On Newsnight tonight, Andrew Lansley called the PCTs bloated for spending £261 million on management consultants. Now, I'm no fan of management consultants, but that is approximately 0.35% of the budget of the PCTs. In comparison, the Conservative / Liberal Democrat administration ruining Birmingham splashed £60 million on consultants, which equates to 1.7% of their total budget or almost FIVE times (4.82 for the pedants) as great a proportion as all the PCTs. So Lansley must think that Birmingham is even more badly managed than the PCTs.
Make no mistake about any of this - just as the promises about parents running schools are used as cover to allow gradual private sector takeover, so this is opening the hospital doors to the private management companies.
This was not a manifesto commitment, indeed the Tories railed against top down reorganisation of the NHS, so you have to ask - was this policy invented in the past few weeks or was it kept hidden from the public? If the former, shouldn't a revolution on this scale have some form of trial? If the latter, why did they keep it away from scrutiny? It will lead to two to three years of institutional chaos as structures need to be rebuilt and contractual issues dealt with.
I'm not convinced that these proposals will reduce management costs, when you consider that you will end up with 500 or more individual GP commissioning groups across the country all negotiating contracts with hospitals and you will also find huge departments dedicated to resolving contractual differences and handling billing.
I'll place a small bet - that if these policies are implemented on this scale suggested, then independent research, will show an increase in the overall proportion of the NHS budget spent on management.