McKinsey & Company

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

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McKinsey & Company is a global management consultancy advising 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 in central positions in the UK's health system (see more on its alumni network below). 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 (2013-); McKinsey
• Tim Kelsey: 'national director for patients and information' (2012-2015) at NHS England, one of only eight 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 (2013-); 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'.
• Nicolaus Henke; McKinsey director and leader of its Healthcare Systems & Services practice globally; was a member of a No 10 ‘kitchen cabinet’ which advised David Cameron on health policy.
• Tom Kibasi: left McKinsey in 2006 to become policy adviser to NHS chief executive David Nicholson, then moved back in 2008 and went on to co-lead McKinsey's research on 'innovative healthcare delivery'.
• David Cox: formerly of McKinsey, focused on healthcare, became NHS London ‘strategy manager’, and now works for a company that seeks to 'demystify meditation' and mindfulness.

Schmoozing of officials

McKinsey has been generous with its hospitality to public officials in the UK health service. For instance:

• In June 2011, David Bennett, the head of health sector regulator Monitor, flew business class to New York, where he stayed at a five-star hotel and attended a lavish banquet, all paid for by McKinsey. The two-day freebie was worth ‘approximately’ £6,200.
• McKinsey director Nicolaus Henke took Adrian Masters, a former McKinsey executive who became Monitor’s director of strategy, and Stephen Hay, Monitor's chief operating officer, and their families to see Cirque du Soleil.
• Monitor's Stephen Hay was also McKinsey’s guest at a performance of La Traviata at the Royal Opera House.
• Department of Health senior official, Ian Dalton was a guest and after-dinner speaker at several McKinsey events to discuss the reforms held at luxury hotels and has received free accommodation and travel expenses. He also attended a McKinsey ‘networking’ conference in Paris in April 2011, naturally at the firm’s expense.

There is evidence that McKinsey will ask for favours from its public sector contacts in return. One such request was sent to Ian Dalton in April 11 when an unnamed McKinsey executive wrote about Paul Wiles, who was about to retire from US firm Novant Health and was ‘looking for some brain activities post-retirement. Ideally this would be on 2-3 boards or advisory roles,’ McKinsey wrote. Eight days later Dalton replied with a possible opening: Mr Wiles might like to apply for a post as a non-executive director of the NHS Trust Development Authority. This would eventually be advertised, ‘though not until July 2011’.

These public sector relationships also appear to be able to generate further contracts for McKinsey. In May 2011, McKinsey emailed Adrian Masters at Monitor, saying: ‘Would you be happy to provide a reference [on behalf of McKinsey] for Maidstone and Tunbridge Wells Trust who are looking for a two-year contract to support the development of the Board?’ Masters’s office replied: ‘Adrian is happy to provide a reference for the policy work but he wouldn’t want it to be inferred that he had been involved in any application decisions.’

A McKinsey executive is also behind an elite networking club in the UK called the Cambridge Health Network. McKinsey's Penny Dash set up the Network in 2004 for NHS leaders to meet and informally discuss policies with the for-profit health sector. Its regular talks, social events and private dinners provide, it says, ‘a place where business connections and relationships are forged’. NHS England boss Simon Stevens delivered both the inaugural speech at the network’s first event in 2004, and on the occasion of its 10th anniversary. Access to this ‘confidential, closed forum’, however, is granted only to those who pass the strict vetting procedure of the network’s founders. Stewart Player and Colin Leys described the network in a piece for Red Pepper in July 2012 as:

a McKinsey front that brings together departmental policy-makers with corporate executives at meetings sponsored by McKinsey client companies, from Halliburton to General Electric.

An example of this might be an event in June 2012 when McKinsey and The Cambridge Health Network came together with Healthcare at Home, a remote health monitoring firm (although it's not known if it is a McKinsey client), to host the Network's annual drinks party at the Manchester Art Gallery.

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.

Lobbying for tech

McKinsey has long advocated the use of more technology in healthcare, the digitisation of whole health systems, and the opening up of provider and patient data.

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 published with GSMA, which represents the interests of commercial mobile operators worldwide, is called mHealth: A new vision for healthcare and 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.

Making the case for massive tech spending (NHS)

At the same time as championing healthcare technology, McKinsey has been charged by health officials in the UK with coming up with evidence to support massive spending on technology.

When parts of the NHS are in crisis due to lack of funding, and doctors are threatening to strike over pay and conditions, evidence to support the mantra that technology will, in time, cut costs and improve the quality of services, is crucial.

