Lord Agnew has some gall to blame the government’s outsourcing decisions on civil servants (Whitehall ‘infantilised’ by reliance on consultants, minister claims, 29 September).
The £10bn spent on the failing, privately-run test-and-trace system is a particularly egregious example. Simon Stevens has acknowledged that this scheme has nothing to do with the NHS, despite the logo (Asking over-65s to shield is ‘age-based apartheid’, boss of NHS England says, 28 September) and it is telling that Dido Harding is calling in a former Sainsbury’s chief executive to sort it out. Any pleasure gained from the notion that the ability of dogs to detect Covid-19 might mean the replacement of Dido by Fido is dissipated by the rumour that she could be in line to succeed Stevens as chief executive of NHS England.
This would be entirely consistent with the manifestly inappropriate suggestions of Paul Dacre and Charles Moore to head up Ofcom and the BBC. Labour is adopting a policy of no comment on these individuals, but a potential triple whammy should surely call for a robust response. The government is inflicting such damage on the public realm that the opposition has a duty to expose the whole shoddy edifice of Tory appointees and donors.
Dr Anthony Isaacs
London
• What is the impact of management consultants on public service efficiency? In the first quantitative study on this matter, Prof Ian Kirkpatrick of the Warwick University Business School and his co-authors studied all 128 acute NHS Trusts in England over a four-year period.
On average each trust spent an astonishing £1.2m per annum on external management advice. Using organisational efficiency outcomes, the authors found a significant correlation between consulting expenditure and organisational inefficiency. Management consultancies had a negative effect on efficiency and costs were increased. Despite the NHS having spent hundreds of millions a year since 2010 on management consulting, there had been no formal evaluation of it.
More generally in the public sector, the authors point to opinions of management consultants pushing their services when there is no need for them, incompetence, poor-quality products, high prices, revolving-door appointments between the public sector and consultancies, and backstage social relationships with decision-makers. A view is of management consultants working mainly to drive ideologically motivated new public management reforms, especially privatisation.
Morris Bernadt
London
• There is an important omission from your graphical list of Covid-related spending on consultants. The absence of McKinsey from the Tussell report – and the longer and costly list of failing test-and-trace contractors – is deeply troubling. Civil Service World reported last month that Michael Gove’s Cabinet Office had given McKinsey over £1m for Covid consultancy. McKinsey’s costly role is included in your report, but we must remember that they previously designed the plan that has produced the 42 integrated care systems that will replace the NHS in April.
Perhaps there is a private war going on between Cummings, Gove and Agnew on one side and Simon Stevens, the NHS chief executive, on the other about the exact form of the destruction of the national public health system. But both are causing havoc, whether it is in the name of “efficiency” or bursting the “blob”. For a Gove ally to complain about this footnote to the deliberate dismantling of the commonweal is nothing short of hypocrisy.
Kevin Donovan
Birkenhead, Merseyside
• The effects of Whitehall’s outsourcing to consultants go far beyond its curtailing opportunities for fast streamers in the civil service. It stymies the development of employee involvement for staff at all levels, which can foster the continuous improvement so badly needed. It has also enhanced the marginalisation of intermediate institutions – eg the CBI, trade unions, local public health bodies, universities – the costs of which are being illustrated so forcibly in the pandemic.
Prof Stephen Wood
University of Leicester
