McKinsey & Company

This article is part of the Health Portal project of Spinwatch.

McKinsey & Company is a global management consultancy, advising senior management of many of the world's most powerful corporations, as well as governments, institutions and philanthropic foundations.

Its advice spans a range of business practices, including: technology, corporate finance, marketing and sales, operations, risk, and strategy.

Established in 1926, the company operates in more than 60 countries and made $8 billion in 2014. It remains privately-held.

Scandal

McKinsey's fingerprints can be found at the scene of some of the most spectacular corporate and financial debacles of recent decades.

Enron: 'the house that McKinsey rebuilt'

The collapse of energy-trading giant, Enron in 2001 was one of those high-profile corporate scandals. Enron's extraordinary growth – it become America's 7th biggest company in just 15 years – turned out to have involved an elaborate scam. Enron lied about its profits and concealed debts so they didn't show up in the company's accounts. Shareholders lost billions, thousands of investors lost their retirement pots, and many people lost their jobs. Enron CEO Jeffrey Skilling and former CEO Kenneth Lay, as well as its former chief financial officer, Andrew Fastow, were handed prison sentences for a range of crimes, including: fraud, money laundering, insider trading, making false statements to banks and auditors, and conspiracy.

The one Enron partner that was said to have escaped largely unscathed is McKinsey, which is odd, writes The New Yorker's Malcolm Gladwell, 'given that it essentially created the blueprint for the Enron culture.' McKinsey were also directly employed by Enron and the consultancy was key in Enron's massive growth and diversification. Under Mr Skilling, himself a former McKinsey employee, Enron was reportedly paying the firm $10m (£6m) a year for advice. McKinsey endorsed the accounting methods that caused the company to implode. The firm's dealings with Enron, however, were kept almost totally secret in the media despite McKinsey employees attending Enron board meetings and public appearances.

As the Observer noted in the wake of the scandal: 'Enron is the house that McKinsey rebuilt.' 'The processes and principles [Skilling] allowed were very McKinsey', it notes. Meanwhile, McKinsey 'used Enron as their sandbox'.

Encouraging risk on Wall Street

McKinsey has advised 'virtually all of the Wall Street banks' in recent years. According to Ben Chu, writing in the Independent, McKinsey's consultants promoted the securitisation of mortgage assets, 'the practice that poisoned the global financial system and precipitated the 2008 credit meltdown'. The firm also encouraged the banks to fund their balance sheets with debt, driving up risk.

Insider trading

In recent years two former McKinsey senior executives were convicted of insider trading.

In January 2010 Anil Kumar, a former McKinsey director, pleaded guilty to insider trading charges and publicly acknowledged giving corporate secrets gleaned on the job to Raj Rajaratnam, a founder of the Galleon Group hedge fund, in return for cash. More damaging for the firm, however, was the conviction in 2012 for insider trading of Rajat Gupta, who ran McKinsey for ten years. He also leaked boardroom secrets to the hedge fund billionaire.

Privatisations and public sector 'reform'

McKinsey is a believer in markets, the private sector provision of services and reducing the role of the public sector in delivering public services. It has controversially advised many national and regional governments on opening up their public sectors to private sector companies.

As Management Today commented in 2013: McKinsey is seen by some as a 'neo-liberal stooge promoting a market-oriented public sector into which its private clients might be helped to win lucrative contracts'.

Healthcare

McKinsey says it works 'with healthcare leaders to improve world health outcomes'.This includes helping national and regional government 'to transform care delivery and make it more sustainable', which has involved the widespread privatisation of services (see 'UK: the privatisation of NHS' below). At the same time McKinsey, earns most of its revenue from advising corporations: health insurers, private hospital groups, pharmaceutical companies, tech interests and investors – in other words companies that might benefit from the opening up of public services. McKinsey is, however, famously tight-lipped about the identities of its private sector clients. Who they work for and what they do for them is confidential.

