients to comprehend. The result was an analysis of the exact revenue, expense, and profit to the client attributable to each of its customers. Finally, the team lined up the customers according to their profitability, thus allowing the client to see how much of its profits could be attributed to its most profitable customers, and how much to the least profitable."
The Whale Chart: "The Whale" is a graph. Its official title is "Cumulative Customer Profitability" and it also goes by the generic name "skew chart".
“I eventually came to understand that it is possible to construct a Whale chart for just about any business anywhere. It makes no difference whether the business is inherently good or bad, well-managed or in the hands of chimpanzees. It doesn't even have to be a business – it can be a football game or a population chart.”
It gets better:
“In fact, you don't even have to do the analysis. You can save 80 per cent of the effort by just borrowing data from a previous analysis. There's always going to be a skew. It isn't science; it's a party trick.”
The Clients---including The NHS and Vogue:
"The management consulting industry depends on a small number of gargantuan clients; we thought we were doing pretty well out of one of our clients who spent $12m annually on our services – until we learned that this behemoth's total spending on "strategy" consultants was about $100m per year. In order to grasp why some large organisations (but not others) spend so much money on something as ethereal as "strategy," one must dispose of the naïve idea that consulting involves the transfer of knowledge."
Communication:
"The most important of the all-too-human functions of shaman-consultants is to sanctify and communicate opinion. Like ministers of information, consultants condense the message, smooth out the dissonances, unify the rhetoric, and then repeat and amplify it ad nauseam through the client's rank and file."
Writing your own report card:
“The pretence of knowledge where none is to be had, after all, is also a licence to represent private interest as a public good. Managers of client organisations easily abuse this licence, using shareholder money to pay for consultants in order to confer legitimacy on actions that deserve proper scrutiny from truly independent sources. For consultants, the arrangement has all the beauty of writing your own report card.”
According to the Management Consultants' Association, the NHS spent £300m on external consultancy last year.
The ultimate message:
“……you will be expected to work much harder than you ever have before and your chances of losing your job are infinitely greater than you ever imagined.”
NHS: Budget 2010-£110 Billion, McKinsey
Labels: NHS
Monday, April 11, 2011
Quantum & M: Penny & Monitor
Metro-Goldwyn-Mayer
Columbia Pictures
On the flight to the US, I saw Quantum of Solace (again) as there was not much else worth seeing. I wanted to look at the Atacama desert. The film missed the fact that it has a very important treasure: lithium. See my previous post.
Columbia Pictures
On the flight to the US, I saw Quantum of Solace (again) as there was not much else worth seeing. I wanted to look at the Atacama desert. The film missed the fact that it has a very important treasure: lithium. See my previous post.
Also a major part of the film was made in Panama and not Bolivia.
Mathieu Amalric played Dominic Greene, the main villain. He is a leading member of Quantum posing as a businessman working in reforestation and charity funding for environmental science. Amalric acknowledged taking the role was an easy decision because, "It's impossible to say to your kids that 'I could have been in a Bond film but I refused.'” Amalric wanted to wear make-up for the role, but Forster explained that he wanted Greene not to look grotesque, but to symbolise the hidden evils in society. Amalric modelled his performance on "the smile of Tony Blair and the craziness of Sarkozy," Wikipedia
Mathieu Amalric played Dominic Greene, the main villain. He is a leading member of Quantum posing as a businessman working in reforestation and charity funding for environmental science. Amalric acknowledged taking the role was an easy decision because, "It's impossible to say to your kids that 'I could have been in a Bond film but I refused.'” Amalric wanted to wear make-up for the role, but Forster explained that he wanted Greene not to look grotesque, but to symbolise the hidden evils in society. Amalric modelled his performance on "the smile of Tony Blair and the craziness of Sarkozy," Wikipedia
But the best bit is in the opening sequence:
Judi Dench as M was told: We have people everywhere!!!
Then her bodyguard for 8 years turned on her!!!
Then her bodyguard for 8 years turned on her!!!
Looks like they too have people everywhere!!!
This amazing and alarming graph can be found in'The Plot Against the NHS' by Colin Leys and Stewart Player. (Click on the graph to see it full size.) A version to download can be found here.
A quick random check:
Penny started her career as a doctor, training in Cambridge and London, and is a member of the Royal College of Physicians. She trained in public health before going to the United States to study for an MBA at Stanford University, where she was a Fulbright Scholar. While at Stanford she worked briefly with Kaiser Permanente.
