SUNDERLAND, ENGLAND - MAY 04: A porter walks through an ICU ward at the new NHS Nightingale North East hospital opened in response to the coronavirus pandemic on May 04, 2020 in Sunderland, United Kingdom. The formal opening will take place on May 5 with Her Royal Highness the Countess of Wessex opening the hospital by video link. The new NHS Nightingale hospital will be operated by Newcastle Upon Tyne Hospitals Foundation Trust. The hospital will have 460-beds to treat patients and will have equipment to support patients who require ventilation. Based at the Washington International Advanced Manufacturing Park (IAMP) development the building was to be used as part of the region’s advanced manufacturing sector until used as a temporary hospital. The country continues quarantine measures intended to curb the spread of Covid-19, but the infection rate is falling, and government officials are discussing the terms under which it would ease the lockdown. (Photo by Ian Forsyth/Getty Images)
Contracted out: consultants KPMG managed the UK's building of emergency Nightingale hospitals © Getty

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Governments grappling with logistical challenges posed by Covid-19 have turned to well-connected professional services consultancies to help craft a response to the emergency. But some observers have raised questions around the efficiency of such contracts and how they are awarded.

Accenture, which specialises in management consulting, technology and outsourcing, has partnered with tech companies such as Microsoft to build a platform that gives governments real-time advice on how to best manage supply chains of scarce resources. These include vital commodities in the fight against coronavirus such as ventilators and personal protective equipment.

In Canada and the US, Accenture has sold technology to some government authorities to help relieve the pressure on call centres handling unemployment benefit claims.

During the Covid-19 crisis, for example, the Texas Workforce Commission, the government agency in the state capital Austin that provides unemployment benefits and services related to employment, has been receiving more than a million calls per week from newly laid-off people. That is more than three times the calls, it says, that it received shortly after Hurricane Harvey in 2017, which was one of the costliest natural disasters in US history.

The commission “asked us for help because of this unprecedented surge of requests”, says Manish Sharma, chief executive of Accenture’s operations services arm.

The result was an intelligent chatbot, a robot that can answer the most frequently asked questions, and learn from these to increasingly improve its performance. The chatbot, says Accenture, answered more than a million questions in its first week in operation at the Texas agency.

“That’s why folks are reaching out to us,” says Mr Sharma. “We have people with a great problem-solving mindset, which can be deployed at scale and speed.” He adds that the crisis has accelerated the technological revamp of government agencies.

At the same time, the UK government’s use of consultants in its handling of the Covid-19 emergency has raised concern around transparency and efficiency. About 30 contracts, totalling a combined £34m, have been awarded to consultants, notably the “Big Four” of the accountancy profession, PwC, Deloitte, KPMG and EY.

PwC was, of these, the largest single beneficiary. It has been contracted for nearly £10m of financial advice to the Cabinet Office and the British Business Bank.

Deloitte was drafted in to help the government raise its capacity for coronavirus testing. The Department of Health and Social Care commissioned it to help establish up to 50 testing facilities across the UK.

The firm has been criticised for administrative errors that caused some test results to be sent to the wrong people. Hospital executives are understood to have discussed taking over the running of one site in Surrey when they became dismayed at the way it was being managed.

The Department of Health and Social Care and Deloitte indicated that the firm had not been involved with day-to-day running of the site. But the events still prompted critics to ask whether such accounting and professional services firms are best suited to deal with critical public health matters.

The government has previously been criticised for the large sums it spends on consultants. Examples include the more than £100m spent on Brexit advice and £600m on the HS2 rail link.

Work commissioned in the wake of the pandemic, however, has been placed in rather a different category. The British government has suspended previous transparency requirements in order to prioritise speed.

NHS England, for example, hired KPMG to manage the building of seven temporary Nightingale hospitals, in preparation for a potential surge in critically ill people. Similar to the case of the Deloitte project, critics noted that the scheme was contracted out to KPMG without either competition, or detail being made public until recently of how much was paid for the work.

An agreement in April between the UK’s Department for Business, Energy and Industrial Strategy and EY, for the latter to provide guidance on how various business sectors might reopen after lockdown, attracted comparable criticism.

Ian Makgill, founder of OpenOpps, a body which tracks government spending with private contractors, says the suspension of the usual procurement procedures has made it hard for his team to identify how much governments are spending with consultancies.

Rachel Reeves, UK shadow Cabinet Office minister, in May criticised the government for not disclosing details of contracts awarded to private entities — such as cost and how the government would evaluate the quality of services provided.

The government should “not just rely on opaque arrangements” with big accountancy firms, she said. At risk was “accountability for the expenditure of huge sums of taxpayers’ money”.

“Have consultancies done a good job?,” asks Mr Makgill. “I really don’t know, that’s the issue,” he says, pointing out that the lack of data is a key problem.

The market for public sector contracts would be more efficient if authorities disclosed complaints on work carried out, Mr Makgill adds. “It’s wrong to assume that all consultants do a bad job,” he says.

“But it’s equally wrong to assume that all contracts are good value for money.”

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