UK: the privatisation of NHS (2010-)

McKinsey has been embedded in the UK health system for decades and has played a central role in efforts in recent decades to marketise and privatise the NHS. It has advised on reform of the NHS at every level of the system: the Department of Health, the health regulator, regional health bodies and local healthcare buyers (the new GP-led 'commissioning groups'). Examples of its advice include a 2009 report recommending the NHS cut ten per cent of its staff.

McKinsey alumni embedded in NHS

The firm has had a large number of former employees (see alumni network below) in central positions in the UK's health system. In recent years these have included:

• David Bennett; CEO of the health sector regulator, Monitor (2010-2015); spent 18 years with Mckinsey
• Adrian Masters; 'managing director of sector development', and former strategy director of NHS regulator, Monitor (2005-); ex-Mckinsey
• Sigurd Reinton; board member of NHS regulator, Monitor (2012-); spent 20 years with Mckinsey
• Paul Bate: 'director of strategy and intelligence' at the healthcare provider regulator, the Care Quality Commission; ex-Mckinsey
• Tim Kelsey: 'national director for patients and information' (2012-2015) at NHS England, one of only 8 national directors in charge of the NHS; ex-Mckinsey (where he led on 'the development of consumer propositions in public services’)
• Kingsley Manning, chair of the Health and Social Care Information Centre, custodians of NHS patient data; ex-Mckinsey
• Penny Dash, former Department of Health head of strategy and planning, co-author of the NHS Plan of 2000, which initiated the marketisation process; current McKinsey director in London office, focused on 'the redesign of healthcare systems'.

McKinsey ready to 'dive in and start trying to help'

In 2010, the UK coalition government, led by the Conservative Party embarked on its structural reform of the NHS. The scale of the planned changes was massive: the then head of the NHS, David Nicholson famously described them as so big as to be ‘visible from space’.

A week before the health secretary, Andrew Lansley presented his controversial Health and Social Care Bill to Parliament on 19th January 2011, McKinsey executives leapt into action. In a document released under FOI dated 11 January, a consultant from McKinsey contacts key health officials with the news that: 'We now have SoS [Secretary of State] approval for me to start working with you good folks again… I’d like to dive in and start trying to help.' To that end, the McKinsey consultant arranged a 'series of regular sessions' with these most senior health officials.

Redesigning the service

Many of the Health and Social Care Bill’s proposals were drawn up by McKinsey and included in the legislation wholesale, noted the Mail on Sunday in 2012. The Firm's executives were attending the meetings of the ‘Extraordinary NHS Management Board’ convened to implement the reforms, and sometimes McKinsey even hosted these meetings at its UK headquarters in Jermyn Street, Central London.

For example, documents released under FOI show that McKinsey was heavily involved in discussions over the organisational design of the 'new' NHS. A presentation emailed by McKinsey to Barbara Hakin, then deputy CEO of the NHS, outlines a workshop facilitated by McKinsey on 'NHS Organisational Design'.

The ambitious 'goals for the day' were to: 'Take stock of where we are in creating the new NHS Commissioning Board and broader system' [the NHS Commissioning Board was later renamed NHS England, which overseas the running of the NHS and its £100bn budget]. The group also sought to reach agreement and agree next steps on: 'Structures' of the reformed system; 'Culture', which was about determining their 'aspirations' and 'how the new NHS will embody our values and culture'; 'Physical space', which in consultancy-speak was concerned with 'leveraging the power of the physical space to strengthen our culture'; 'Managing change', which meant getting agreement on 'key aspects of whole system change, such as co-production'.

