Dangerous consultants
Few things are more dangerous for the healthcare systems of Developing Countries than a PFI consultant. Suited and booted, we are told they often impress politicians and policymakers. If this is how the NHS in the United Kingdom funds hospital construction then why not follow its example?
There are several good answers to that one. Starting with the obvious point that PFI has proved extremely costly. Why should a sovereign state borrow from private investors if it can raise the money directly for a fraction of the sum on the bond market?
And there are plenty of other problems with the model. Not least the fact that any changes to a PFI-financed hospital structure are extremely expensive. Buyers are essentialy having to say they know what their hospitals should look like in 20-30 years time.
And if the UK can not control PFI properly what happens in countries with far lower standards of governance?
What is needed is not consultants peddling poor First World solutions, people who are selling transactions, but rather consultants who understand local healthcare needs and how to meet them. That sounds so elementary as to be barely worth stating. Yet we are told again and again that only a few dozen consultants worldwide can do this. And that they do not work for the Big Four or McKinsey.
We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.
