In a previous blogpost for #JusticeforLB, using Freedom of
Information requests I went through how much Southern Health NHS Foundation
Trust spent on external consultancy and legal/professional services in 2013/14
and 2014/15 (see http://dataforlb.blogspot.co.uk/2015/07/watching-consultants.html
). I’ve now got this information for 2015/16 (in two batches because I was
impatient, see https://www.whatdotheyknow.com/user/chris_hatton
) via the good offices of What Do They Know? and the genuinely efficient FoI
office at Southern Health.
The previous blogpost goes through a lot of the issues in
too much detail, and I don’t want to repeat all of that detail here. Instead, I
want to talk about some general trends in Southern Health spending over these
three years.
The graph below shows the total amount that Southern Health
spent on consultancy and legal/professional services (although these categories
seem to be somewhat arbitrary to me) from 2013/14 to 2015/16.
Overall, in 2015/16 Southern Health spent £2.23 million on
consultancy/legal/profs - 0.7% of their total income of £331 million in 2015/16.
Overall this is down from 2014/15, when Southern Health spent £3.28 million
(0.9% of their total income of £346 million). But still not a trivial amount
when your income has dropped by 6% in two years.
Looking at the two main categories of spending, the big drop
came in spending on consultancy (from £2.17 million in 2014/15 to £1.06 million
in 2015/16). However, spending on legal/professional services stayed pretty
steady (from £1.12 million in 2014/15 to £1.17 million in 2015/16) and is now
outstripping spending on consultancy.
So who are the lawyers and what are they getting paid for?
We know from the excellent My Life My Choice (see http://mylifemychoice.org.uk/how-much-did-southern-health-nhs-trust-spend-on-connor-sparrowhawks-inquest/
) that Southern Health apparently spent £318,121 (including VAT) just on the
costs of lawyers at LB’s inquest. The FoI tables don’t typically give that
level of detail, but there are some clues.
First, there seem to be some law firms that do the kinds of
tasks you would expect, for example relating to property (Paris Smith LLP;
Savills LLP) or a whole range of legal stuff (Capsticks LLP; DAC Beachcroft). The
amount that Southern Health pays to these law firms fluctuates over the three
years and adds up to a tidy sum (£236,003 across these four law firms).
However, it’s not nearly as much as the amount paid to three
other law firms, whose services go under the strategically vague ‘clinical
governance and audit’ category. By far the biggest is Bevan Brittan LLP – from £47,802
in 2013/14 and £44,932 in 2014/15, their income from Southern Health leapt to
£265,522 in 2015/16. Their stance on inquests involving the deaths of people in
public services can be gained from articles on their website such as “Avoiding
a Coroner’s Rule 43 report at an inquest”
(https://www.bevanbrittan.com/insights/articles/2011/avoidingacoronersrule43reportataninquest/
) and “Under the microscope: a note on inquests and NHS Trusts” (https://www.bevanbrittan.com/insights/articles/2013/thewideninggyre/
), which has the following gem of wisdom:
“There is a
view that if something goes wrong, it is usually somebody’s fault and unless
the mistake is paid for by the person responsible it is more likely to be
repeated. At the same time, post-incident investigations undertaken within the
NHS are usually expected to adopt a no-blame approach. The inquest process
still seems to pay lip-service to both ends of the spectrum. A stock phrase at
the outset of an inquest is that ‘no-one is on trial, least of all the
deceased’. At the same time it is becoming common for inquests involving
healthcare staff to be a trial by ordeal in all but verdict and sentence. And
yet there is little that can be done to protect such staff or the Trust from
gratuitous intimidation, particularly given the cost of a challenge to an
inquest and the likelihood that, even if successfully challenged, it will only
mean the inquest will be repeated.”
Other new entries for 2015/16 were Hempsons (‘Leading lawyers
for health and social care’ http://www.hempsons.co.uk/
) – paid £52,147 in 2015/16 by Southern Health, and Weightmans LLP (‘A top 45
law firm’ http://www.weightmans.com/ )
– paid £45,669 by Southern Health in 2015/16.
On the consultancy side (although boundaries are blurred, to
say the least), the reduction in Southern Health spending is largely accounted
for by the demise of Going Viral, designed by occupational psychology firm
Talent Works (http://www.talentworksltd.com/case-studies/going-viral-wins-national-award
) - spending went from £908,832 in 2013/14 to £642,272 in 2014/15 to a big fat
zero in 2015/16.
Other consultancy firms are still being paid large amounts
by Southern Health – by far the biggest is Deloitte, which was paid £65,455 in
2013/14; £285,128 in 2014/15; and a stratospheric £611,721 in 2015/16.
Local management consultancy buddies Consilium Partners
continue to get regular bungs from Southern Health - £158,250 in 2013/14;
£114,261 in 2014/15; and £103,920 in 2015/16. IRG Advisors (another ‘management
consulting firm’ https://www.linkedin.com/company/irg-advisors
) got £64,893 in 2015/16 (although way down on their £265,599 in 2014/15).
Newcomers PA Consulting (their website seems to suggest they will do absolutely
anything http://www.paconsulting.com/
) pocketed £56,056 in 2015/16.
In what strikes me as an even more sinister turn, we have
MBI Health Consulting – they were paid £25,000 in 2013/14, £296,431 in 2014/15
and £39,600 in 2015/16. What particularly perturbed me was that the 2015/16
amount was, according to the spreadsheet, for ‘LD management’. And even worse,
in 2015/16 Southern Health paid £4,536 to St Andrews Healthcare (yes, that St Andrews), also for ‘LD
management’.
If I had any sort of role in the governance of Southern
Health, I’d be very concerned about what all these shadowy management
consultancies are doing (quite apart from demanding my money back…). What is
their role in the management of an NHS service? Where’s the scrutiny (they very
rarely appear in Board papers, and don’t seem to ever be called to Board
meetings)? Where’s the accountability? (I know such a question seems naïve to the
point of, I don’t know, something, but how could a person in one of those
consultancies be disciplined for bullying members of staff, for instance, or
for taking a management decision that directly led to a person’s death in the
service?).
Just to finish off, a couple of snippets that caught my eye.
In 2015/16, Southern Health paid Hampshire County Council £59,459 relating to
Southern Health’s Chief Operating Officer, Chris Gordon. A thickening of the
local web of connections, and a disincentive for Hampshire County Council to
push Southern Health too hard?
And finally, Southern Health paid £47,280 to Aston
Organisation Development, but £42,552 was paid back. Aston Organisation Development (see http://www.astonod.com/ ) is a consultancy
company based on team-based working, and its director is Mike West, guru of promoting
health service cultures to promote high quality care. Southern Health is not
listed as one of Aston’s recent clients on its website. An accounting error, or
one of the parties deciding very quickly that an intervention from Aston wasn’t
going to work out?
