David Mummery is a GP in London
If you get a chance to watch the very interesting documentary ‘The Great NHS Heist’ I would certainly recommend it.
Watching the documentary should be cautionary to those who value and depend on the NHS as it is: free at the point of care, depending on clinical need, and providing universal health coverage for all. The argument is that, for decades, ‘business friendly’ governments have been allowing private interests to extract vast fortunes from the NHS and that over time the service has been increasingly reformed to make it ready for corporate takeover. This would make our NHS more like what is seen in the USA.
During the documentary there are several shots of the Aneurin Bevan memorial stones in Wales, where the founding father of the NHS gave a talk to his constituents about the foundation of the NHS 75 years ago. There are some quotes by Bevan that are enduring and hard to argue with: “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community … No society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means.”
The documentary argues that there are people who do disagree with this, who are privatising the NHS by stealth and making the profit-motive and increase in profit for shareholders the paramount concern. This has happened in the NHS largely by stealth and the ‘revolving door,’ where senior public servants and politicians are hired by large private companies, and senior management from large private companies take leadership roles in public organisations such as the NHS. These senior executives, it is often alleged, are well connected with policymakers and with big business, and sympathetic to the increasing role of the private sector.
So, who are the agents of this deep infiltration of the private sector into what should be a publicly funded healthcare system without a profit motive? The answer is the management consultants of the ‘Big consultancy’. The names of the firms are well known and many. McKinsey (for example) is famous for having extremely close connections to the top tier of the Conservative party and being instrumental in the Lansley reforms and impenetrable Health and Social Care act of 2012 (see recommended reading below).
The documentary is arguably one-sided in that many of the eminent academics and clinicians quoted are openly critical of what is seen as the privatisation by stealth of British healthcare – the documentary features interviews with Ioannis Varoufakis, Danny Dorling and David Graeber (among others). The documentary also takes frontline testimony from clinicians and hospital management. Whilst watching I recognised a brilliant and dedicated and kind lead A&E nurse, who I worked with for six months in 2000, brought to tears by the unkind and unreasonable managerial demands placed on him and the department regarding unachievable targets and metrics.
Watch the documentary but if you think what it has to say is far-fetched (or want to find out more) a look at two recent books on the societal impact of big consultancy. Both of these books are required reading in trying to understand the consultancy firms pervasive and unbelievably expensive grip on the NHS. They are When McKinsey Comes to Town (2022), by Bogdanich and Forsythe (investigative journalists at the New York Times) and The Big Con (2023) by Mazzucato and Collington (economists at UCL).
The Great NHS Heist, Bob Gill (writer) Drew McFadyen (Director), 2019, https://m.youtube.com/watch?v=Www0cHLQulw&feature=youtu.be (accessed 16/9/2022)
- When McKinsey Comes to Town: The Hidden Influence of the World’s Most Powerful Consulting Firm by Walt Bogdanich and Michael Forsythe, Bodley Head, 2022 (£20), see https://amp.theguardian.com/books/2022/oct/31/when-mckinsey-comes-to-town-the-hidden-influence-of-the-worlds-most-powerful-consulting-firm-review (accessed 16/9/23)
- The Big Con: How the Consulting Industry Weakens Our Businesses, Infantilizes our Governments and Warps our Economies by Marianna Mazzucato and Rosie Collington, Allen Lane, £25, https://marianamazzucato.com/books/the-big-con, see also https://www.theguardian.com/books/2023/feb/16/the-big-con-by-mariana-mazzucato-and-rosie-collington-review-how-consultancy-firms-cash-in (accessed 16/9/23)