Michael Cross
In a gift to the Department of Health, renegade management consultant David Craig makes a succession of factual errors in his latest broadside, Plundering the Public Sector, on this government’s infatuation with consultancies. Especially with his main case study, the National Programme for IT.
Like many commentators, Craig seems to believe that NPfIT itself has been “sexily renamed” Connecting for Health. According to the book, Sir John Pattison was “head of the NHS”. In October 2005, apparently, Craig had a meeting with the IT director of a “regional health authority”. And in chapter eight, we have Richard Granger joining the NHS from Deloitte in May 2005. (That blip may be down to co-author Richard Brooks, of Private Eye – a publication which has been unaccountably slack at getting to grips with NPfIT.)
While such slips – and, more significantly the assumption that NHS X-rays are to be stored on one central database through PACS – will give spin doctors ammunition to dismiss Craig’s attack, the book raises enough valid points in a sufficiently provocative way for the message to get through. Plundering the Public Sector could tip the chattering class’s perception of NPfIT from indifference to outrage.
Craig’s thesis, as set out in his previous book Rip-Off!, is that management consultants are not dispassionate professionals but predatory salespeople, mainly interested in personal bonuses. Tony Blair’s government, suspicious from the beginning of advice from civil servants, is a sucker customer.
Perhaps because of the spectacular sums of money involved, Craig’s evidence comes almost entirely from IT projects. And although he dips through fiascoes in the HM Customs and Revenue, the courts service and the MoD, Connecting for Health (sic) gets by far the most thorough treatment.
Systemic weaknesses
Craig (not his real name, incidentally) has a special claim to NHS expertise. He was one of the team involved in the West Midlands regional supplies imbroglio in the early 1990s, which, with Wessex and London Ambulance, established a public perception of NHS IT incompetence. He told the story in Rip-Off! and repeats it, more or less word for word, here.
Little has changed since those days, Craig suggests, except that the sums of money wasted have grown much bigger.
Despite the irritating errors, he identifies systemic weaknesses in the NHS’s approach to IT which will resonate with many, even inside CfH. There is the “not invented here” syndrome, the absurd political cart-before-the-horse of Choose and Book, and the drawbacks of local monopolies created by the LSP system.
Then there is the familiar charge of secrecy. Craig spots Connecting for Health’s reluctance to map its Soviet-style streams of statistics boasting of achievements against original targets.
Finally, he suggests the programme’s systems are ridiculously over-specified: “What the government is doing is what we consultants used to call ‘building the church for Easter Sunday’ – building an IT system that is so massive that it can cope with every possible eventuality.”
What he doesn’t say is that this is a feature of most public sector IT programmes. Unlike banks or retailers, public agencies have to deal with every one of their ‘customers’, even the heartsink ones. Designing systems to cope with the 10% of difficult cases is a cross that government has to bear.
No doubt the CfH spin machine has already collected a dossier of factual errors to throw at MPs and other inquisitors inclined to accept Craig’s conclusion that the NHS is in the process of building a “multi billion pound electronic Millennium Dome” at the expense of staff and patients.
But in the current blizzard of propaganda and counter-propaganda about the NHS, facts carry little weight. Craig’s charges will stick.
Plundering the Public Sector: How New Labour are letting consultants run off with £70 billion of our money. David Craig with Richard Brooks, Constable 254 pp £9.99