Anyone a patient at the Royal Free?

[snoozequeen1]

Here is a lovely current job add offering ?1000 a day:

Turnaround Finance Consultant

Location Hampstead, London

Salary ?600.00 - ?1,000.00 per day

Sector Accountancy (Qualified) - Public Sector Finance

Applications 1

Job ref no 18154585

The role will involve looking at what proposals needed to be put in place and work with the managers as financial advisors to get a 30% saving year on year.

The Turnaround consultant will be expected to make suggestions about the performance of departments, benchmark them against other providers, and also look at strategies such as whether if a service was shut either clinical or non clinical (managerial) how this would create savings and how affect the hospital in the long term.

So they are going to pay ?1000 per day to draft in an accountant, who's job is to explain to them how not to waste money.

How can an accountant drafted in to a hospital understand the quality of care provided or what that service does for patients? Sometimes the outcomes will play out over many years and I don't believe that eg. number of patients seen per hour or any other such simple measure will tell you anything about the value of a service.

Task number one for the luxury accountant: recommend dismissal of hospital manager who approved this. Task number two: sack yourself, and replace yourself with someone who is value for money, say on ?40,000 a year instead of ?250,000.

They don't seem to have any criteria at all other than making 30% cuts. Looks like butchery coming at what I guess must be the Royal Free? - location Hampstead.

[JohnL]

http://www.thecnj.co.uk/islington/2009/073109/inews073109_12.html

So a new CEO and

"Royal Free bosses announced this week they are facing ?unsustainable? cuts of ?900million over the next five years. "

Seems so - thats a lot of cuts.

[Huguenot]

Isn't the debate kind of weird?

I mean, if there's no money, there's no money.

Drafting in someone to help make the cuts in a reasonable way isn't necessarily a bad idea?

To assume that they won't "understand the quality of care provided or what that service does for patients" is the kind of prejudiced comment that makes me think that the biggest problem in the NHS is some of their employees.

We would all prefer that there were no cuts at all, but guess what NHS, it's the population that pays your wages, and if they're skint, so are you.

[SeanMacGabhann]

It's a fairly simple question ask isn't it Huguenot

"How skint is an organisation if they can shell out up to a grand a day on a single consultant?"

If savings can be made by closing down areas, or efficiencies made - does it need someone on that kind of wedge to come up with the ideas? And are they not as likely to make headline-grabbing savings to justify that kind of money, regardless of the long-term effects

[Moos]

In standard consultancy, a graduate will be hired out at around ?400-?600/day. In the organisation where I work, ?1000/day will buy a client a specialist consultant with no more than 5 years' experience post university.

No doubt in larger public-sector organisations, and certainly in the world of independent contractors, ?1000 will get you a lot more value for your money. But I would be surprised if you could get someone who could do sensible data analysis, market comparison and offer strategic solutions for much less than ?1000/day.

This is all assuming this is a temporary consulting role, rather than a permanent job.

[SeanMacGabhann]

No doubt it's a going rate, but an organisation that can pay that rate is not entirely out of cash

As for how much "data analysis, market comparison and offer strategic solutions" is needed for an organisation where people get sick/broken at arbitrary rates (as opposed to growing a business) I'm also unsure

[bignumber5]

wow, that shows how na?ve I am about the world of consultancy and accounting and all that guff - until I saw moos' post, i was going to point out the likelihood of it being a typo and them meaning to offer ?1000 for a week. I mean, a grand a day? that's stupid money!

[Moos]

I don't know anything about how hospitals are run, so I need to be careful not to make assumptions. And I have no idea whether the Royal Free needs this job, was only extrapolating from the job description given.

But although people get sick arbitrarily, does that mean that a hospital shouldn't plan its services? That doesn't seem to make sense?

[Moos]

bignumber5 Wrote:

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I mean, a grand a day?

> that's stupid money!

Yep.

[bignumber5]

I don't know anything about how hospitals are run

i've been working in hospitals since i was 18, but at the significantly less profitable patient-care end, so i've got no idea how they are run either. One for MamoraMan, methinks...

[SteveT]

I would be quite happy to receive such stupid money a grand a day sounds alright to me even if it were temporary work.

I have never heard anyone who works within that establishment to actually praise it.

Everyone seems to tolerate it but not enjoy their time there.

It is riddled with expensive err free masons.

[Moos]

Again, independent contractors work differently (although being self-employed I think they pay 50% tax? Is that right?), but a consultant being charged out to a client at ?1000/day will not be being paid that. He will be on a salary and a considerable proportion of the daily fee will be margin.

[Moos]

Sorry, Chair, I appreciate that this is somewhat off topic.

