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Doctor Accused of Fraud Against Medicare

Two fraud cases in a row here … but a new (for me) angle today.

Procurement related fraud and corruption has interested me for many years, long before I started collecting case studies specifically to include in my Bad Buying book. So it is unusual to see a new type of fraud, but I came across a US case recently that was somewhat different to any I‘ve seen before.

At the heart of it, the scam is that an organisation ends up paying for goods that are not really needed (or maybe aren’t even delivered).  An internal budget holder creating their own company, setting it up as a supplier, then creating and authorising invoices and payments to themselves is the typical case. But here, it was more complex, as the fraud was against the US publicly-funded Medicare system.

At a federal court in Brooklyn Elemer Raffai, an orthopedic surgeon, was charged last month with health care fraud in connection with a $10 million scheme. He allegedly submitted false and fraudulent claims to Medicare and Medicare Part D plans. Raffai was arrested and was due to make his initial court appearance in the United States District Court for the Northern District of New York.

“In exchange for kickbacks from telemedicine companies, Dr. Raffai allegedly submitted millions of dollars in false and fraudulent claims to Medicare on behalf of beneficiaries without even examining them or based on conversations on the phone that lasted less than three minutes,” stated United States Attorney (Breon) Peace.

Dr. Raffai purported to practice “telemedicine” (phone or Zoom I assume) with the AffordADoc Network and other telemedicine companies. He was paid approximately $25 or $30 per patient consultation.  Between July 2016 and June 2017, he allegedly signed prescriptions and order forms for medical equipment, including orthotic braces, that were not medically necessary, simply based on a short phone call. Some $10 million in false and fraudulent claims were made to Medicare for that equipment and Medicare paid more than $4 million on those claims.

Presumably the “patients” were in on the alledged scam as well, and were recompensed for making the call to the doctor and playing their role in the process. And (again presumably) it was the manufacturers or sales agents for this equipment who were the masterminds behind it all. They received funding from Medicare for goods that either weren’t needed by the “patients”, or perhaps that equipment was never actually supplied. That isn’t clear from the information made public so far.  We might also hope that those firms have been or will be charged with fraud, as well as the doctor.

This type of fraud where different parties are colluding can be very difficult to detect – think of the famous Sainsburys potato example, which went on for years and was only detected in the end by the supplier’s external auditor. The buyer worked with a potato supplier that charged the firm over the odds, which funded bribes to the buyer. But one positive for those trying to fight fraud is that the more people are involved, the more likely it is that someone involved will “crack” and expose what is going on.  I wonder if that is what happened in this Medicare case, where many people must have known what was happening?

Another positive is that technology will increasingly be called into play to fight fraud. AI (artificial intelligence) can look at huge amounts of data, and perhaps in this case could have worked out that this doctor had a prescribing pattern that was out of line with his contemporaries.  I know organisations are using tools to examine payment records and look for anomalies; for instance, someone who always places orders with a value just below the threshold for further approvals.

Anyway, this is an interesting case and we will keep an eye on it to see what happens to Doctor Raffai.

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Fraud at Coca-Cola Enterprises- a “Basic” Example

There was major “Bad Buying” fraud case in the media last week. Perhaps the most surprising element of the story was that the offences were discovered in 2013, and related to some years before that, yet the case only came to court in 2022. Did it take than long to gather evidence? Is the Crown Prosecution Service really working on that sort of timescale? It’s a concerning issue in itself.

But back to the case and I’m afraid it was a “classic” fraud, a pretty basic case of an internal decision maker colluding with suppliers in return for payment. At Southwark Crown Court, Noel Corry, a former electrical and automation manager at Coca-Cola Enterprises Ltd (CCE), pleaded guilty to five counts of corruption and was sentenced to 20 months in prison, suspended for 21 months, plus 200 hours of unpaid work.

He accepted cash bribes, free tickets to events as well as sponsorship for his local football club, Droylsden FC near Manchester. A total of £1.5m was paid by Boulting Group Limited (now trading as WABGS Limited), Tritec Systems Limited, and Electron Systems Limited. The firms that paid the bribes were also fined – the first time the Met has prosecuted firms for failing to prevent bribery. That sets an interesting and good precedent. WABGS Limited was fined £500,000 – between 2007-13 the company benefited from contracts with CCE worth over £13m. Tritec Systems and Electron Systems were each fined £70,000 plus costs. Individuals at those firms also received suspended sentences.

