UK Health Security Agency still dependent on consultants

One-tenth of people working at the UK Health Security Agency are management consultants. New releases from the Public Accounts Committee suggest that some are earning upwards of £3,000 a day.

A decade of austerity left the UK civil service dangerously understaffed going into two of the greatest upheavals in British politics in 70 years. Brexit and then the state’s response to the Covid-19 pandemic required huge amounts of time and resources, and in both cases, the Government leant heavily on the consulting sector for support.

In recent months, this has seen questions increasingly raised as to whether this yields value for money – and whether it has left the civil service unable to deal with future problems itself. For example, the Government spent millions of pounds on various consulting firms throughout the pandemic – its advisory bill hitting £175 million by autumn of 2020 alone. This splurge was so large that UK Parliament announced a probe into the Government’s heightened use of management consultants amid the crisis.

In the months since, pressure has continued to build – externally and internally – on the Government to wean itself from consulting contracts. Cabinet Office minister Lord Agnew said the government's extensive use of external suppliers “infantilises the civil service,” while providing poor value for money. According to emails leaked to The Telegraph, meanwhile, the department launched plans to set up an in-house “Crown Consultancy” in 2020. But two years on, it has emerged that there is still a huge dependency on consulting firms from the Government.

A letter from Dame Jenny Harries to the Public Accounts Committee has admitted that, as of the end of January 2022, management consultants made up 13% of the UK Health Security Agency (UKHSA) workforce alone. Harries is a British public health physician, who has been the Chief Executive of the UKHSA and head of NHS Test and Trace since April 2021.

Test and Trace was another part of the Government’s operations which has reportedly spent large sums of public money on consulting work. In 2021, it was reported that consultants from Deloitte had milked it for a combined £1 million in daily fees, with some senior advisors billing more than £6,000 for a single day.

On this occasion, UKHSA is apparently paying management consultants between £706 and £3,100 a day – excluding VAT – according to Harries. However, in November 2021, when the most recent analysis took place, the average day rate was between those – at £1,244 excluding VAT.

Harries defended this, suggesting in the letter that the reduced (from £3,100) rate “reflects an approach focused on minimising the cost of management consultants for those deemed essential to operational delivery.” At the same time, she has publicly stated that consultants are a necessity in part due to the difficulty of filling roles relating to the pandemic. As Covid-19 response roles are generally offered on the basis of short-term loans, secondments and fixed term appointments “to avoid a permanent increase in the size of the organisation”, she had stated, “these are often less attractive, which reduces the supply of candidates.”

Looking ahead, however, it is unclear how UKHSA will reduce its dependency on consultants for future work either. Following the February announcement of the Government’s “Living with Covid” plan, and its Spending Review settlement, it has since been reported that the health agency plans to cut 40% of its jobs – around 800 full-time equivalent roles. The move, which public-health experts have called “irresponsible”, has not been confirmed by UKHSA. However, it seems at odds with Harries’ further claim that the review would enable “further significant reductions in the number of management consultants working in the UKHSA.” Especially not in the advent of another pandemic in the coming decade.