There is scepticism that technology can cut healthcare costs in the way that McKinsey advocates. Several studies on the use of Electronic Patient Records (EPR), for example, suggest that EPRs can improve quality, but don’t necessarily lead to efficiency savings. Dr Philip Scott, a senior lecturer in health informatics at University of Portsmouth, called it 'very naive' to assume that billions of pounds will be saved from having electronic health records. According to Robert Wachter, a physician who teaches at the University of California and who in 2015 became an adviser to the UK government on technology in the NHS: 'The simple narrative of our age—that computers improve the performance of every industry they touch—turns out to have been magical thinking when it comes to healthcare.'

In March 2014, NHS England director of intelligence and strategy Christine Outram, also acknowledged that the Cabinet Office, Treasury and individual hospital trusts in England “need persuading that it’s worth investing in empowering patients and the power of technology”.

McKinsey was commissioned in 2014 to come up with the case for technology investment in the NHS, supported by evidence, and what a new digitally enabled NHS could look like.

The firm was part of an NHS 'Working Group' examining the Impact of Data and Technology on the NHS. Slides prepared by McKinsey for a 'kick off meeting' of the group on 17 January 2014 – prepared for NHS England's Patient and Information Directorate, which is led by Tim Kelsey, formerly of McKinsey – show that over a third of the members of the 20 person working group were from McKinsey, with the rest from the NHS.

In the presentation, McKinsey set out what it aimed to achieve, which was to come up with an 'estimate of the total potential improvement opportunity in the NHS'; review the evidence to support this estimate; create a model documenting all levers and assumptions; and come up with a business case that assesses the cost/benefit of different programmes, prioritises the various technology interventions, lays out their impact over time, and which is stress-tested with a model region'.

In June 2015, the NHS' Tim Kelsey came out with a figure thought to be based on McKinsey's work. He claimed that the greater use of technology in the NHS could create savings of up to £13.7 billion a year by 2020. The unpublished McKinsey evidence was also used to support key NHS England plans: the ‘Five Year Forward View’ and ‘Personalised Health and Care 2020’. The latter has been described as having 'many laudable and common sense ambitions', but being 'light on evidence to support its aspirations'.

The McKinsey report also underpins NHS England's funding bid, submitted in September 2015, to the Treasury's spending review. Health officials submitted a bid for 'technology, data and digital' of between £3.3 billion and £5.6 billion.

Despite NHS England's 'excessive reliance on this single McKinsey report' to support its technology plans, officials have refused to make it public. NHS England refused a freedom of information request by Digital Health to release the document, claiming it is exempt as it 'relates to the formulation or development of government policy.'

A PowerPoint presentation of the McKinsey report, however, was released to Public Interest Investigations/Spinwatch under FOI law and published in November 2015. It suggests that the evidence on which projected savings are being based is problematic. As Digital Health noted:

'No specific evidence for the savings is available in the presentation, while some of the estimated economic benefits mentioned come with a high level of uncertainty. For example, in acute care the report says that remote monitoring equipment “has the potential” to reduce length of stay, while in primary care the use of teleconsultation, web messaging and other means to avoid face-to-face GP consultations “may lead to substantial benefits.” Also in primary care, the summary says: “While it is envisaged that data transparency may have benefits for patient care, direct evidence for economic impact has not been found.” In primary prevention, it says that there is “relative scarcity of longitudinal studies linking digital programmes to encourage healthy living to long term impact” and in integrated care and screening it described the evidence for telehealth as “mixed”.

Despite the uncertainty – and the state of the NHS' finances – the presentation states that the NHS needs to spend an additional £7.2 billion to £8.3 billion on digital technology over the next five years in order to achieve the promised savings.

The world's biggest IT disaster' (NHS)

McKinsey has long advocated the widespread adoption of electronic patient records (where patient health information is collected into one electronic record). EPRs 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?

Assessing the 'market' for patient data (NHS)

More recently, McKinsey has been involved in the NHS' ventures in 'big data'.

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 HSCIC. 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”.

Education

McKinsey says it 'helps educational systems and providers to improve outcomes for millions of students globally.' It claims to have completed 600 education projects in 50 countries over the past five years at local, regional, and national levels. Its clients in the education sector include governments, foundations, nonprofits, and corporations.

McKinsey's work in education includes:

• Reform of school systems, including more than 10 national and 20 regional 'system transformations'.
• Promoting educational technology in schools. McKinsey says it has undertaken almost 100 edtech-related projects at every level from primary school to university, including working with 5 US school systems with 'strategies to scale up personalized learning in the classroom'.

