Words by Richard Fleury
Cartoon from Martin Rowson
Back in 2008, Tatler magazine treated ten fresh-faced young twenty and thirty-somethings to an 'A-list makeover' photoshoot. This Yves Saint Laurent-modelling brace of 'top Tory totty' might one day constitute a Conservative Cabinet, gushed the hooray bible.
Number nine was “Helen Whately, 32, PPC (Prospective Parliamentary Candidate) for Kingston and Surbiton. Tipped as future health secretary. Married and expecting her first child, she is a former national dressage champion who was educated at Westminster and studied PPE at Oxford”.
Back then Helen was working for the healthcare department of McKinsey, the powerful US management consultancy driving the race to replace the NHS with a private, American-style health system.
Twelve years later, none of the Tatler Tories have made a political mark – except Helen Whately. Recently appointed health minister, Helen's career plan is still very much on track. Health Secretary could be just one more promotion away. She is closing in on the prize.
As Faversham's local MP, Helen claims to “champion our local NHS” and work for a “fair share of funding”. Meanwhile she is a member of a government that has starved the NHS of funding and demolished its founding principles at the request of her former employer.
Unfortunately, Faversham's local NHS faces the same problems, from a shortage of doctors to longer waiting times, as the rest of the country. Because they are the result of Government policy.
Helen often expresses a wish to "improve" healthcare and "make the NHS better". But improve how and make it better for whom? She often mentions her experience "in healthcare" and "working in hospitals" But what, precisely, did that work entail?
Born in Norfolk in 1976, Helen grew up in Surrey, a horsey public school girl with doctor parents. Her father Robin Lightwood was a surgeon, her mother Andrea an NHS staffer. But instead of following them into medicine, she chose a very different path. Not only did she pursue a lucrative corporate career, she set her sights on a global company credited with a decisive role in the NHS' destruction: McKinsey & Co.
The world's most expensive management consultancy, McKinsey has been sinking its fangs into our health service for decades while orchestrating its impending Americanisation. The Mail on Sunday dubbed it 'the firm that hijacked the NHS'. Insiders know it simply as 'The Firm'. Where its sharp-suited, jargon-spouting consultants go, cuts follow, jobs vanish and its accounts swell with public money.
To the private sector, the NHS' £120 billion annual budget is a bottomless treasure chest. Management consultancies like McKinsey open it up, diverting vast sums from patient care in the process.
Every year, they siphon hundreds of millions from an underfunded service to find cuts that will damage it further. Annual NHS spending on management consultants more than doubled from £313 million in 2010 to £640 million in 2014. Each trust now pays them an average of £1.2 million a year; the equivalent of around 20 more hospital managers, 10 consultant doctors or 35 senior nurses.
For that, management consultants concoct a financial case to justify selling off profitable services while closing down vital but costly acute units such as A&E.
Yet trusts spending millions on them actually became less efficient. A 2018 Bristol University study concluded: “Management consultants are not only failing to improve efficiency in the NHS but are making it worse.”
After Oxford, Helen began her management consultancy career as a trainee in PricewaterhouseCoopers' media and telecoms department. After a short stint with AOL Time Warner, she spent nine months advising then Conservative shadow culture secretary Hugo Swire MP on media policy.
In 2007, she landed a job with McKinsey's healthcare division. For the next eight years she worked at The Firm's London office in Jermyn Street, Picadilly, rising to 'engagement manager''
Just below partner in the McKinsey pecking order, engagement managers typically earn more than £100,000 a year: double the salary of an NHS GP.
Working for McKinsey is corporate CV gold. The most expensively-educated, sharp-elbowed young overachievers on the planet compete for the privilege. But the 'up or out' company culture is brutally selective and only one in five last long enough to make partner. Those who do collect multi-million pound salaries. The rest fan out across the world's boardrooms and governments, taking The Firm's ruthless, uber-capitalist ethos with them. There's a saying: “Once a McKinseyite, always a McKinseyite.”
McKinsey staff admit The Firm is 'a bit of a cult', with some comparing it with the Freemasons or Scientology, according to a Sunday Times article last year.
In his 2013 bestseller The Firm: The Inside Story of McKinsey, The World's Most Controversial Management Consultancy, business journalist Duff McDonald writes: “Like almost no other firm in existence, McKinsey becomes a part of its people's self-image. Years after leaving the firm, ex-consultants still use 'we' when referring to McKinsey, even in the present tense.”
What sets The Firm apart from its rivals is what Duff McDonald calls its “extraordinary alumni network, the McKinsey mafia”, which has “succeeded in getting lucrative government business around the world”.
“The one place where it has truly infiltrated government is in London,” he writes. “It has had pretty much uninterrupted access to 10 Downing Street for decades.”
