If any one company has played a decisive role in the destruction of the NHS, it is the US consultancy giant McKinsey – a fact avoided by the media until the passage of Andrew Lansley’s health bill looked assured. By then the sheer scale of the company’s penetration of the corridors of power was impossible to ignore. Its influence extends far beyond the privatisation of the NHS. The former management consultant David Craig was not exaggerating when he said the company ‘has gained unprecedented power over the lives of British citizens’.
McKinsey has about 9,000 consultants in 55 countries, working with more than 90 per cent of the 100 leading global corporations and two-thirds of the Fortune 1000 list of companies. Forbes estimated the firm’s 2009 revenues at £4 billion. It consults for rival firms at the same time, and while it maintains that its left hand doesn’t tell the right hand what it is doing, this is widely disputed. It has certainly offered to share information gained from its work on privatisation for the Department of Health with private health companies seeking business from the department, as revealed in emails obtained by Spinwatch under the Freedom of Information Act.
Each of the firm’s 400 senior partners is estimated to make between £3 million and £6 million a year, and ‘junior directors’ over £1 million. Partners and other McKinsey staff regularly take senior jobs inside government. Dr David Bennett, a former senior partner, became chief of policy and strategy for Tony Blair from 2005 to 2007, and is now chairman and acting chief executive of Monitor, which will regulate the new healthcare market and play a crucial role in offering NHS business to private companies.
Dr Penny Dash was the Department of Health’s head of strategy from 2000 and a key author of the NHS Plan that set in train New Labour’s privatisation agenda. She subsequently became a McKinsey partner and played the lead role in producing New Labour’s two Darzi reports, the first of which sought to radically restrict levels of provision and staffing in London, while the second envisaged a system of privately owned polyclinics across the nation, under the guise of patient-friendly ‘clinical leadership’. In 2004 she set up the Cambridge Health Network, a McKinsey front that brings together departmental policy-makers with corporate executives at meetings sponsored by McKinsey client companies, from Halliburton to General Electric.
Besides penetrating the government McKinsey also plays a key role in the King’s Fund and the Nuffield Trust, the two dominant healthcare think tanks that have pushed the privatisation agenda. Both have senior McKinsey partners on their boards, and while they portray themselves as ‘independent’ they routinely endorse models of care that replicate the US health system – especially the concept of ‘integrated care’, which, while sounding progressive, points towards the US model of ‘managed care’, with its high insurance premiums, exorbitant CEO salaries and denial of care.
Among other key McKinsey initiatives leading up to the health bill – much of which is thought to have been drafted by McKinsey staff – were the Department of Health’s ‘World Class Commissioning’ initiative, and the ‘Framework for External Support for Commissioners’. These made it clear that private firms, not GPs, would end up spending the budgets of the new clinical commissioning groups – and McKinsey would be one of them. It was also a McKinsey report for the department in 2009 that called on the NHS to find ‘efficiency savings’ of £4 billion every year for five years, leading to the cuts now being imposed – another topic on which the media have been culpably silent, as the report was full of fallacies.
Of special relevance to the future of health care in England is a 2008 document produced by the American Association of Justice listing the ‘10 Worst Insurers’ in the US, at least three of which were advised by McKinsey. The worst was the property and auto insurer Allstate. According to the AAJ and lawyer David Berardinelli, Allstate sought, on McKinsey’s advice, to transform the very basis of the insurance relationship. Previously insurers always had a fiduciary responsibility to policyholders, but by following McKinsey’s advice to put shareholders’ interests first Allstate’s payments to policyholders fell by over 25 per cent, while its ten-year operating income leaped from £510 million to £17 billion. In effect, said Berardinelli, it institutionalised bad faith.
With the passage of the Health and Social Care Act, private health insurance and payments for care are clearly on the agenda again. With McKinsey and its clients set to play a dominant role in this shift, are we in for an English version of the Allstate model too?
Illustration by Martin Rowson
Grassroots posters giving an alternative take on the general election
Hundreds of people surrounded the fences this weekend. Hera Lorandos spoke to women who have suffered inside.
Laying out the case for Labour's leadership of a Progressive Alliance, Jeremy Gilbert argues that far from posing a threat to the Left, the Progressive Alliance offers a golden opportunity to end Tory rule and build a 21st century government committed to social justice
The Greens have stood down in Brighton Kemptown to clear the way for Labour, and the Lib Dems won’t stand in Brighton’s other seat, Green-held Pavilion. Davy Jones, who would have been the Green candidate in Kemptown, says this shows the way forward
The snap general election represents a unique opportunity to defeat this terrible government. We believe that visual artists have a crucial role to play!
Drax is the UK's biggest source of CO2 emissions – and we're paying for it, writes Almuth Ernsting
For the past 3 years, Barby Asante and members of London-based artists' collective, sorryyoufeeluncomfortable, have been responding directly to the vision of James Baldwin. Ahead of the nationwide release of a new film about the American activist and author, they reflect on the enduring relevance of Baldwin in Britain today.