Part of Corry’s job  was choosing suppliers to carry out work. Over some years, he favoured certain firms in return for cash payments. He could spend up to £50K without others getting involved, so I assume he made lots of small payments or contract awards to these firms.  “The court previously heard how Corry was given bribes through payments for “bogus” contracts for Coca-Cola, in which work was never carried out, or had Coca-Cola pay more than the actual amount charged for real work and was sent the difference”, as the Shropshire Star reported.

But in 2011, the firm changed the policy and the professional procurement team started getting more involved and a more structured process was implemented (hooray!)  They started getting suspicious as some firms changed their bids late in the process, and suspected that someone on the inside was tipping off firms about competing bids. That led to discovery of evidence which eventually led to prosecution. (Tip – if you’re committing fraud, don’t have a spreadsheet on your laptop called “Slush”)!

It’s all rather sad in some sense – of course it is good that he was caught, but his wife divorced him and their son has mental health issues now, according to the reports. And Corry eventually repaid £1.7 million to CCE.  So if you are ever tempted, just remember that it probably will ruin your life.

What are the lessons here for organisations? Well, I gave 7 key anti-fraud principles in the Bad Buying book, and several are relevant to this case – proper supplier selection processes, for example. But perhaps the most pertinent is this principle (taken from the book).

“Opportunities for collusion between suppliers, and between suppliers and buyers, must be minimized – Many frauds rely on collusion between buyer (or budget holder) and seller, so reducing the opportunity of this reduces the chances of fraud. Organizations should ensure there is always more than one person involved with any major purchase and in signing- off work with suppliers. Moving staff regularly is another option, so there is less time for the relationship, and perhaps the fraudulent plans, to mature. Some organizations have a policy that no one in a decision-making buying role will  stay for more than three years in that same job role, for this very reason.

It is not just professional buyers (procurement staff) to whom this applies. Indeed, it can be stakeholders such as budget holders or service users who by the nature of what is being bought find themselves getting too close to suppliers. I once discovered that my firm’s major IT equipment supplier was sponsoring our internal IT budget holder’s expensive car- racing hobby!

It may be very innocent, but when a marketing or IT manager makes it clear they don’t want professional procurement or finance colleagues involved in ‘their’ relationship with a key supplier, that can be a warning sign that it isn’t totally innocent. Organizations should look at discouraging closeness that goes beyond the need to work well with a supplier to get a job done. This should influence the organization’s policy on hospitality, gifts and entertainment, which should be clear and should err on the side of caution”.

So well done to CCE for eventually discovering this, but a better policy would have perhaps made it less likely in the first place. And if you work for a large organisation that allows budget holders to spend thousands without anyone else being involved, I can pretty much guarantee that one or more of your colleagues is committing exactly this type of fraud at this very moment.

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Will My Supplier Deliver? Lotteries, Camelot and Challenges

In part 1 here I discussed the reports that Camelot, the current operator of the UK National Lottery, is going to challenge the government’s decision to award the contract for management of the Lottery to a different firm, Allwyn, headed by a Czech tycoon. That decision follows a lengthy and no doubt exhaustive “procurement” process.

There are suggestions that Allwyn have offered to make more money for charitable causes than Camelot included in their proposal. According to reports, that amount is not contractually  guaranteed, but may have played a major role in the selection decision.  Which leads us into the question of confidence – how do we know that supplier really will deliver what they promised?

There was a great comment on LinkedIn related to the part 1 article. The writer told of a major NHS procurement where a US supplier came in with a knockout bid, which led to other potential suppliers simply pulling out. Then, literally on the day the new service was due to go live, “At the eleventh hour the supplier had withdrawn, admitting that they couldn’t deliver the brief and make the savings claimed”.

There is a huge difference between what suppliers (some suppliers at least) will claim they can do and what they actually can deliver. There are no magic answers to this, but in my book “Bad Buying” I suggest thinking about “analyse, reference, test”.

Analyse means looking into the firm, the product or service that you’re going to buy, doing your research on the supplier and on whatever you are buying. The amount and depth of research needs to be proportionate to how much you’re spending and how critical what you’re buying is.

Reference means asking other customers of your potential supplier or users of the product or service you are buying about their experience. It’s an obvious step, yet it is amazing how many organisations don’t bother with this step. I was asked for input on a legal case in 2018 where an incumbent supplier challenged the decision by a large government body to award a contract to several other firms, meaning that the incumbent was going to lose all its business. This was a really sensitive service; if it went wrong, you might well see reports on newspaper front pages.