Penny returned from the United States in 1994 to work for the Boston Consulting Group in London, leading strategy and change projects with blue chip companies.
In early 2000 she joined the Department of Health as Head of Strategy and Planning, working closely with Alan Milburn in the development of the NHS Plan.
Penny returned from the United States in 1994 to work for the Boston Consulting Group in London, leading strategy and change projects with blue chip companies.
In early 2000 she joined the Department of Health as Head of Strategy and Planning, working closely with Alan Milburn in the development of the NHS Plan.
From McKinsey Site:
Most recently, she led the work conducted for the Darzi review of London's healthcare system, and supported Lord Darzi in his national review.
Penny is also Vice-chairman of The King's Fund and Founder/Director of the Cambridge Health Network, a discussion and networking forum for over 500 senior executives from organizations working in health.
From 2004 until 2006 she was a non-executive Director of Monitor, the regulator of foundation trusts.
Prior to joining McKinsey, Penny was Head of Strategy for the NHS, during which time she played a lead role in the development of the NHS Plan.
Interesting that both sites did not use Dr but Penny. Penny was of course the nickname of Moneypenny.
Q 195 Jeremy Lefroy (Stafford) (Con): I have a couple of questions about the role of Monitor. The first is about the Mid Staffordshire trust into which the Francis inquiry is looking at the moment. It seems to me as the local Member of Parliament that Monitor approved the foundation trust status without going into sufficient detail as to the status of that trust, particularly the quality of care at the time. What assurances can you give us that Monitor’s approval of foundation trusts will be more rigorous in the future than it was in the case of Mid Staffordshire?
David Bennett: Yes. I was not around at the time, but looking at the evidence, the trust was approved at a time when it was not delivering appropriate care to its patients, and that was wrong. Monitor has done three core things in the light of that, all based on an external review of what happened and why, and therefore what lessons can be learned. First, it has set a clear quality bar. That did not exist before—there was no clear definition of what was an adequate level of safe care for any trust to be providing to be authorised. In conjunction with the CQC and the Department of Health, there is now a clear definition of what the quality bar should be.
Q 196 Jeremy Lefroy: Sorry, are we saying that there was not a clear quality bar for approval of foundation trusts up till now?
David Bennett is the current head of Monitor (a sort of health FSA!) He is not a medical doctor.
David was a Director at McKinsey & Co. In his 18 years with McKinsey he served a wide range of companies in most industry sectors, but with a particular focus on regulated, technology-intensive industries.
We have people everywhere!!!
Friday, March 11, 2011
NHS & Monitor: Toyota & McKinsey
Dawn, anyone?
©Am Ang Zhang 2011
The new head of Monitor may indeed be too busy to note that quoting the car industry may not be the wisest thing to do.
Dr Bennett: Yes. I will start with two points. First of all, the fundamental goal of all this, of course, is about providing the best possible care for patients, and indeed specifically in Monitor’s case we will have a duty to promote and protect the interests of users of the system. In a sense, it would be a contradiction of what I think the Bill is aiming to do if we finished up with arrangements that did not enable commissioners to commission the services that were in the best interests of their patients.
More specifically, I know people are concerned that the further introduction of competition, or indeed Any Willing Provider, might make it impossible or very difficult to arrange for different providers to collaborate and provide the sort of integrated care that you are talking about. I don’t see why that should be, not least because of the starting point, but also because we see in lots of other sectors, lots of other markets where collaboration is needed in order to meet the needs of the end user or an intermediate user, that it works perfectly well.
I am very cautious about using examples from other sectors, lest I be immediately quoted as saying "Health care is just like X", which, of course, it is not. Health care is different. But one example which I was discussing with a colleague just the other day is the way the car industry works. You have very effective competition between the manufacturers of different cars but, in practice, when you are making a car you have all sorts of suppliers working together collaborating in order to produce the finished product. Indeed, you will sometimes finish up with providers who are working with more than one manufacturer. You may think it is a big step to go from there to health care but, in practice, if what you are talking about in a similar sort of way is multiple providers working together, collaborating- maybe a couple of different groups working in competition with each other but nevertheless providing the sort of integrated or long term care that is needed-then that should be entirely consistent with a degree of competition.