[bignumber5]

Moos Wrote:

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> Sorry, Chair, I appreciate that this is somewhat

> off topic.

not really - the topic seems to be appropriate use of funds (or lack there of) and adding the details of what's appropriate for the industry adds valuable context

[SeanMacGabhann]

not really offtopic Moos - the question isn't how much the contractor gets, it's how much the NHS pays

And if it's paying ?1000 a day to someone to figure out ways to not waste money.... (times however many people they have doing this) there is an argument to be had that it isn't short of cash, but it is directing it wastefully

[Moos]

Hmm, see what you mean but I meant talking about consultants' salaries! :)

I'm going to stay away from the specifics of the Royal Free and the NHS, because as I said I really don't know how hospitals work. And given that we are talking about a hospital and that the cash in question might be used instead to pay some midwives or buy a scanning machine or an ambulance or something very directly beneficial to patients, then I can certainly see that someone who knows more could invalidate my in-principle argument with some real information.

But, in principle, I don't think that spending money on saving specialists is necessarily a waste. It is in the nature of consultants to go into organisations to do specific tasks which they will probably have done before in similar organisations and which are not things that the people who are permanently employed in the organisation know how to do. Efficient information-gathering and analysis, coming up with appropriate solutions and means to implement those, is what consultants do. I don't know what the NHS does but many of my company's clients will compare our quotation for a piece of work with what it would cost them to do it internally, and it needs to be competitive with that. In principle therefore, it may cost the NHS less for a specialist consultant to come up with a workable solution than for someone internally to do it.

[bignumber5]

indeed - a department that i used to work in once hired a management consultant to establish why the middle grade doctors were so disgruntled and what could be done about it. The management consultant concluded that motivational strategies were needed as the middle grade doctors felt over-stretched in their daily work environment. The middle grade doctors rota was a member of staff short. The consultant got paid more than a middle grade doctor to fill the slot would have cost. Can anyone not being paid stupid money spot the likely source of the doctors being overworked and a potential solution?

Since this whole "consultancy" thing isn't a set up that I really understand, and certainly isn't one that I have any respect for, I think I'll step back now. Sorry for the rant.

[DaveR]

The history of the effectiveness of private sector consultants in large public organisations is not a happy one, for various reasons. All too often, the result is one of the following:

- their recommendations are accepted without question rather than being critically assessed

- their recommendations are ignored because accepting them would result in taking unpalatable action

- their recommendations are shelved because (for whatever reason) the people who hired them are not, or are no longer, the actual decision-makers.

I have heard quite a few 'war stories' from both sides, including one from a guy who was working for a certain leading consultancy firm (called McK...) and was hired by a biotech start-up. They wheeled him in to see their investors and said "look, we've hired a McK... consultant, if you give us a shitload more money he'll make sure it's put to good use!" They got the dough, put this guy back in his office, paid his salary, and never spoke to him again. Not even when the company went belly up 18 months later.

[Keef]

Asset I hope you're reading this. Looks like you chose the right subject to study! I can't believe those figures!

[paragon]

It is very simple to say, you can't be that broke if you can afford ?1000 a day on consultant. Ultimately you need to invest money to improve processes and reduce costs, bringing in an expert with a mandate is one way to make step changes to how an organisation operates and cut through internal political issues.

That kind of rate is common place and to attract any kind of quality the NHS needs to pay market rates. If the consultant has provided similar services to other organisations then the knowledge will be invaluable.

With regard to 30%, you have to start somewhere and you have to have a benchmark to judge yourself against. Otherwise it will just be a case of lets pay you ?1000 a day and save where you can. All organisations have fat that can be trimmed, whether it is staff, stock, equipment, bad deals with suppliers etc. All he needs to do is save ?220,000 in the first year and he has paid for himself and those savings continue year on year.

[SteveT]

Moos wrote:- But, in principle, I don't think that spending money on saving specialists is necessarily a waste.

They should be paid a peppercorn salary plus a percentage of what they save the company.

[paragon]

SteveT Wrote:

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> They should be paid a peppercorn salary plus a

> percentage of what they save the company.

Which is the model that a lot of BPO consultancies companies work on. However those contracts take a long time to agree and there is considerable workloads around governence, validation of savings etc etc. Imagine the outcry if the consultant saved ?100m and was given 20% of that. The headlines would be ridiculous.

[Moos]

What peppercorn said. With a cap. :)

[SteveT]

Paragon wrote:- Imagine the outcry if the consultant saved ?100m and was given 20% of that. The headlines would be ridiculous.

I doubt that, we probably wouldn't hear of it bit like the bankers who are queing up for there share of taxpayers bonus even as we speak.

[paragon]

SteveT Wrote:

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> Paragon wrote:- Imagine the outcry if the

> consultant saved ?100m and was given 20% of that.

> The headlines would be ridiculous.

>

>

> I doubt that, we probably wouldn't hear of it bit

> like the bankers who are queing up for there share

> of taxpayers bonus even as we speak.

I'm sorry but bankers pay has hit the headlines again recently in a major way. I think it would be even more loud if an institution which has always been paid for by the public suddenly starting paying multi million pound rates to consultants. Much like the GP's that made a fortune up north or the copper who has topped 100k