Yet when the incumbent firm asked questions about how the procurement decision was made, it became clear that the government organisation had done virtually nothing to check out what other suppliers were claiming in their bids. They had not researched the track record of the firms; they had not taken up references from other customers; they did not even seem to have checked whether the directors of bidding firms had criminal records! The buyer was simply believing the bidders and hoping for the best. The competition was eventually re-started as I assume the lawyers told the contracting authority they were going to lose in court.

Test means using techniques such as pilot programmes or small-scale rollouts that enable you to get a sense of the supplier and their capability, without immediately betting the farm on a particular approach. In a large organisation, you could run a geographical experiment with a new supplier or product. Give it a try in an area, region, an office or a factory, rather than moving immediately to handing over your entire business. Or you might initially use a supplier on a relatively unimportant piece of work.

In the case of the lottery, I assume that Allwyn’s references have been thoroughly checked out. Perhaps most critical – if this comes to court – will be how the projections of the money to be made for charity have been developed and verified. I’m sure the buyer would be expected to analyse Allwyn’s assumptions and proposals very carefully to assess the level of confidence in their figures. If they did not, that could spell trouble.

The final point to make here is that one report quoted Camelot as saying the evaluation had not been carried out as described in the tender. Now if that is the case, the lottery folk are in real trouble.

In terms of public sector tender evaluation, not doing what you told the bidders you would do is in most cases enough for a challenge to succeed.

You simply can’t introduce new factors once bids have been received evaluation; or even use factors that aren’t explicit. Don’t make assumptions. You can’t mark down a bidder for not providing a detailed quality plan if your question simply said, “tell me how you will deliver this work”. If the quality plan matters, tell them to provide it.

Enough of my ranting about evaluation processes (a favourite topic of mine, and we haven’t even got onto evaluating and scoring “price”). We will await the next stage of the Camelot story with interest.

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Camelot Challenges UK Lottery Decision – Highlights Key Issue of “Confidence”

Over the weekend, we saw reports that Camelot, the current operator of the UK National Lottery, is going to challenge the government’s decision to award the contract for management of the Lottery to a different firm, Allwyn, headed by a Czech tycoon. That decision follows a lengthy and no doubt exhaustive “procurement” process. This is from The Times (behind the paywall unfortunately).

The Czech bid, led by Sir Keith Mills, the man behind the London 2012 Olympics, and the former J Sainsbury boss Justin King, was deemed to have had an inferior business plan but managed to pip Camelot at the post by promising to deliver a much higher sum for good causes. There are suggestions that Allwyn’s bid was based on a forecast that it would raise £38 billion over the ten-year licence, which starts in 2024. This is believed to be a much higher figure than the forecast included by Camelot … Bidders were asked to supply a detailed forecast of how much they expected to raise, but with no obligation to achieve it or any form of penalty for failing to do so.

So this may come down to an issue that sits behind one of the common causes of “Bad Buying”.  In my book of that title it has its own chapter – “Believing the Supplier”.

That can relate to suppliers actually lying or deliberately misleading the buyer. It’s the tech firm that says they can develop and install the new software for you in six months, when they know its going to be more like 18.  Or the consulting firm that tells you they have lots of experience running M&A studies in Spain, when in fact they have one junior analyst in the London office who has a girlfriend in Madrid.

But more often it is suppliers whose intentions are good, but make promises and offers that they can’t really deliver on. They really do believe that software will be ready in six months; but they don’t actually have the experience or expertise to make it happen.

This leads to a particular issue in public sector procurement. Because that relies on formal tendering processes (for larger contracts anyway), we see a real difficulty for buyers in assessing two different aspects of the proposals received. They have to evaluate the apparent value of the solution proposed, which is what the legal procurement framework focuses on. But they should also assess the credibility of the proposal – the confidence the buyer can have in its actual delivery.

You might remember the “scandal” back in 2008 when the UK’s Qualifications and Curriculum Authority (QCA), which managed the school ‘national curriculum’ and associated testing process, terminated a contract it had put in place with ETS Europe to deliver tests for schoolchildren.  ETS failed to meet agreed timescales and the whole thing was a bit of a shambles.