In 2010 The Conservatives granted Helen a try-out as their youthful new Prospective Parliamentary Candidate for Kingston and Surbiton. Our 'future Health Secretary' was endorsed by senior Tories including then actual Health Secretary, Jeremy Hunt.
“With her experience working in healthcare, she'll make a particularly valuable contribution to the challenge of improving the NHS,” said Hunt, the politician who literally wrote the book on health privatisation.
At the time Helen was still working for McKinsey. Her own department proposed the £20 billion cuts in the NHS budget that slashed 137,000 jobs and are still devastating public health today.
On her own electoral doorstep, the same cuts threatened Kingston Hospital's A&E and maternity units with potential closure. Five years later, McKinsey was paid £500,000 – enough to pay for 100 hip replacements – for yet another report on the underfunded hospital.
Helen didn't win Kingston and Surbiton for the Tories. But she performed well enough to be considered future MP material.
With senior McKinsey director Nicolaus Henke, Helen wrote a 2011 report calling calling for the NHS to share more of its data, titled: ‘Transparency the most powerful driver of health care improvement?’
No such transparency applies to McKinsey itself however. Even by management consultancy standards, The Firm is notoriously secretive. As a private company, it is not obliged to name hospital trusts or private health companies it works for. And, like its corporate health clients, it is exempt from full public scrutiny under Freedom of Information rules.
But in 2011 Spinwatch, an organisation investigating the lobbying industry, revealed McKinsey acted as a “middleman” between the Government and global health corporations. The firm helped hold Health Department discussions about “international players” running “up to 20 NHS hospitals” with “a free hand on staff management” reported The Guardian.
Spinwatch unearthed more emails showing McKinsey staff had actually written key sections of the 2012 Health and Social Care Act, a bill widely regarded as the NHS' death warrant.
Known as the 'Lansley Act' after the health secretary responsible, the bill abolished the Government's fundamental duty to provide healthcare, one of the principles the NHS was founded upon back in 1948. Thanks to McKinsey, we no longer have a national health service based on sharing the cost of ill-health.
Not content with pocketing £13.8 million from contracts arising from the bill it helped draft, McKinsey also used its privileged access to share information with its clients – including US corporations lining up to bid for NHS work.
The Mail on Sunday published Spinwatch's findings in an exposé headlined 'The Firm that Hijacked the NHS'. It reported how Helen's colleague and co-author Nicolaus Henke had entertained top NHS officials and their families with lavish jollies including Royal Opera House performances and a trip to Cirque du Soleil. A member of David Cameron's so-called Number 10 'kitchen cabinet’ Henke regularly advised the then Prime Minister on health policy.
“The ‘revolving door’ between McKinsey and the health service means that numerous former employees are already embedded in jobs which will be critical if the radical reforms are fully enacted,” the paper warned.
Sadly, the scandal changed nothing. If anything, the revolving door is spinning faster than ever. For years, the cabal running the NHS, the Health Department, health think tanks and regional health bodies is stuffed with senior private sector figures. NHS England CEO Simon Stevens himself was, until 2014, president of the global health division of UnitedHealth Group, a US private healthcare giant.
This decision-making elite share a common, coded language, impenetrable to outsiders, which dresses up the dismantling of our health service in euphemism. It's a language Helen is fluent in.
Veteran investigative journalist John Pilger calls it 'deadly spin'. “They use a vocabulary that is a deceitful one. What they mean by reform is privatising and destroying,” says Pilger, whose recent ITV documentary The Dirty War on the NHS, revealed the horrifying reality of the American health system.
The NHS is being 'transformed' in the same sense that the Luftwaffe transformed London, its services 'reconfigured' like a butcher reconfigures a cow. Parts of the NHS ripe for private companies to profit from are 'sustainable', while downgrading a hospital is 'bringing care closer to home'. What communities losing their vital medical services call hatchet jobs, McKinsey refers to as ‘hospital transformation programmes'. Helen has personally led several.
“Some of these projects have been about the whole hospital, others have been specific services like maternity or surgery,” she said.” They have all aimed to dramatically improve patient care.”
Note the carefully inserted “aimed to”. Did Helen's efforts improve patient care dramatically? Or at all? “I’ve worked with staff from the CEO to frontline doctors, nurses and healthcare assistants,” continued Helen. How many still have their jobs?
One high profile McKinsey 'transformation' Helen was involved in was the destruction of Lewisham Hospital, in South London.
In 2013 Health Secretary Jeremy Hunt tried to downgrade Lewisham, a successful, well-managed community hospital in South London. Consultants led by McKinsey were paid £3 million to plan the closure of acute services, staff cuts, bed losses, land sales and the transfer of profitable planned operations (so-called elective care) to private health companies.