Toyota, one of the most successful motor car companies ran into major safety problems leading torecalls and litigations:
Toyota has, for the past few years, been expanding its business rapidly. Quite frankly, I fear the pace at which we have grown may have been too quick. I would like to point out here that Toyota's priority has traditionally been the following: First; Safety, Second; Quality, and Third; Volume. These priorities became confused, and we were not able to stop, think, and make improvements as much as we were able to before, and our basic stance to listen to customers' voices to make better products has weakened somewhat. We pursued growth over the speed at which we were able to develop our people and our organization, and we should sincerely be mindful of that. I regret that this has resulted in the safety issues described in the recalls we face today, and I am deeply sorry for any accidents that Toyota drivers have experienced. Especially, I would like to extend my condolences to the members of the Saylor family, for the accident in San Diego. I would like to send my prayers again, and I will do everything in my power to ensure that such a tragedy never happens again.
Akio Toyoda, the president and CEO of Toyota
But the whole thing may indeed be academic: see the following exchanges earlier in the same sitting:
Professor Corrigan: That is what I am unclear about in the Board. The Secretary of State talks about a mandate to the Commissioning Board. Whether that mandate means I then will answer a question about a particular locality within the year, again, force majeure, I don’t think he will have a choice. But that may not be the powers the Bill gives.
Nigel Edwards: He has no powers to intervene in individual consortium areas.
Chair: Are there any other issues here?
Q115 Rosie Cooper: Yes, if I may. Under the Bill, the Secretary of State will no longer have a statutory duty to provide health services and will only have to act with a view to securing the provision of health services in relation to the Board. How accurate is it to see this as spelling the end of a state provided National Health Service?
Nigel Edwards: That is precisely what it is, is it not? That is what it says. It is there in black and white. That is my reading of it as well. In fact, when every NHS hospital is a foundation trust, apart from the fact that the state would be a residual owner of roughly £36 billion of assets which belong to the taxpayer, there is no direct state control over the provision of health care except indirectly through the commissioning process. That is my reading of it.
Q116 Chair: Can I push on that because Rosie’s question was: "Is this the end of state provided health care?" The trusts are still owned by the state and they are delivering care in response to a tax funded budget that is accountable, through the process we have been discussing, to the commissioning boards.
Nigel Edwards: I was taking a narrower view of the definition. But you are absolutely right, yes.
Professor Paton: I am not trying to be smart but that expresses part of the theology of the purchaser-provider split, expressed in 1989 to 1991, which was suspended in culture but not in structure between 1997 and 2001 and then was gradually rolled out again in a new and indeed more radical form. It is just putting the top hat on that. That is what it is saying, but the practical reality will be exactly as the Chairman says. In other words, the reality is that public money is in the providers by one way or another and the theology may not be worth more than that proverbial bucket of spit when it comes to the-
McKinsey:
Tony Blair must indeed be very proud; his people are now on both sides, private health provider side and health regulator side of a Conservative government.
But I do not want to give credit to Blair. According to The Independent it is McKinsey: The Jesuits of Capitalism.
“They are the modern buccaneers of the business world. They jet between cities, rack up huge expenses, and charge up to £6,000 a day to think the unthinkable for clients including big corporations and governments.
They are the star consultants of McKinsey, the élite global management consultancy. Their backgrounds are diverse - former SAS commandos, business people, aid workers - but they are drawn together by the distinct McKinsey culture. Known as "the Firm" or the "McKinsey Mafia", they are radical, zealous - and above all secretive.
But now, it seems, McKinsey is becoming the problem rather than the solution. After almost 80 years as the most prestigious name in the management consultancy world, these "Jesuits of capitalism"are under attack.
McKinsey stands accused of cronyism, greed and arrogance, as a result of associated scandals that stretch from the offices of Enron in Houston, Texas, to the corridors of 10 Downing Street.”
Monday, March 14, 2011
NHS & McKinsey: David Nicholson & David Nicholson
Do not believe everything you read, but perhaps this one?
Q318 Valerie Vaz: ………but I want to clarify something, Sir David. It was something that was in the paper, that you had had discussions with someone from McKinsey who is running a company and wants to float GP surgeries on the stock market. Is that where you see-
Sir David Nicholson: That I have had discussions with them?
Q319 Valerie Vaz: Yes. Apparently he ran the plans before you. Is that not right? Are you not having discussions with anyone?
Sir David Nicholson: I am having no discussions with anyone in relation to that. I can genuinely say "It wasn’t me, guv."
Chair: Another David Nicholson.
Sir David Nicholson: Yes.
Guardian: NHS reform could see GP surgeries on stock market
NHS & Market Forces: Uncomfortable Readings!!!
Related:
NHS & Market Forces: Uncomfortable Readings!!!
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