Education system transformation

An example of McKinsey's involvement in education system reform is New York City. The largest urban school district in the US, NYC schools were subject to radical market-based reforms in the early 2000s.

McKinsey consultants played critical roles in planning the restructuring of the New York City school system under Mayor Michael Bloomberg and his schools chancellor Joel Klein, and several McKinsey “graduates” were key members of the Chancellor’s team in the early years of 'Children First' reforms, as the reform programme was called.

The planning for the Children First initiative was funded by $4 million in private philanthropic funds, half of which was said to have come from venture philanthropist Eli Broad. The planning for Children First was contracted out to McKinsey.

According to an academic review of the NYC reforms: 'As soon as Chancellor Klein took office, he contracted McKinsey and Company to facilitate the planning process for Children First... Little publicly available documentation of the Children First planning process exists, which highlights a central paradox of the Children First process that would continue throughout the Klein administration: the reforms “aim towards creating a ‘bottom-up’ system, which grants greater authority to individual schools. Yet much like the planning process, the implementation of Children First has largely occurred from the top down”... The working groups that developed the Children First reforms included representatives from the Broad Foundation and the Bill & Melinda Gates Foundation, as well as leading educational figures... [but] parent, student, and community constituencies usually learned about these new initiatives through media coverage, press conferences, and website releases.

Michael Barber was one of the advisers drafted in by the City after he left Tony Blair's Delivery Unit in 2005 (he joined McKinsey in 2006).

As we have seen in the reform of healthcare in the UK (see 'McKinsey alumni embedded in NHS' above), the 'revolving door' plays a critical role in creating these elite networks of decision-makers. An example in NYC is James Shelton. He was one of the chief planners of Children First, who worked at McKinsey (and the New Schools Venture Fund), was education program director at the Bill & Melinda Gates Foundation, and was appointed Assistant Deputy Secretary for Innovation and Improvement at the US Department of Education. He now works for the education technology company 2U.

New York City's school system featured in McKinsey's 2007 influential report How the world’s best-performing schools come out on top (see 'Shaping global reform debates' below), which outlined the features the firm thought were common to excellent school systems. However, its follow up report, How the world’s most improved school systems keep getting better, which profiled school systems that achieved significant improvement, excluded New York City's schools.

Shaping global reform debates

In its reports and commentary on the education sector, McKinsey demonstrates its support for markets and the private sector provision of public services. Typical is this excerpt from an article by McKinsey in August 2015:

'US education is a $1.5 trillion industry and growing at 5 percent annually. On the face of it, those figures warrant attention from investors. But most of that spending is hard for investors to access: education is everywhere seen as a public good, entrusted to government and nonprofit institutions, and most spending is on personnel... This decades-old picture is now changing in several ways... forces are causing traditional providers to rethink how they serve their students—and providing a moment for investors to reconsider the sector.' It goes on to outline some of the ways companies can profit, including the primary and secondary education market in digital resources.

McKinsey's reports on education reform have had a big impact on global debates. They are frequently cited by other education reformers and provide an 'evidence-base' for reform.

Two influential reports in particular that compare education systems around the world - and consequently claim to have identified policy interventions which enable all school systems to improve - have led to the spread of reform ideas. Both reports are co-authored by Michael Barber, formerly of McKinsey, now an advisor to Pearson, and McKinsey's Mona Mourshed :

• “How the world’s best-performing schools come out on top” (2007).
• “How the world’s most improved school systems keep getting better” (2010).

More lobbying for tech

McKinsey is a vocal champion for the digitisation of education.

For instance, as in healthcare, McKinsey teamed up with GSMA, the trade organisation representing the interests of mobile operators worldwide, to push the case for mobile technologies in delivering public education (see 'Lobbying for tech' in Healthcare section above). In a similar way to mHealth: A new vision for healthcare, the 2010 McKinsey / GSMA healthcare reform publication, Transforming learning through mEducation co-published in 2012, outlines the mobile education, or 'mEducation' market, its 'product landscape', the ways in which mEducation 'enhances learning outcomes'; and the size of the financial opportunity:

'Although mEducation is a nascent market, publishing houses, mobile network operators and device manufacturers have been focusing on it for years... The market for mEducation products and services today is worth approximately $3.4 billion—a sliver of the $4 trillion spent on education globally. By 2020, we expect global spend to double to $8 trillion. mEducation may address up to $70 billion of this market through specialized product offerings and a growing market for devices.'

