(Press-News.org) Annual NHS spending on management consultancy has doubled from £313m to £640m between 2010 and 2014, despite a promise by Health Secretary Andrew Lansley to 'slash' spending after the 2010 election, reveals an article in The BMJ this week.
This is enough to run three medium sized hospitals or employ about 2000 extra nurses, says David Oliver, a former clinical director at the Department of Health, who obtained the figures through a Freedom of Information request.
"In times of war, arms dealers, rebuilders, and racketeers profit from the chaos," he writes. "Disruptive innovation" has led to similar spoils for management consultants, with taxpayers' money diverted from already struggling health and care services.
The health sector regulator Monitor, meanwhile, has placed contracts worth about £32m with the "big four" management consultancy companies, though its work was done with a fraction of such spending before the election, explains Oliver. It also often helps install "interim" executives on eye watering daily rates.
Senior partners charge £3000-£4000 a day - the amount that a senior doctor earns in two weeks, he says.
Meanwhile, Oliver points to a "constantly revolving" door between the Department of Health, NHS England, Monitor, 10 Downing Street, and the consultancy firms, "creating commercial advantage." He also points out that consultancy firms "are unaccountable and can walk away from bad or damaging advice with no consequences."
With about a million staff and 10% of gross domestic product, the NHS has experienced clinical and organisational leaders, writes Oliver. "If these well paid individuals lack the skills to solve most local problems in-house, or by learning from other NHS colleagues, perhaps they shouldn't be leading at all."
"Let's ensure that all consultancy is subject to a rigorous audit of value and impact and whether it needed to be contracted out at all," he concludes. "It's time for management consultants to face the same transparency and accountability as the rest of us."
INFORMATION:
Since August 2009 all UK trainee doctors have been restricted to a 48 hour week, but some say this has had negative effects on the quantity and quality of medical training. Is there any evidence to substantiate these fears? Doctors discuss the issue in The BMJ this week.
Andrew Hartle and Sarah Gibb of the Association of Anaesthetists of Great Britain and Ireland find no evidence that implementation of the European Working Time Directive has led to a decline in the quality of training.
They point out that several reviews on the impact of restricting working time have ...
Poor professional performance is an unlikely cause of delays in referral for suspected cancer, argue researchers in The BMJ this week.
Instead, such delays largely reflect "limitations in scientific knowledge and in the organisation and delivery of healthcare." And they question government plans to rank general practices according to how promptly patients are referred to specialist services for suspected cancer.
Most patients who have cancer diagnosed after the onset of symptoms are referred after one or two GP consultations (80%), but a substantial minority (20%) ...
Most exaggeration in health related science news is already present in academic press releases, finds a study published in The BMJ this week.
The researchers suggest that improving the accuracy of academic press releases "could represent a key opportunity for reducing misleading health related news."
Health related news has widespread potential to influence health related behaviour but often misreports the science. It is not known whether exaggerations - claims going beyond those made in the research paper - originate in the news stories themselves or in press releases ...
The analysis of 3,494 contracts awarded by 182 Clinical Commissioning Groups (CCGs) in England between April 2013 and August 2014 - disclosed to the BMJ under the Freedom of Information (FOI) Act - showed that in total, non NHS providers have secured 45% of contracts awarded since April 2013.
A total of 1,149 contracts (33%) were awarded to private sector providers, 335 contracts (10%) were awarded to voluntary and social enterprise sector providers, while 100 contracts (2%) were awarded to other providers, such as joint ventures or local authorities.
A further 1,910 ...
WASHINGTON, DC (December 9, 2014)--A study published today in the Journal of the American Medical Association (JAMA) shows that physicians who do residency training in regions of the country with higher health care spending patterns continue to practice in a more costly manner - even when they move to a geographic area where health care spending is lower.
Immediately following residency, physicians whose residencies were in higher-spending regions spent 29 percent more on average than their peers who had trained in lower-spending areas of the country, according to the ...
The cognitive effects of poverty can be mitigated during middle school with a targeted intervention, according to researchers at the Center for BrainHealth at The University of Texas at Dallas.
In a paper published today in the open-access journal Frontiers in Human Neuroscience, researchers for the first time examine the efficacy of cognitive training in a large and diverse group of 7th and 8th grade public middle school students as compared to typically developing students who received no specific training.
"Previous research has shown that growing up in poverty ...
Rules don't reduce death, morbidity or adverse effects
Surgeon who best knows patient should continue with critical care
Restrictions may hurt patient safety
CHICAGO --- Controversial restrictions on hospital residents' duty hours imposed in 2011 did not improve surgery patients' outcomes, reports a large new Northwestern Medicine study of U.S. hospitals, one of the first national evaluations of the results of the restrictions.
The restrictions also did not result in any differences in surgical residents' performance on exams.
"Our study suggests that these ...
An examination of the effect of resident duty hour reforms in 2011 finds no significant change in mortality or readmission rates for hospitalized patients, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new duty hour reforms for all ACGME-accredited residency programs. The revisions maintain the weekly limit of 80 hours set forth by the 2003 duty hour reforms but reduced the work hour limit from 30 consecutive hours to 16 hours for firstyear ...
An examination of the effect of resident duty hour reforms in 2011 finds no significant change in outcomes for general surgery patients, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
Ravi Rajaram, M.D., of the American College of Surgeons, Chicago, and colleagues conducted a study to determine if the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance.
The study examined general surgery patient ...
Among primary care physicians, the spending patterns in the regions in which their residency program was located were associated with expenditures for subsequent care they provided as practicing physicians, with those trained in lower-spending regions continuing to practice in a less costly manner, even when they moved to higher-spending regions, and vice versa, according to a study in the December 10 issue of JAMA, a theme issue on medical education.
Regional and system-level variations in Medicare spending and overall intensity of medical services delivered to patients ...
