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Bedbugs and consultants are both bleeding us dry

  • 12 Comments

We have bedbugs. Annoying, blood sucking, pointless little insects. They’re like bankers but less smug.

They only bite me. My wife is untouched by bedbugs. This amuses her. I wake up after a night of combat, covered in bites and poorly applied antihistamine and she lies there all serene, saying things like “I slept right through” and “are you sure you’re not imagining them?”

In the end, we got someone in. Bedbug experts. Not only do these people get rid of the bugs but they also kidnap some of them and keep them in jars so they can study their bedbug ways. I don’t know why and I expect an angry email from some animal rights activist but I rather admired that. These experts did not take their expertise for granted - they want to stay one step ahead of bedbugs, and apparently they feed them by letting them sit on their arms. They understand the enemy and, as a consequence, we are now free of bedbugs.

‘One trust spent £12m on consultants. Maybe senior managers were unable to decide if they should draw the curtains without hiring some external advisers’

Sometimes that’s what we all have to do isn’t it? Hire some experts to do something we can’t. Even the NHS has to do it on occasion, although you would expect to be able to find most skills lurking somewhere in that organisation. Or you would if it was a national organisation rather than the regionalised corporations it has become.

However, do we really expect to find that the NHS spent £300m on buying in consultancy “experts” last year? One small primary care trust (Camden) managed to spend £12m on its own - £50 per head of the local population. One imagines that its senior managers were unable to decide if they should draw the curtains or not without first hiring some external advisers.

Obviously, this is ridiculous. It not only means a waste of resources but also creates a new and in my view quite sinister “consultancy class”, a group of people who never have to take responsibility for what they do nor actually produce anything, but get paid lots of money nonetheless. This is a small part of the wonderful private sector we keep being told to try to be more like.

Goodness knows, sometimes we all need help from experts. But when calling for expertise becomes an excuse not to engage in or take responsibility for decision making or even think through a problem, something unhelpful is happening. Managers do themselves no favours when they divert costs out of the public purse in that way. It needs to be managed, either by capping consultancy costs or by docking the pay of senior executives who are unable to do their jobs without recurrent external help.

Alternatively, could we find a way of cooperating across trusts and PCTs; sharing skills and expertise, maybe even employing a centralised pool of problem solvers who would be available to all NHS organisations? Try to think creatively about how we could help fellow trusts or organisations to solve problems? Act like the NHS is a national organisation and work in partnership with colleagues across the country? Could work, would save money. What are the odds?

  • 12 Comments

Readers' comments (12)

  • A management consultant came to the PCT I previously worked in and (in my absence) declared that my reasonably new printer had to be taken, 'to save money' and it was replaced with one that was old and basically didn't work. I used the printer regularly and 5 days out of 5 it would not 'just work' and after much connecting/disconnecting / switching off power and finally shaking, it would come on for the odd page of printing. I logged calls with IT every day, sometimes they responded but basically the printer was broken and nothing could be done. I wasted hours of my nurse specialist pay, not to mention unable to work properly, trying to sort the printer. I emailed the chief executive and told him I was wasting hours of my time/pay sorting out printer problems due to his management consultant's 'money saving plan'. He did not reply, nor did the consultant (no responsibility), but IT did upgrade my printer to one that worked 3 days out of 5. My newish printer, paid for by my department was, I heard, given to GPs, but I don't know if this is true, no other explanation was given. IT then declared they would no longer try to mend the printer they had given as a replacement as it was old, and my department had to pick up the cost for replacement. After an apoplectic email to the Head of IT and HR, they agreed to continue 'supporting my printer'. I don't know what else the management consultant did except make every working day very difficult for me and of course steal from the poor to give to the rich, but the rumours were he was paid £30,000 for his 'work'. Those managers now run a social enterprise.

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  • Hear hear Mark, well said!!! Keep the money on front line resources. The public pay for a service and not for some consultant to tell us how to ineffectively cut costs whilst bleeding the sytem dry with their exhorbitant bill. WE too pay our taxes into the system, that is only too happy to shaft us at every turn. Not all of these consultancy teams are a waste of space by any means, but their renumeration should be capped according to the efficency of their ideas surely.

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  • Charlotte Peters Rock

    Management Consultants are only part of the problem. Total lack of accountability by Management is far greater. If any one senior employee at any NHS Trust were to be accountable for his/hewrown actions, perhaps that accountability might catch on and sweep down to every level at all Trusts?

    As it is the lack of accountability, publicly paraded by senior managers, is bolstered by overpaid bully boys of legal firms, who threaten, block and collude with Courts to prevent any sensible resolution of problems if a member of staff has made a damaging or fatal error in treating patients.

    The result.. public knowledge -the public not being as stupid as NHS Managers seem to think -which then mistrusts all even the very best workers.

    Accountability - accountability - accountability (and hand washing) should be a requisite part of all and every job within our NHS. Where that accountability (and hand washing) is flouted, the sack should follow. I realise that for a short time, as people catch their breath, there would be a severe shortage of 'professional' and 'managerial' staff, but the end result would be the start of accountability.. and not before time.

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  • Charlotte Peters Rock

    Management Consultants are only part of the problem. Total lack of accountability by Management is far greater. If any one senior employee at any NHS Trust were to be accountable for his/hewrown actions, perhaps that accountability might catch on and sweep down to every level at all Trusts?

    As it is the lack of accountability, publicly paraded by senior managers, is bolstered by overpaid bully boys of legal firms, who threaten, block and collude with Courts to prevent any sensible resolution of problems if a member of staff has made a damaging or fatal error in treating patients.

    The result.. public knowledge -the public not being as stupid as NHS Managers seem to think -which then mistrusts all even the very best workers.

    Accountability - accountability - accountability (and hand washing) should be a requisite part of all and every job within our NHS. Where that accountability (and hand washing) is flouted, the sack should follow. I realise that for a short time, as people catch their breath, there would be a severe shortage of 'professional' and 'managerial' staff, but the end result would be the start of accountability.. and not before time.

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  • You are right most of the problem is caused by the system itself and not by the worker,i hope and pray that the management understand this and have an insight on this and they should have accountability of there actions.

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  • Could we not have a system where consultants get paid a low initial fee and then get paid a second fee after one year of working with their suggestions based on how well the system improved as a result?
    Maybe it would have the effect of creating only workable suggestions being offered as the consultant would need to rely on it for future income. It's not accountability but it does make people stop to think about their ideas.

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  • something is wrong somewhere. when will many nurses especially the leaders stop being self centered rather than put the profession first.

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  • pls can someone help with the DSM - IV TR

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  • Roger Rowett

    Being a consultant myself I can only make the obvious comment - the headline statement is an over simplification! Sadly I think that in many cases the use of consultants is an avoidance of internal managers taking decisions or a reaction to the health and safety paranoia driven by the claims culture. However, in better examples an external consultant can provide a 'fresh' perspective on issues of a specialist technical nature or organisational development. In the latter case this should always totally involve and empower those people working on the front line and other key stakeholders.

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  • In my department we suffer from two layers of management who are unable to make a single decision between them, and if anyone of them goes on leave the other becomes paralysed with fear! So maybe the issue is the quality of people trusts are employing as managers, but maybe it suits some Chief Execs to employ spineless fools who will toe the line and not think too much.

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