The National Health Service in England spent an estimated £1 billion last year on management consultants - a figure that dwarfs the funding deficit in the health service.
That's just one element of the litany of almost unbelievable incompetence, mismanagement and waste catalogued in a wonderful polemic delivered by Dr Paul Miller, chairman of the British Medical Association's consultants committee, in a speech to the hospital consultants' annual conference in London.
Some choice morsels:
"So where has the NHS money gone? Let me give you a few answers, starting with tens of thousands of pounds.
"One trust with big debts, Surrey & Sussex, paid over £52,000 for less than two months' work from an interim chief executive from a management consultancy in February and March 2005.
"The finances remained dire, so the Strategic Health Authority brought in more management consultants, McKinsey, for half a million pounds.
...."Colleagues, it is hard to avoid the conclusion that we are working in a service which is being broken by policies which do not work; devised by officials who have resigned; implemented by managers who don't believe; on staff in disbelief; and patients without a say. Enough is enough. The emperor of English health policy is wearing no clothes.
...."And to top it all, the massive total spend on management consultants is starting to become apparent. The Management Consultancies Association represents 65 per cent of the industry, does not include McKinsey, but still billed the public sector £1.9 billion in 2004 and £2.2 billion in 2005. It seems the whole industry is therefore charging the public sector £3 billion, with perhaps £1 billion pounds being charged to the NHS. That would dwarf the deficits.
"This has been the NHS's best year ever …for management consultants…for losing staff…for wasting money."
As Dr Miller said, "if you had made this up, you would be laughed at. If you were the one who did make this up, you should be ashamed."
The full text of his speech online thanks to The Times and is well worth a read.