As part of this discussion on the NHS's organisation design, McKinsey also presented health officials with three examples of other organisation structures. The examples were: the US health provider, Kaiser Permanente, which McKinsey noted bore similarities to the new NHS Commissioning System; a 'Professional services firm'; and the 'New Zealand Health Board', an example of a public system. There is an enormous difference in the way these examples are presented: 6 pages are devoted to Kaiser Permanente, complete with diagrams, photographs, screen shots and headlines detailing the company's 'world-class' services with their 'rich patient interface'; by contrast the 3 pages given to New Zealand's health board consist of only very basic, grey/blue flow diagrams. The question leading the discussion after the presentation was 'Which element of each system made the strongest impression?'

'We have started to share this with clients'

In May 2010, just after the coalition government won the general election, McKinsey wrote to its former employee, David Bennett, head of the NHS regulator, Monitor, whose role it is to police the relationship between the private and public sectors. The subject of the email was 'The Future of the NHS'. It read:

'We have been gathering our thinking on the implications of the new government's programme for the NHS... We have started to share this with clients and thought this would be interesting for Monitor. Would you like to meet to discuss it?'

As the Mail on Sunday commented: 'Has the firm been exploiting its privileged access? The email from May 2010 suggests it has.'

Acting as a 'broker' between health officials and private healthcare

McKinsey also appears to be acting as a bridge between the public and private sectors. Further internal emails from the Department of Health show McKinsey connecting London’s health officials with one of Germany’s largest private hospital chains, Helios, to discuss ‘potential opportunities’ to take over public hospitals in London.

On 9 November 2011, a McKinsey executive wrote to senior health official Ian Dalton, saying: ‘We had good discussions... on how international hospital provider groups may help to tackle the performance improvement of English hospitals.' ‘They would be ready to step in if there were £500million revenue on the table, can keep real estate and pensions with NHS, needs free hand on staff management. This may now be a time when both sides [the NHS and foreign firms] may usefully explore their position as an input into how policy would be shaped.’

In the emails, McKinsey warned the department not to bundle off all the hospitals to the private sector at once – and instead start "from a mindset [of] one at a time". The consultants told officials to be mindful of the "various political constraints" associated with privatisation.

Taking over the 'buying' of healthcare

The government's reforms of the NHS were sold to the public as empowering GPs to make decisions about the planning and buying of healthcare (known as 'commissioning' in NHS-speak). However, critics accuse the government of handing these powers over to corporate providers of 'commissioning support services', which GP-groups are being encouraged to hire to make decisions for them. This includes decisions on everything from the planning of services to managing relationships and contracts with healthcare providers, and crucially deciding what the NHS will look like in the future – what NHS England calls ‘transformation and service redesign’.

It was revealed in August 2014, that McKinsey was part of a a select group of consultancy firms (and a US health insurance giant) that had been operating a discreet forum at which they received regular briefings from senior health officials on this commissioning support market, which is estimated to be worth £1bn. Other members of the group are outsourcing giant Capita; consultancies PwC, Ernst and Young and KPMG; and US health insurer UnitedHealth.

In 2015 NHS England announced the list of approved 'consortia' of suppliers of commissioning support services to the NHS. McKinsey is a supplier to over half of them.

Tech, tech, tech

McKinsey has long advocated the use of more technology in healthcare, and the digitisation of whole health systems.

For example, a 2012 McKinsey report – The ‘big data’ revolution in healthcare: Accelerating value and innovation - looks at the impact of data and analytics on the healthcare sector. Big data, it claims, will both cut costs and improve the quality of services, by: empowering people so they look after themselves better; promoting more evidence-based care (tailored more to individuals); providing accurate assessment of healthcare providers and the quality of their services, and by 'improving innovation'. The consequences, it says, will be improved health and a reduction of potentially hundreds of billions of dollars in healthcare costs. It does, however, include a few (important) caveats:

'Patients will not benefit from [big data] research on exercise, for example, if they persist in their sedentary lifestyles. And physicians may not improve patient outcomes if they refuse to follow treatment protocols based on big data and instead rely solely on their own judgment.'

