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Public health: why so many private consulting firms?

In France, private consulting firms have been called upon to play a role in public health, an area in which they have hardly distinguished themselves.

The decision to entrust the design of France's covid-19 vaccination campaign to the consulting firm McKinsey surprised many. Yet it is neither new nor rare to outsource public interest activities to private consultants.

Successive French governments have handed important roles in the French hospital system to consulting firms (McKinsey, Boston Consulting Group, Accenture and Capgemini, to name some of the better-known ones). These firms have instigated hospital reforms and provide management consulting services for numerous hospitals. France's Court of Auditors (Cour des Comptes) considers this outsourcing disappointing, however, commenting that many mission reports merely copy information that is already known, that financial analyses are superficial and their conclusions sometimes wrong, and that strategy consulting work is often of poor quality, offering very general recommendations.

A consulting firm's core business consists of helping its private-sector clients maximise profits. McKinsey presents itself as a major provider of consulting services to companies in the pharmaceutical sector. Services that are not always beneficial for patients, as was revealed when McKinsey's pivotal role in the sales tactics employed by opioid producers came to light during legal proceedings in the United States, including for Purdue and its opioid drug Oxycontin° (oxycodone). Overdoses of prescription opioids killed about 250 000 patients in the United States between 1999 and 2019. McKinsey downplayed the accusations, but nevertheless agreed to pay nearly US$600 million to stop the legal action.

What role did McKinsey play in France's covid-19 vaccination campaign, and how effective was it? Why give responsibility for a public health issue to this type of organisation rather than to people who have the interests of public service and society at heart?

©Prescrire 1 November 2021

Source: "Consultants on anything and everything" Prescrire International 2021; 30 (231): 277. Free.

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