Trust in the private sector
Shock, horror – we’re being told that KPMG’s intervention to sort out the financial management of more than 80 NHS trusts might have been worthwhile.
Last week, Accountancy Age reported that the number of trusts in
need of intensive financial care from the Big Four firm was not 50, as
understood from government, but a much more widespread 81 – a figure that seems
to indicate that the contagion of poor finances was heading toward epidemic
proportions.
This week we report that FDs in the NHS have actually found KPMG’s work and
advice to be of great value. This is surprising because there tends to be a knee
jerk reaction to the involvement of the private sector in public sector
concerns. Indeed their appointment is sometimes viewed much like the arrival of
witchdoctors – full of drama, expensive and not resulting in the outcome
entirely hoped for.
Unlike witchdoctors, however, the staff of Big Four firms tend to make little
fuss and are not reliant on a bag of bones for seeing the future. They bring
with them experience of management elsewhere, methodology, analytical skills and
rationality.
That doesn’t necessarily mean they can cure all ills, but it does give them a
fighting chance. That’s because financial problems tend not to be caused by evil
spirits. The causes can be sought and identified, and potentially remedied. It
just sometimes takes a different mindset and a different experience to do it.
The surprisingly positive reaction of the NHS FDs we spoke to indicates that
a change is underway. The public sector is beginning to accept that it doesn’t
have all the answers and that experts from the outside may have something to
offer.
Although this seems to be stating the obvious, it is not always the case. In
many quarters there’s still something of an ideological battle between public
and private sectors to determine who knows best, and the health service has in
the past provided the cause for some of the most vociferous disagreements.
If our FDs are anything to go by, however, the public sector might now be
giving way to a general acceptance of external wisdom. The important thing now
is that whatever KPMG does provide, it should live up to the growing faith being
placed on it.
There is enormous risk involved. Failure would allow doubters to continue
claiming that the private and public sectors do not mix, just as a witchdoctor
would never administer antibiotics.