Another 2010 McKinsey report on technology in healthcare - mHealth: A new vision for healthcare - similarly discusses the benefits from healthcare systems adopting mHealth (the use of mobile technologies to deliver healthcare services). This includes texting people to remind them to take medicines; remote diagnosis and even treatment for patients; and remote health monitoring devices that track and report patients’ conditions. Remote monitoring, for example, 'could help overweight adults... by tracking activity levels and nutrition intake,' i.e. whether they exercise and what they eat.

2005-:The world's biggest IT disaster

McKinsey has also advocated the widespread adoption of electronic health records (where patient health information is collected into one electronic record), which are central to many of the healthcare reforms advocated by the firm. McKinsey was involved, for example, in the NHS's attempt in the mid 2000s to move towards a single, centrally-mandated electronic care record for patients, as part of the NHS National Programme for IT. The IT programme cost the NHS £12bn and was widely condemned as a failure. It has been described as 'the biggest IT failure ever seen'.

Richard Brooks, writing for Private Eye in 2007, documented McKinsey's involvement in the project, and in particular the role of then McKinsey consultant, David Bennett who Brooks describes as playing 'a prominent role', and who then moved to head up Tony Blair’s Policy Unit:

It was never going to grab the headlines at the time, but a “seminar on information technology in the NHS” one February morning in Downing street five years ago was soon to unleash the most ruinously expensive civil technology programme in British history... the gathering brought together the government’s top IT zealots and the obligatory consultant from McKinsey in the shape of David Bennett... All agreed that the NHS could and should be radically transformed by IT. The vision was of a new NHS National Programme for IT, under which all patients’ health records would become electronically available, all admissions and appointments would be booked on-line and all medicines would be prescribed and dispensed without pharmacists having to decipher GPs’ handwriting. Not only would the plan galvanise the NHS’s creaky administration, it would realise the Blairite vision of choice in public health services.

..with billions of pounds of public cash on offer, management consultants were crawling all over the project. McKinsey, whose David Bennett was instrumental in winning Blair’s support for the programme, was rewarded with a contract to examine the healthcare IT market. Sitting alongside Granger in Harrogate, Bennett declared it to be in rude health. All that was needed, then, was for the many decent IT companies to “join up” and “roll out” what was already out there and within a couple of years the NHS would be electronically transformed. What could be simpler than that?

McKinsey's report designed 'to inform the approach before the start of the programme' was never published.

2010: The next tech steps

McKinsey remains involved in the NHS's IT plans.

For instance, a January 2014 'discussion document' by McKinsey, which was sent to Kingsley Manning, head of the NHS's Health and Social Care Information Centre (HSCIC) who is also ex-McKinsey, 'provides initial thoughts on how McKinsey could help with [the NHS's] Care.data programme'. Care.data is the NHS's data-sharing project, which will for the first time bring together data on hospital stays with patient data from GP surgeries into a central database held by the . It has been hugely controversial, mainly because of well-founded fears of what would happen to the data. As Phil Booth of campaign group Med Confidential, said: 'The basis of the programme is unchanged - identifiable medical information will be extracted from the GP record of every man, woman and child in England. This data will be centralised and made available in various forms to an open-ended array of organisations and companies for ill-defined purposes.'

The McKinsey discussion document for the NHS - Care.data: Turning data into insights - provides insight into some of the possible purposes. According to the document, one of the ambitions for Care.data is to create ‘Product lines of data insight available to “customers”’. ‘Is there a product and a matching customer,’ and ‘what are they interested in knowing?’ the document asks. The document also discusses the level of analysis the service will need to provide and the depth of the insights ‘we are pushing to the customer’. McKinsey also suggests a process for deciding the ‘service lines’ leading from the data. This includes: ‘market analysis’, including ‘Competitor analysis’; ‘quantify market need’; and ‘assess how to meet need’.

Care.data has been sold to the public, by contrast, as merely “creating a more substantial picture of our nation’s health so we can improve care for patients”.

