Editor’s blog Sat 21 August 2010: The right question for "staggered" Lansley 0.3% of NHS budget spend on management consultants

Well done to The Guardian's social affairs editor Randeep Ramesh, who seems to be first with the figures of the NHS's £300 million management consultancy spend in 2009-10.

Ah, I remember the happy days when it took zillions of FOI requests to find those figures. Now they are collected centrally - and that, folks, is progress.

Although the £300 million figure is an adornment to the catechism of Interesting Things, it is also another brick in the wall of Things That Are Not Surprising. Management consultancy may or may not be largely snake oil - as Flaubert wrote, "all generalisations are dangerous - even this one".

The total spend is not the point. (It is, incidentally, slightly worrying that Health Secretary Andrew Lansley is "staggered" by this figure of £300 million on a budget of £110 billion. With what his proposed reforms are bringing down the track, he is going to need to become less staggerable very swiftly indeed.)

Seeing total spend as the point is a classic lapse into the Old-Time Religion Of Inputs which Mr Lansley's policy revolution claims to reject in favour of the new testament of outcomes and outputs. Even if Mr Lansley were not sensible of the fact that much management consultancy spending was officially or semi-officially sanctioned under the ancien regime (this £300 million figure, for example, will include expenditure on the wholly non-optional world-class commissioning assurance process), to ask 'how much did it cost' about use of management consultants is to ask the wrong question.

The right question - information you may have gratis, free and for nothing from the ever-benevolent Health Policy Insight, Providers And Procurers Of Management Consultancy To Gentlemen And Their Sons And Gentlewomen And Their Daughters - is 'what provable value did it add?'

If Mr Lansley had described the NHS's woeful record of seeking and recording the value added for this management consultancy spend, then we could more readily understand his 'staggeritude'.

In our link above to the Independent article yesterday, David Craig, author of the worrying Plundering The Public Sector suggested that customers should 'insist that, from now on, all management consultants are paid by their results. If they promise greater productivity or higher sales, fine: don't pay them until it comes through'.

Generous rewards for whistleblowers, including immunity from prosecution, would also work.