NHS spending debate focuses on the wrong type of consultant

There is an important debate to be had about the use of external management support in the NHS, most notably to deliver Mr Lansley’s reforms, but the health secretary did not seem interested in having it. Thank heaven, as ever, for the sane and wise words of NHS Confederation acting chief executive Nigel Edwards, whose ubiquitous media presence meant that some of the context was explained.

At almost the same time as the government was trying to whip up a frenzy over management consultancy spending, it announced a review of the clinical excellence and distinction awards

The government’s announcement of the findings read exactly like the kind of bulletin released by opposition parties during the dog days of August and designed to bring the relevant minister scuttling back from their summer holiday to combat the press furore. As with other politically led announcements made over the summer, the tone and content had many DH officials cringing with embarrassment.

So why do it? The most likely reason seems to be as a diversionary tactic. It is better for the government for attention to be focused on the record of the last administration than the challenges to come.

At almost the same time as the government was trying to whip up a frenzy over management consultancy spending, it announced a review of the clinical excellence and distinction awards given to medical consultants. The news received a tiny proportion of the coverage given to the management consultancy story. But, as a marker to future action on NHS spending, it is of much greater significance.

There is a growing awareness in the NHS that getting a tighter grip on the additional and incremental aspects of NHS pay is the main ingredient of delivering the £15bn of savings likely to be required by March 2014. This review of existing contractual entitlements is likely to be wide ranging and affect most staff. It is also likely to be the biggest cause of strife in the service over the next three years - and no diversionary tactic will disguise that.