McKinsey is also pushing the case for the greater use of data and advanced analytics in teaching and learning. A May 2015 article by the firm outlines its thinking:

'Across industries, data and advanced analytics are being used to personalize products and services, generate more impact at lower cost, and improve the user experience. Education is [a] field that stands to benefit from this trend: there is much evidence that data-fueled learning tools can dramatically improve student outcomes... Increasing the use of student data in education could unlock between $900 billion and $1.2 trillion in global economic value; upward of $300 billion of that would come from improved instruction.... As the type and volume of student data increase, so do concerns about who exactly will have access to the information and how it will be used. To get the benefits of data-enabled instruction, schools would need to collect and analyze more student data than they have in the past. They would also need to collect this information more often and more rigorously, and then make relevant portions of it available to more people and organizations. The risks are real, but they can be managed, leading to real rewards in the form of better student learning and achievement.'

Connections to education reformers

McKinsey has ties to a number of significant organisations in the 'education reform movement'.

• Bill & Melinda Gates Foundation: McKinsey has long worked with and for the philanthropic Gates Foundation, one of the leading organisations pushing the education reform agenda.

• Teach for All: McKinsey is one of the founding partners of Teach For All, the global network of organisations that recruit top graduates into teaching for two years before they pursue other careers. It was founded in 2007 with the coming together of the original Teach For America and its UK offshoot Teach First. The global network has a great many links to McKinsey: until 2015, Teach for America's co-CEO was Matthew Kramer, formerly of McKinsey; its VP of Finance, Technology, and Administration Dan Obus, is ex-McKinsey; as is its Senior Director, Leadership & Learning; Teach for All board member Ian Davis (Chairman, Rolls-Royce) spent 31 years at McKinsey, serving as the firm's Chairman and Worldwide Managing Director; Teach for All board member Frank Appel (CEO of Deutsche Post DHL Group), is ex-McKinsey; TeachFirst board member, Mary Meaney is a McKinsey director; the Mumbai director of Teach for India is ex-McKinsey; Teach for Belgium board member, Philippe Mauchard is a principal at McKinsey...

• Teach First began, in former Education Minister, Andrew Adonis' words, when 'a McKinsey project team came to see me in No.10 with a plan to launch an English equivalent of Teach for America... A project board led by Rona Kiley, Ken Livingstone's Transport Commissioner for London, had already lined up blue chip business sponsors for a proposed English equivalent, provided the government could rewrite teacher training regulations to make it possible, pay for the training and salaries of the recruits, and arrange placements in schools... I jumped at the proposal.' Teach First was started by the McKinsey project leader Brett Wigdortz, who became Teach First's CEO.

• Khan Academy:The Khan Academy, the free online course library and poster child of education technology has a number of former McKinsey people on the payroll. Its first employee, president and COO, Shantanu Sinha, for example, is ex-McKinsey, as is: the Director of Content; as was its Chief of Staff;

• Education Foundation, UK education reform / edtech lobby group; McKinsey is a funder and the Education Foundation hosted a McKinsey event.

• Ashoka, 'social entrepreneur' company founded by McKinsey's Bill Drayton. In 2016 Ashoka wrote that it was 'bringing together the UK’s most innovative and impact-focused schools and partners in the country, to build a network of schools and other important actors in education to re-imagine learning for the 21st century.' It intended to use this network to promote 'innovation in education'.

Revolving door in education

As in healthcare, there is a well-oiled 'revolving door' between McKinsey and policy-making. Examples in the UK include:

• Michael Barber, former head of Tony Blair’s Delivery Unit; became head of McKinsey's global education practice; current adviser to governments around the world, as well as Pearson; Barber is a vocal advocate of education reform
• Claudia Harris, former member of Tony Blair’s Delivery Unit; McKinsey partner until June 2015 when she was appointed CEO of the Department for Education's new £20m, employers-led Careers and Enterprise Company
• Tom Shinner, ex-McKinsey; UK free school (like charter schools) founder; became UK Department for Education director of strategy and performance in February 2014 at the age of 28.
• Thomas O'Reilly, associate at McKinsey; O'Reilly spent a year out of his time at McKinsey to become senior strategy adviser at the UK Department for Education

US examples include:

• David Coleman, ex-McKinsey; Coleman has been dubbed the 'architect' of the controversial Common Core standards reforms in the US; as of 2015, he heads the College Board.

Rail privatisation: UK

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.'

Agricultural reform: India

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.

Mining reform: India

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.

