A recent article in a London paper stated that the NHS in London “splashes out £114M on advisers”. Here, they helpfully explained, 'advisers' meant ‘management consultants’. As a management consultant myself I should be saying, Good! But I am not. Andrew Lansley, the Health Secretary, is staggered by the bill and wants to reduce it by at least 45% over the next four years.
I am reminded of the worst client I ever acquired some ten years or so ago. This was a huge family-owned food production company that had just been purchased by Venture capital; they asked me to go in to do some training work on developing middle managers’ capabilities. Sounds great! I wasn’t expecting the hero’s welcome awaiting me on my first visit in.
“We are so pleased to see you,” they said.
I said, “Fantastic, but I don’t usually get such an enthusiastic initial welcome."
“You don’t understand,” they said. “We’ve never had training before.”
“Jeez!” I said.
And then one almost surreptitiously whispered, “Except of course when we do it in threes”.
“I’m sorry,” I said, “I don’t follow you.”
“Well, we’re not allowed to do training – or we weren’t until the buy-out. It was an offence punishable by instant dismissal. So we had to do it in threes.”
I must have looked more bewildered still. “I don’t get it – if you weren’t allowed to do it, then why were you doing it and doing it in threes? What’s does doing it in threes mean?”
“We had to have training; we couldn’t function without it, but it was sack-able. So we had one person train another, and the third person had to keep a lookout down the corridor in case the MD was patrolling. That way we could stop in time and pretend we were doing something else.”
“B—y heck,” I said. The full horror of the regime dawning on me, and then the critical question: “But why? Why would any MD not want training for staff?” I guess I was innocent in those days!
“Because he reckons he pays us to do the job.”
“Yes?”
“Well, if he recruits and pays us to do the job, why do we need training to do it? If we can’t do the job, then he wouldn’t employ us. If we can’t do the job we’re expected to leave or be sacked.”
“I see,” I said, incredulously.
And ain’t that it, bizarrely? Of course, this was an extreme situation. But let’s return to our London NHS. If the senior executives were being paid £50-60-70-80K pa to do their jobs, then buying in specialist expertise might seem warranted, but when you are on 3 or 4 or even 5 times these salaries, why do you need ‘experts’? Aren’t you being paid enough to be an ‘expert’ yourself? What are we paying these hospital chiefs for, exactly?
Further, the management consultants that I largely know – in small practices throughout the UK – add massive and measurable value. The kind of consultants used in these NHS contracts tend to be one of the big 20 conglomerates, and they all have a common practice: charging senior partner rates whilst installing junior-somethings-in-their-twenties-learning-on-the-job, whose particular aptitude is largely feeding back what the client – and the senior partner responsible – wants to hear.
So, as a management consultant myself I think I can agree with Andrew Lansley – cut by 45%? Go on, Andrew, make it 85%! Nobody will notice the difference – except the big 20. Expect an upturn in the freelance market!
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