Exclusive! Pat Mills Is Mysterious New Commercial Director for Department of Health (and Other Puzzles)

Continuing our “hot topic” for November, procurement in the UK health service, and we ask – what’s going on at the Department of Health?

One problem with procurement across the NHS is its fragmented nature. Indeed, some of the biggest issues in terms of how suppliers are engaged and markets used to meet the health needs of the population are not even considered as “procurement.” But the contracting mechanisms to manage and negotiations with GPs (“family doctors”), who are in the main independent businesses and contractors, is a procurement issue. The huge sums of money now being spent on temporary staff, from admin to nurses and doctors, is indicative of another failure of a “market” in a sense.

The work of the CCGs (clinical commissioning groups) is also clearly largely “procurement” (in its wider sense) as well. The problems of hospitals burdened by onerous PFI deals is fundamentally a procurement and contract management issue. So looking at all of this, as well as the more accepted definition of NHS procurement, around pharma- and hospital-related goods and services, you might think that the Department of Health (DH) would place a strong emphasis on the subject. But instead, it appears to be getting more and more dysfunctional.

Now you may know that I count a handful of the procurement people involved in DH as personal friends, and indeed there are some very good people there, working as hard as they can. We were also generally positive about the strategy issued in August 2013. But that was well over a year ago – and now we have to ask, is the momentum going from that programme already? I’ll be talking about this more at the HCSA conference in a couple of weeks, (do come along and heckle), but what’s happened to key initiatives such as the “Academy for Procurement Excellence” or the diagnostic work that was much heralded?

Then we have the wonderful creation that is the Procurement Atlas of Variation, which caused so much conflict when the first version was issued back in July. Now we heard that version 2 was coming out last week. It didn’t. Is that because someone realised it was causing far more harm than good? We understand that a group of Trust procurement leaders is advising in some sense on version two, but if it is still limited to simply NHS Supply Chain products, then what use is it? And why it didn’t appear last week?

So really, we need some strong leadership in the Department. Which leads on nicely to congratulate the new Commercial Director at the Department of Health – who has quietly slipped into the post with no public announcement from the Department.

52 year old Pat(rick) Mills appears to have the perfect qualifications for a modern government procurement leader i.e. he was a partner at Accenture when the firm floated, so doesn’t have to worry too much about where the next pay-cheque is coming from, and he’s never worked in procurement in his life. Clearly what we need! In fact, his career for the last 7 years or so is a bit of a mystery, according to his LinkedIn page; since 2007 he appears to have been involved in a number of non-executive roles and as an investor rather than having what we might call a proper job. And he has no Web presence except that LinkedIn entry, hence the not very good photo here  - mysterious.

Now if that sounds like we’re being a bit harsh on Mills, you’re right. However, we have tried for the last two weeks to get some further information about him out of the Department of Health, with no success. He may turn out to be a brilliant commercial director, but if his organisation doesn’t want to say anything positive about him, then we’ll draw on what we can find publicly, which suggests it is a rather odd appointment.

Finally, the incentives for GPs to diagnose dementia is just such a bad idea that if it was a sub-plot line in a bad sitcom (“Doctor in the PFI Funded Surgery They Can’t Afford Any More” maybe) we would think it laughable. Yes, GPs are going to be paid £55 a head for diagnosing dementia. Incentives lie at the heart of much good and bad practice in public contracting, and this is bad practice (as well as immoral) for so many reasons we don’t even need to explain – it would be insulting our audience. And the fact that the new CEO of NHS England, Simon Stevens, hailed as a saviour in most quarters, defended it recently is very disappointing.

Luckily, we’re not alone in that view – a whole load of eminent medical folk wrote him an open letter here. Show some leadership, Mr Stevens and scrap this. And then put some real weight behind improving the procurement and commercial performance of the whole health system, or you will not achieve the goals you clearly feel passionate about.

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Voices (4)

  1. Nick Allen:

    Well said David Lawson. I believe some of the good work procurement teams do in the NHS is not supported nor praised enough. Picking up an what David has said around its all not about unit price is fact. Buyers need to get into the ‘total cost of care’. Patient pathway from entering the hospital at point A to exiting at point Z. There are products which are innovative, a little more expensive (did I just say that…) which may impact on length of stay, a hip op from 5 days stay to 4 days stay. The hip joint may not be from Stryker/Depuy but somewhere else. Innovative yes, little more costly, but saving almost £900 on total cost of care pathway. Public sector buyers need to be like private sector buyers and more networking across sectors needs to be a focus.

  2. Mark Lainchbury:

    Actually Atlas II limped out last week. No Surgeons Gloves, No Extra Products, No Estates & No fanfare.


    1. Peter Smith:

      Well spotted that man! Very low key, even people I know in health didn’t realize…

  3. David Lawson:

    If the development of the DH procurement strategy sometimes felt like a soap opera its attempted implementation over the last 12 months seems like Series 2. I just hope we don’t get a box set.

    DH still remain too distant from procurement practioners on the ground. The Key Supplier Strategy is a case in point. A central team was set up with no input or reference to hospitals. Engagement with suppliers was one dimensional focused on unit price reduction/ removing price variation. The Initiaitve has now all but stopped while it is reviewed.

    Over the same period hospitals on the ground have continued to engage with the same suppliers. Industry wants to and is engaging with hospitals in different ways beyond simply unit price, to help improve clinicial practice, reduce length of stay, deliver real efficiency. And this is the point, good procurement is delivered on the ground not in smoke filled rooms at the centre. However, the centre has a role to help scale up/ support examples/ pockets of good practice, organise and develop capability. Yet it must learn to genuinely engage and involve hospitals to do this. In some areas they are starting to do this but they need to do so consistently and across all initiatives. Healthcare is arguably one of the most challenging yet rewarding areas of Procurement, DH still have a real opportunity to make a positive change if they engage properly. Let’s hope Series 3 has a happy ending!

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