Hunt infamously used the debts of a struggling nearby trust to justify closing Lewisham's A&E department. When an A&E hospital is downgraded, losing acute facilities like blood banks, oxygen and surgery, it can no longer have an obstetric-led maternity unit. So its maternity services are also downgraded, leaving mothers with midwife care but no specialist staff trained to deal safely with potentially risky births.
Desperate to save Lewisham hospital and its maternity unit, supporters took legal action and a judicial review found Hunt's decision to be unlawful. So he changed the law. In 2014, Clause 119 of the Care Bill – known as the ‘Hospital Closure Clause’ – gave the Health Secretary powers to close local hospitals, even those performing well.
Legal obstacles removed, Lewisham was immediately back in Hunt's and McKinsey's sights.
“In comes Helen Whately to 'reconfigure' maternity services across Lewisham and Greenwich boroughs,” recalls Jessica Ormerod, then Chair of Lewisham's Maternity Services Liaison Committee. “I worked with Helen on this through gritted teeth. I was so angry that the very same company that wrote the Health and Social Care Act privatising the NHS, who gave Lewisham illegal advice, were then brought in to further destroy maternity services.
“She knew absolutely nothing about maternity services. I had to tell her how they work,” said Jessica. “They put a young woman with young children in that job to absolutely kneecap us. You've got this simpering, sweet, very petite woman in front of you. She looks like butter wouldn't melt. But really she's serving corporate interests in order to privatise health. She's an operator.
“A lot of the midwives were taken in. I said to them: "Look at who she works for, What have they just tried to do to your jobs?"
McKinsey consultant Helen constructed a case for replacing properly staffed and equipped obstetric car with more midwife-led units. “But they are not linked to acute units,” says Jessica. “So they are not safe. It disregards all the women who are vulnerable, who have health needs and couldn't possibly ever give birth at home.”
Although some services remain, Lewisham Hospital is now “basically a glorified GP”, says Jessica: “In terms of the public being provided with a properly managed and staffed maternity service, it was disastrous.”
Across England, the number of babies dying within 28 days of birth (the neonatal mortality rate) was falling until 2014. Now it is rising again. The number dying before their first birthday (the infant mortality rate) has also climbed significantly across England and Wales since 2014, with poorest communities affected worst.
“There is a rise in babies dying who shouldn't die and who wouldn't have died before,” Jessica says. “I believe that's linked to the massive downgrade in maternity care that's offered in hospitals across England.”
“I subsequently read articles Helen published in different magazines posing as a maternity specialist or campaigner almost, saying 'let's bring care to women'. It made me feel physically sick.”
A year later Helen was gifted Faversham and Mid Kent, one of the safest Tory seats in England. She was on her way to parliament, declaring her mission was to 'fix the NHS'.
Speaking at a hustings event at Queen Elizabeth’s Grammar School, she was challenged to reveal her profession and employer by Green Party candidate (now Swale councillor) Tim Valentine.
“I was on the panel and pointed out that she is a management consultant working for McKinsey & Co,” Tim recalled. “She said: 'They are not paying me now!'”
Helen made her maiden speech in the Commons in June 2015, once again focusing on the NHS. She was immediately invited to join the Health Select Committee, an appointment conferring access to privileged information about the Government's health plans, and has since climbed rapidly up the ladder of power. Last year she was made deputy chair of the Conservative Party, then given her first ministerial role of Parliamentary Under-Secretary of State for Arts, Heritage and Tourism. In his latest reshuffle earlier this month, Boris Johnson made Helen a health minister.
McKinsey continues to be handsomely rewarded for its central role in the Government's 'NHS transition programme'. But what is the NHS transitioning into? And why?
Our Conservative Government's long term plan for the NHS (outlined on page nine of their election manifesto) mirrors the American system and gives global health corporations exactly what they want. By the time our future Health Secretary becomes a former Health Secretary, the transition will be almost complete.
The US-style future we are racing towards is a disaster. Around 45,000 Americans die every year as a direct result of having no health insurance. Life or death decisions are routinely made not by doctors but by anonymous insurance company employees. Illness causes a million bankruptcies a year. This entirely avoidable nightmare is being sold to us on the back of the lie that the market will improve healthcare by the very same companies that run the market: McKinsey and its clients.
"The American system is the worst value for money in the world,” said one Faversham GP who asked not be named. “Their health outcomes generally are poorer. In some parts of the US maternity death rates are higher than in some parts of Africa. Mothers are more likely to die in childbirth."
Sooner rather than later our NHS will be gone in all but name. Already operations and treatments are being rationed including hip and knee replacements, cataract removals and drugs for arthritis. Here in Kent, hernia patients have to "prove their pain" to get surgery, the Royal College of Surgeons revealed last year. As the Government's health privatisation accelerates over the next five to ten years, more care will be denied to those without costly health insurance.