Another presentation by McKinsey from January 2014 reveals that the firm was part of an NHS 'Working Group' examining the 'Impact of Data and Technology on the NHS'. .

UK:rail privatisation

Railtrack, the track operator created in 1994 as part of the privatisation of British Rail, is a good example of McKinsey networks at work.

For example, Railtrack's former CEO Gerald Corbett has links with one of its former board members, the Tory MP and ex-McKinsey man, Archie Norman. There is also a link with Kingfisher chief Sir Geoff Mulcahy, who subsequently appointed Mr Corbett to run Woolworths, until recently owned by Kingfisher. Archie Norman was once Sir Geoff's finance director at Kingfisher. Kingfisher is a big customer of McKinsey, and the retail group's former chairman, Sir John Banham, is a former McKinsey partner.

McKinsey has been accused of contributing to and profiting from Railtrack's collapse in 2002. According to reports, in the late 1990s Corbett commissioned McKinsey to devise a blueprint for Railtrack. The central recommendation was that Railtrack should "sweat" its assets. This meant replacing its cyclical system of rail maintenance with a programme where infrastructure was mended on an as-and-when basis. "The theme was very much that we should get the most out of the assets before we renewed them," says a Railtrack insider.

Railtrack's approach to limiting repairs on its infrastructure resulted in accidents and their ultimate demise. A 2002 article in the Independent commented on McKinsey's role:

'Once it has been paid millions to create something, it can knock it down again, as is about to happen at Railtrack.'

India: agricultural reform

In 2002 McKinsey were contracted by the Andhra Pradesh government in India to create a development plan which would bring them into the global economy.

The document it produced, entitled 'Vision 20/20, cost the Andhra government £3 million and advocates the industrialisation of farming and the influx of energy intensive industries to the region, boasting of India's exceptionally cheap wage labour (e.g $0.24/hour for textiles manufacture). The Department for International Development (DfID) offered £65 million to the project, which would benefit British corporations and industrial interests, but arguably exacerbate real poverty in the area. According to a Corporate Watch article a DfID spokesman said:

'Vision 20/20 is going ahead…Our aim is to take farmers out of the poverty they and their families have been in for centuries. The only way to do so is by modernisation, commercial consolidation of farms and the introduction of up to date farming methods, including the use of pesticides and machines and GM crops.'

In response the International Institute for Environment and Development, the University of Hyderabad and other bodies, created a 'citizens jury' which analysed the evidence around the Vision 20/20 strategy and unanimously rejected it. Their objections included claims that 20 million farmers would lose their land and livelihoods and fail to find other employment (being of lower castes); that there would be mass displacement; environmentally and socially destructive farming practices; bias towards export crops and goods at the expense of the local economy.

Corporate Watch note the implicit bias in the involvement of McKinsey, who represent large corporate interests and help them to maximise profits, in developing a poverty alleviation plan, especially at great expense (£3m) to the local government, money which could arguably have gone some way towards really alleviating the poverty in the state.

India: mining reforms

McKinsey's report 'Turning the minerals and metals potential of eastern India into a gold mine' suggests that exploiting the deposits (mostly bauxite, coal and iron ore) in three East Indian states - Chhattisgarh, Jharkhand and Orissa could lead to an 'unprecedented economic boom'. However, they note that;

Capturing this potential however will require a concerted and coordinated effort by industry players and the government.'

This area of East India contains some of the largest concentrations of Scheduled tribes, and reserved forest in India, and has already been the subject of major controversy over mining and refinery projects which have destroyed forest reserves, displaced tribal communities and been approved despite massive local resistance. Felix and Padels book 'Out of This Earth: East India Adivasis and the Aluminium Cartel' documents mining and metals developments in these states highlighting the clash of cultures between companies and the Government- looking for profit, and the needs of local people, who's livelihoods are invariably left in tatters by the health, environmental, social and economic ill-effects of mining projects. The book documents hundreds of environmental and human rights abuses, and collaboration between the legal system, companies, foreign aid agencies, consultancies and the government which have led to illegal and damaging projects.