Housing campaigners' gains in Bristol are spurring on a national movement to build a renters' union, writes Stuart Melvin
A new Espionage Act threatens whistleblowers and journalists, writes Sarah Kavanagh
We need an anti-austerity alliance, not a vaguely progressive alliance, argues Michael Calderbank
Greece’s heavy load
While the UK left is divided over how to respond to Brexit, the people of Greece continue to groan under the burden of EU-backed austerity. Jane Shallice reports
On the narcissism of small differences
In an interview with the TNI's Nick Buxton, social scientist and activist Susan George reflects on the French Presidential Elections.
Why Corbyn’s ‘unpopularity’ is exaggerated: Polls show he’s more popular than most other parties’ leaders – and on the up
Headlines about Jeremy Corbyn’s poor approval ratings in polls don’t tell the whole story, writes Alex Nunns
The media wants to demoralise Corbyn’s supporters – don’t let them succeed
Michael Calderbank looks at the results of yesterday's local elections
In light of Dunkirk: What have we learned from the (lack of) response in Calais?
Amy Corcoran and Sam Walton ask who helps refugees when it matters – and who stands on the sidelines
Osborne’s first day at work – activists to pulp Evening Standards for renewable energy
This isn’t just a stunt. A new worker’s cooperative is set to employ people on a real living wage in a recycling scheme that is heavily trolling George Osborne. Jenny Nelson writes
Red Pepper’s race section: open editorial meeting 24 May
On May 24th, we’ll be holding the third of Red Pepper’s Race Section Open Editorial Meetings.
Our activism will be intersectional, or it will be bullshit…
Reflecting on a year in the environmental and anti-racist movements, Plane Stupid activist, Ali Tamlit, calls for a renewed focus on the dangers of power and privilege and the means to overcome them.
West Yorkshire calls for devolution of politics
When communities feel that power is exercised by a remote elite, anger and alienation will grow. But genuine regional democracy offers a positive alternative, argue the Same Skies Collective
How to resist the exploitation of digital gig workers
For the first time in history, we have a mass migration of labour without an actual migration of workers. Mark Graham and Alex Wood explore the consequences
The Digital Liberties cross-party campaign
Access to the internet should be considered as vital as access to power and water writes Sophia Drakopoulou
#AndABlackWomanAtThat – part III: a discussion of power and privilege
In the final article of a three-part series, Sheri Carr gives a few pointers on how to be a good ally
Event: Take Back Control Croydon
Ken Loach, Dawn Foster & Soweto Kinch to speak in Croydon at the first event of a UK-wide series organised by The World Transformed and local activists
Red Pepper’s race section: open editorial meeting 19 April
On April 19th, we’ll be holding the second of Red Pepper’s Race Section Open Editorial Meetings.
Changing our attitude to Climate Change
Paul Allen of the Centre for Alternative Technology spells out what we need to do to break through the inaction over climate change
Introducing Trump’s Inner Circle
Donald Trump’s key allies are as alarming as the man himself
#AndABlackWomanAtThat – part II: a discussion of power and privilege
In the second article of a three-part series, Sheri Carr reflects on the silencing of black women and the flaws in safe spaces
Joint statement on George Osborne’s appointment to the Evening Standard
'We have come together to denounce this brazen conflict of interest and to champion the growing need for independent, truthful and representative media'
Paul O’Connell and Michael Calderbank consider the conditions that led to the Brexit vote, and how the left in Britain should respond
On the right side of history: an interview with Mijente
Marienna Pope-Weidemann speaks to Reyna Wences, co-founder of Mijente, a radical Latinx and Chincanx organising network
Disrupting the City of London Corporation elections
The City of London Corporation is one of the most secretive and least understood institutions in the world, writes Luke Walter
#AndABlackWomanAtThat: a discussion of power and privilege
In the first article of a three-part series, Sheri Carr reflects on the oppression of her early life and how we must fight it, even in our own movement
Corbyn understands the needs of our communities
Ian Hodson reflects on the Copeland by-election and explains why Corbyn has the full support of The Bakers Food and Allied Workers Union
Red Pepper’s race section: open editorial meeting 15 March
On 15 March, we’ll be holding the first of Red Pepper’s Race Section open editorial meetings.
Social Workers Without Borders
Jenny Nelson speaks to Lauren Wroe about a group combining activism and social work with refugees
Growing up married
Laura Nicholson interviews Dr Eylem Atakav about her new film, Growing Up Married, which tells the stories of Turkey’s child brides
The Migrant Connections Festival: solidarity needs meaningful relationships
On March 4 & 5 Bethnal Green will host a migrant-led festival fostering community and solidarity for people of all backgrounds, writes Sohail Jannesari
Reclaiming Holloway Homes
The government is closing old, inner-city jails. Rebecca Roberts looks at what happens next
Intensification of state violence in the Kurdish provinces of Turkey
Oppression increases in the run up to Turkey’s constitutional referendum, writes Mehmet Ugur from Academics for Peace
Pass the domestic violence bill
Emma Snaith reports on the significance of the new anti-domestic violence bill