People

Leadership

• Dominic Barton, CEO

Lobbyists

• Steve John, Global Director of Communications (May 2014-); former Bupa lobbyist

Sector specific

Healthcare

• Nicolaus Henke, director and leader of the Healthcare Systems & Services practice globally; London-based.
• Penny Dash, director focused on the redesign of healthcare systems; London-based
• Martin Markus, director; leads healthcare work in the UK and with European payors, working on strategy and health system design; London-based

Education

• Mona Mourshed, director working on school systems, vocational programs, universities, and education-to-employment programs around the world; Washington-based
• Susan Colby, expert principal; leads the firm’s North American Education Practice working with social and public sector clients on society’s most pressing problems with a special focus on education; San Francisco-based
• Dirk Schmautzer, prinicple; leads McKinsey’s Education Practice in the Middle East and co-leads its Global Economic Development Practice; Dubai-based

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."

According to a 2013 CBNC report:

There are approximately 27,000 McKinsey alums spanning 120 nations in virtually every business sector. In recent years, 150 McKinsey alums had a top spot at companies with more than $1 billion in annual sales. According to USA Today, the odds of a McKinsey consultant becoming a CEO were the best the world, at 1 in 690.

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.
• Luis Ubiñas, until recently the president and CEO of the Ford Foundation
• Ronald Cohen, British venture capitalist who is a huge promoter of social enterprise tools and techniques such as Social Impact Bonds
• Bill Drayton, founder and chair of Ashoka
• Sylvia Mathews Burwell, the current US Secretary of Health and Human Services, previously a vice president of the Bill & Melinda Gates Foundation and president and CEO of the Walmart Foundation
• Peter Orszag, economist and head of the US Office of Management and Budget under President Obama and previously with the Brookings Institution.

Political connections: UK

See also above: 'McKinsey alumni embedded in NHS'

Other connections to UK politics have included:

• Matthew Elson, a former McKinsey senior partner, who become transport adviser in the Downing Street Policy Unit.
• Nick Lovegrove, another senior McKinsey partner also working on transport.
• Adair Turner; the former head of the Confederation of British Industry.

Clients

McKinsey is notoriously secretive about its clients: ‘We just don’t talk about our client work,’ is the standard response to inquiries.

As a result, little is known about who it works for. They do include, however, in the healthcare sector: health insurers, private hospital groups, pharmaceutical companies and financial sector investors.

Known clients:

• Bill & Melinda Gates Foundation; joint work by McKinsey and the Gates Foundation includes, for example, studies of Global Health Partnerships.

McKinsey Social Initiative

According to the firm, McKinsey Social Initiative (MSI) was founded 'to develop innovative approaches to global problems'.

'Its unique model leverages relationships across the public and private sectors to create, test, and scale new ways to address the world’s most pressing issues.

It is run by Helene D. Gayle, formerly CEO of CARE USA and before that Bill & Melinda Gates Foundation.

MSI, according to NonProfit Quarterly MSI 'will start life with a $70 million capital infusion from McKinsey plus access to 25 of its consultants to work on MSI projects and advice from 10 McKinsey partners.' It also suggests that MSI has also started off with a $15 million infusion from USAID—'if that’s so, it had to have been in the works when Raj Shah, a former Bill & Melinda Gates Foundation official, was still USAID administrator'—and $3.2 million from Walmart.

'For MSI, the Walmart and USAID grants are parts of a larger program it calls Generation Initiative that will “give youth the practical skills and personal confidence for career success—and build a cohort of work-ready, high-energy new hires who are set up for long-term career success” in a program of 8-12 weeks (sites are planned or already operational in Pittsburgh, Kenya, India, Spain (Madrid and Barcelona), and Mexico. The expectation of the initiative is one million young people trained and placed in jobs in five years.'

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. McKinsey will also 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.

Contact

• Website: http://www.mckinsey.com
• HQ: 55 East 52nd Street, New York, NY 10022
• London: 1 Jermyn Street, London, SW1Y 4UH

Resources

Documents released under Freedom of Information law

• Emails from McKinsey to senior health officials, 2011
• McKinsey: NHS Organisational Design Workshop presentation; 14 February 2011 with UK Department of Health and McKinsey
• Email correspondence between McKinsey and NHS regulator, Monitor, 2010
• Email correspondence between health official, Ian Dalton, and McKinsey, 2010-11
• McKinsey: Modelling the potential of digitally-enabled processes, transparency and participation in the NHS: Evidence Summary, powerpoint presentation for NHS England, April 2014
• McKinsey: Care.data: Turning data into insights, a discussion document for HSCIC, January 2014

Other resources

• Tamasin Cave, The privatising cabal at the heart of our NHS Spinwatch, 1 April 2015.
• David Rose, The firm that hijacked the NHS, Mail on Sunday, 12 February 2012

References