Helen can look forward to a rather brighter future. Government experience commands top dollar in the upper echelons of the NHS privatisation business. Penny Dash, for example, the McKinsey senior partner behind the downgrading of Lewisham Hospital, was the Department of Health's strategy director under New Labour. Ten years ago Penny was reportedly earning £7 million a year plus bonuses. That was before McKinsey promoted her to senior partner in charge of the firm's European healthcare operation.
“Helen is extremely ambitious. I see her as someone who wants to move up: a proto-Penny Dash,” says Jessica Ormerod. “I can't imagine she would want to be in public service for her entire career. She's not going to get paid enough. She would be invaluable to McKinsey. What a great way to move up the food chain, if you have had experience as Health Secretary.”
“A lot of people have gone backwards and forwards between management consultancy and Parliament. Look at Patricia Hewitt, Stephen Dorrell. They walked into extremely lucrative jobs at PricewaterhouseCooper and KPMG, absolutely using their experience in government to work with government to rewrite legislation in favour of corporations.”
One day, her work in Parliament done, Helen too will be free to spin her way through the revolving door, leaving our NHS well and truly 'fixed'.
McKINSEY: 'THE FIRM THAT HIJACKED THE NHS'
McKinsey doesn't do morality. Despite guiding the actions of world’s most unethical corporations and despotic governments, it accepts no blame for the consequences.
“We do not support or engage in political activities” is the firm's official line.
A monster whose invisible tentacles encircle the globe, McKinsey has 127 offices around the world, 27,000 staff and a £7 billion annual revenue. Serving more than 2,000 institutions – including 90 of the top 100 corporations – it has propelled every trend in the world's economy.
“The “no policy” policy is classic McKinsey: a complete abdication of responsibility (moral or otherwise) for the courses of action it recommends,” said an anonymous McKinsey insider in an article for Current Affairs magazine last year, headlined Capital’s Willing Executioners.
Authoritarian governments in Ukraine and Turkey have hired McKinsey as a key advisor. While the Chinese government imprisoned a million ethnic Uighurs in internment camps in Xinjiang Province, McKinsey offered its services to 22 of the 100 biggest state-owned companies.
Saudi Arabia's rogue ruler – Crown Prince Mohammad Bin Salman – is one of McKinsey's biggest clients, The Firm has run more than 600 projects in the Kingdom since 2011.
In 2015 McKinsey produced a report identifying Saudi Arabian Twitter infuencers critical of the government. One activist, Omar Abdulaziz, is now in exile in Canada, another was arrested, and a third vanished, his tweets all deleted. Abdulaziz has linked the Twitter crackdown to the murder of his friend and fellow Saudi exile Jamal Khashoggi in 2018.
Khashoggi, a Washington Post journalist, was killed and dismembered by a Saudi hit squad in Turkey on the orders of the Crown Prince Bin Salman, according the CIA. The so-called Davos in the Desert conference in Riyadh just weeks later was boycotted by many US firms. But not by McKinsey.
But McKinsey hasn't just aided and abetted despotic governments. Its private sector record is equally reprehensible.
Energy company Enron was created by McKinsey consultant Jeff Skilling. McKinsey earned £6m a year advising Enron while endorsing the accounting methods that caused its collapse amid scandal and fraud in 2001.
McKinsey consultants pushed the securitisation of mortgage assets, the practice that triggered the credit crash of 2008. And in 2012 McKinsey's head for ten years, Rajat Gupta, was convicted in the US for insider trading.
More recently with America facing a devastating opiod drug addiction scrisis, the firm allegedly advised Purdue Pharma on how to “turbocharge” OxyContin sales and keep users hooked.
Here in Britain, McKinsey helped Margaret Thatcher privatise state industries and advised John Major on his disastrous Railtrack privatisation.
During the 1990s, McKinsey brought a bureaucratic 'internal market' to the BBC, making it more expensive to run while employing fewer people.
McKinsey “may be the single greatest legitimizer of mass layoffs” concluded one bestselling book. The Firm, by Duff McDonald, tells the story of how the company “helped invent what we think of as American capitalism and spread it to every corner of the world”.
McKinsey's role in the privatisation of the NHS also goes back to the 1990s, when its staff served as senior advisers to Tony Blair's government.
Behind its success, The Firm casts a dark shadow. “McKinsey has done direct harm to the world in ways that, thanks to its intense secrecy, are hard to know,” says Current Affairs' anonymous insider. 'We are now living with the consequences of the world McKinsey created.”
Helen Whately meeting Saudi King Salman in 2017