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Editorial Sunday 12 February 2012: McOops! McKinseys Helios-centric hospitality, McFavours and McIcarus policy hubris

If I'm reluctant to use the phrase 'game-changing', it's because the Health And Social Care Bill started off playing football; then went to Australian Rules rugby; had an interval 'pause' scripted by Harold Pinter; and then took up hurling using golf balls and squash raquets. (And we can shortly expect 'ping-pong'.)

It's definitely not been cricket.

All that said, the Spinwatch (yes, the body which exposed the McKinseys link to hospital privatisation and Helios) FOI work that forms the basis of this story in today's  Mail feels like an inflection point over the controversial 'Monitor and competition' Section Three of the Bill, which returns to the Lords next week.


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What does the story tell us that we didn't already know?

It reveals that Monitor's interim chair and acting CE Dr David Bennett (who this month last year, gave his memorable  "taking monopolistic, monolithic markets and providers and exposing them to economic regulation" interview to The Times) accepted £6,200 worth of hospitality from his former employers McKinseys.

It reveals the extent of McKinseys' generosity with its hospitality to the NHS family, taking Monitor's director of strategy Adrian Masters and chief operating officer Stephen Hey and their families to Cirque Du Soleil. The choice is rather brilliant, given that 'Soleil' means the same as Helios: the sun.

Is it getting hot up there, Icarus?

Better still, McKinseys took Stephen Hay to a Royal Opera House production of La Traviata, which includes the classic 'Drinking Song'. "Let's drink from this chalice of joy", indeed.

La Traviata also includes the appropriately-titled 'Sempre Libera', which opens with the lines "Madness, madness! It's all a mere illusion". 'Sempre libera' means 'always free', which frankly feels ironic.

McKinsys: what a charming host
Damagingly for public confidence in the legislation, the SpinWatch / Mail story also reveals that "Many of the Bill’s proposals were drawn up by McKinsey and included in the legislation wholesale. One document says the firm has used its privileged access to ‘share information’ with its corporate clients – which include the world’s biggest private hospital firms – who are now set to bid for health service work.

"One document says McKinsey has used its privileged access to ‘share information’ with its corporate clients – which include the world’s biggest private hospital firms – who are now set to bid for health service work

"McKinsey’s involvement in the Bill is so great that its executives attend the meetings of the ‘Extraordinary NHS Management Board’ convened to implement it. Sometimes McKinsey even hosts these meetings at its UK headquarters in Jermyn Street, Central London".

Hosting board meetings. McOoops. If nobody involved can see how bad that looks, then there has to be a staggering outbreak of common-sense deficiency syndrome in both the DH senior management team and McKinseys.

Two damaging emails
Perhaps the most unfortunate are a series of emails. The first was sent to Monitor Dr Bennett from an un-named McKinseys executive, sent in May 2010 just after the Coalition Government's formation, which reads "We have been gathering our thinking on the implications of the new Government programme for the NHS [and] have started to share this with clients.  Would you like to meet to discuss it?"

It is a gobsmacking and insulting offer to the independent regulator of NHS trusts, implying a combination of undue policy influence on McKinsey's part and strategic and policy incompetence on Monitor's.

The second email was sent on November 9, 2011, by an un-named McKinsey's executive to Ian Dalton, now the NHS Commissioning Board chief, saying: ‘We had good discussions... on how international hospital provider groups may help to tackle the performance improvement of English hospitals. They would be ready to step in if there were £500million revenue on the table, can keep real estate and pensions with NHS, needs free hand on staff management. This may now be a time when both sides [the NHS and foreign firms] may usefully explore their position as an input into how policy would be shaped". Dalton had also received various hospitality from McKinseys.

Another email on April 13 2011 reveals that Mr Dalton was asked by "an unnamed McKinsey executive wrote about Paul Wiles, who was about to retire from US firm Novant Health and was ‘looking for some brain activities post-retirement. Ideally this would be on 2-3 boards or advisory roles.’ Eight days later Mr Dalton replied with a possible opening: Mr Wiles might like to apply for a post as a non-executive director of the NHS Trust Development Authority. This would eventually be advertised, ‘though not until July 2011’."

And in May 2011, "McKinsey emailed Mr Masters at Monitor, saying: ‘Would you be happy to provide a reference [on behalf of McKinsey] for Maidstone and Tunbridge Wells Trust who are looking for a two-year contract to support the development of the Board?’ Mr Masters’s office replied: ‘Adrian is happy to provide a reference for the policy work but he wouldn’t want it to be inferred that he had been involved in any application decisions'." The jesuitical nature of willingness to provide a reference as distinct from unwillingness to be perceived to be involved is rather lost on me.

There is nothing illegal in any of the above. It's all within the law.

Which would be fine, if it didn't display such spectacularly bad judgment, on all parts, by people who are shaping the future of the NHS.

From the point of view of those who think the Bill is a dangerous mess, the timing could not be better. This will overshadow the Prime Minister's bland reassurances in The Sunday Times, which re-deploys the inept TINA defence.

That Nice Mr Cameron asserts "while the values (of health care for all, free at the point of use, unrelated to the ability to pay) are right, the system isn't. It needs to change - and that is why I am at one with Andrew Lansley, the reform programme and the legislation going through Parliament. Choice, competition and transparency may unsettle some people, but it's these things at the heart of our reform that will lead to the better NHS I care about and our country deserves".