How Private Consultancy Firms have brought the NHS to its knees.
The NHS has spent billions of pounds on management consultants in recent years. It was profit-making private management consultancy firms (who shall remain nameless) that explored and reported on ways in which the NHS would make efficiency savings. The £20 billion pounds of 'savings' that were identified were built around the concept of what became known as QUIPP "Quality, Innovation, Productivity and Prevention".
Central to the theories around QUIPP was the idea that much more of our patients should and indeed would be treated in the home. It was argued that the successful triaging of patients would relieve much of the pressure on our NHS. The logic on the face of it appeared reasonably sound. Many patients who arrive at A&E could indeed be treated elsewhere. If a way could be successfully found to divert patients to the most suitable care setting then it was argued that savings could be made in reducing A&E admissions, and that some wards could close as a result.
The theories behind QUIPP took quite a sinister turn however when they were used to justify the decimation of NHS services. Efficiencies we were told were the reasons that Trafford General Accident and Emergency Ward had to close. Patients could instead be diverted to nearby Manchester Hospitals. In all, 10% of A&Es were earmarked for closure. As well as this, Walk-In Centres were deemed superfluous to requirements. Many of them were not deemed cost efficient, and so the Tories shut 30% of them. It was argued that none of this would be at a risk to patient safety since the new methods of treating patients eg. GP referral and care in the home would reduce demand on emergency services.
Unfortunately for the NHS the exact opposite of what management consultants predicted actually transpired. I have read literally thousands of NHS Trust Board Minutes and they all say the exact same thing. A&E admissions are rising above predicted or targeted levels. The forecast fall in admissions just is not materialising. The net consequence is that the performance of our A&Es is at its worst for 10 years.
What will anger many NHS campaigners, including me, is that we warned this would occur. Handing GP out of hours to profiteers who employed just 1 GP per 500,000 patients was a gross mistake. Scrapping an NHS Direct staffed by experienced and qualified nurses only to replace it with often minimum wage untrained teenagers straight from school was negligent and done so with only the profit motive in mind. Shutting ambulance stations, A&Es and Walk-In centres at the same time as trialing a new NHS111 service was a recipe for disaster. But most of all, assuming that a country with a growing population as well as an aging one would have less demand for A&E is just plain daft. Supply was on the increase it is basic logic to conclude that demand would also increase. Even if successful triaging occurred, our A&E services would still be under severe pressure. Shutting Wards at a time of increased need borders on criminally negligent if not completely stupid.
The management consultants have failed us and failed us miserably. The entire theory on which hospital closures occurred has been discredited. Mocking local NHS campaigners who fought closures as "HIMBYs (Happening in My Back Yard) is something I witnessed from both Tories as Free-Market reformists on the right of the Labour Party. It is important that someone takes the time out to point out to them. You were wrong. Conventional wisdom that led to the decimation of our NHS was built on entirely false premises, and what's more we told you so.