McKinsey's report recommends; reducing clearance ands approval time and hurdles for mining projects, de-regulating the mining sector and privatising government mining companies and bodies, creating faster and cheaper infrastructure, providing cheaper power supply (coal or hyrdo-power). Their more detailed recommendations include creating 'Special Mining Zones' where conservation areas such as reserved forest are de-registered.

Culture

McKinsey has a strong reputation for advancing the interests of its clients partly through strict and ruthless employment rules and organisational strategy. These include:

• The 'up or out' policy, whereby staff must either get regularly promoted or be fired, encouraging a particularly rapacious breed of employee, eager to maximise the profit of clients and the firm.
• Non-exclusivity, whereby they will accept any client, even if they are direct competitors of another client. Though this rule requires absolute confidentiality, it works to their advantage as they can attract competing companies who are keen to get the same high profile advice.

Political reach

Alumni: the 'ultimate old boys' network

McKinsey has been described as acting as the "ultimate old boys' network" as past employees and clients become part of the 'alumni network' which includes Enron boss Jeffrey Skilling and Tory leader William Hague. According to a 2002 Independent article:

One source close to McKinsey says: "The alumni are seen as ambassadors to the McKinsey brand. The network isn't openly exploited, but the firm maintains a database of members and holds an annual reception for the alumni."

Political connections: UK

Matthew Elson, a former McKinsey senior partner, has become transport adviser in the Downing Street Policy Unit. Also working on transport is Nick Lovegrove, another senior McKinsey partner. He has agreed to work for nothing with his old friend Lord Birt, the former BBC director-general, on a similar transport study.

It's not the first time Mr Lovegrove, who would normally charge clients well over £1,000 a day, has offered his services to the Government for free. In 1998 he wrote a report on productivity that formed the backbone of Lord Falconer's reforms to the town and country planning system.

Another ex-McKinsey partner drafted into Lord Birt's "Forward Strategy Unit" is Adair Turner. He is a former head of the Confederation of British Industry, which boasts three past and one present McKinsey-trained director-generals.

People

Senior managers/directors

Due partly to the company structure, which lacks an executive board, there is very little information on senior employees on the firm's website.

In 2009:

• Ian Davis CEO (age 58)
• Dominic Barton Managing Director

Alumni

A 2008 USA Today article reported that McKinsey were the top company worldwide for producing CEOs from its alumni.

Some of McKinsey notable alumni are:

• Louis Gerstner, Jr. - former chairman and CEO of IBM and chairman of The Carlyle Group,
• William Hague - Ex-Tory leader
• James McNerney - chairman and CEO of Boeing,
• Helmut Panke - former chairman and CEO of BMW AG,
• Christopher Sinclair - former chairman and CEO of PepsiCo,
• James Gorman - Co-President of Morgan Stanley,
• Stephen Green - chairman of HSBC,
• Jonathan Schwartz, CEO of Sun Microsystems,
• Jeffrey Skilling, former (now incarcerated) CEO of Enron,
• Marius Kloppers - CEO of BHP Billiton,
• Bobby Jindal, current Governor of Louisiana,
• Vittorio Colao, CEO of Vodafone.
• Chelsea Clinton, daughter of former President and present Secretary of State Bill and Hillary Rodham Clinton.

McKinsey Quarterly

McKinsey publish a quarterly journal giving advice on market exploitation in various areas. Their 'Food and Agriculture' section contains articles on supermarkets, the brewing industry, genetic modification and selling packaged food to the Chinese.

Contact

55 East 52nd Street New York NY 10022 Phone: 212-446-7000 Fax: 212-446-8575

http://www.mckinsey.com

Resources

See: The Corporate Capture of the NHS

• Tamasin Cave, The privatising cabal at the heart of our NHS Spinwatch, 1 April 2015.