The case illustrated a central challenge in many buying situations – how the buyer can assess whether proposals can actually be delivered by a potential supplier, even if they sound credible. It is relatively easy to write a convincing proposal to carry out services-type work or even to deliver certain physical items. I might tell you in beautifully written prose that my firm can supply you with the finest cocoa beans, or handle your outsourced pension administration absolutely brilliantly. Or even build a nuclear submarine … But how do you know I can actually do it? Here is an extract from Bad Buying that explains what went wrong with ETS, following an independent review into the case. 

“The Sutherland Review found that in many ways the procurement (buying) process in this case wasn’t run badly– the authors called it ‘sound’. ETS won with the lowest price, but also scored better than the alternative bidder on non-cost factors. The ‘Gateway reviews’ undertaken by the Office of Government Commerce were in general positive, too. However, the contract and the supplier clearly failed to deliver what was required. Why was that?

Issues were identified by the report around governance, the contract- management approach, some legal issues in the contract and specifications. But the report suggests that the weakness in the selection process came from two key factors. First, the QCA and the consultants running the process did not fully check out the history of previous contracts delivered by ETS. That might have picked up warning signals, as there had been issues with contracts in the United States. Basic financial health checks were done, but not an extensive reputational and performance due diligence.

Second, the buying process did not check that the assumptions about capacity made by ETS in their bid were realistic and accurate. The firm should have been challenged more strongly on its staffing plans. There were also concerns about the ‘end-to-end’ solution proposed and whether the firm really understood how different elements needed to fit together. Those issues appear to have been at the heart of subsequent problems.”

So it is this “confidence in the supplier’s ability to deliver” that has to be assessed somehow, and whether the supplier’s assumptions and plans are “realistic and accurate”. It is not just their conformance to the specification, the elegance of their proposed solution, or indeed the apparent financial benefits they might be offering.  

Going back to where we started, it is this issue that may come to the fore in the UK National Lottery case, assuming the decision is challenged. More on that in part 2.

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Efficiency Savings – UK Government Looks for a Few Billion

It’s usually  a sign of desperation in terms of the public finances (in the UK anyway)  when politicians suddenly start talking about “efficiency savings”. It’s even more serious when they start building them into future forecasts of public expenditure before identifying where the “savings” might actually come from.  

There is nothing wrong with looking for savings from procurement or internal efficiencies, an any good manager should be doing so continuously. But if you really wanted to run such a proper programme across the UK government, you would need to plan and think carefully about how you structure and resource that, which areas you will focus on and so on.  I was involved in the Gershon efficiency programme way back in the mid-noughties and whilst it probably did not deliver everything it wanted to, it was a serious attempt to address difficult issues such as cross-departmental collaboration and a structured category management approach to central government buying.

Last week, Rishi Sunak, the Chancellor, announced a new efficiency drive. “The drive will be spearheaded by a new Chancellor-chaired “Efficiency and Value for Money Committee” that will cut £5.5 billion worth of waste – with savings used to fund vital public services”.

Set up a committee – I’ve always found that’s a great way of making savings! But when you look closely at the announcement, it seems to apply mainly to the NHS and the arm’s length bodies (“Quangos”).  They “will be expected to save at least £800m from their budgets”.  The Arm’s Length Body Review will see savings supposedly come from “better use of property, reduced reliance on consultants, increased digitisation and greater use of shared services, as well as the use of benchmarking to drive efficiencies”.

What has the last government been doing all these years to leave these savings on the table?!  It’s a good job the Conservatives are now in power to sort it out!  Hang on a minute – they’ve been in office for over a decade now. It’s taken quite a while to realise that issues such as “reliance on consultants” are costing the taxpayer a fortune.  

Meanwhile, the “£4.75 billion worth of savings agreed with the Department of Health and Social Care will come into effect financial year 2022/23.”  So together that gives us £5.5 billion in “savings”, which more than covers the £5.5 billion target previously mentioned. So are central departments not covered by this? It’s not clear.  We may come back to where exactly these huge health savings are going to come from.

The other element of the announcement is this. “The Treasury will also launch a new Innovation Challenge to crowdsource ideas from civil servants on how government can reduce waste and improve public services, with winners selected this Summer and best ideas becoming Government policy…. A 2015 Innovation Challenge received 22,000 responses with 16 measures implemented”.

I predict there will be many ideas from civil servants, and the most common will be “stop Ministers coming up with stupid f***ng policy ideas that will never work and cost a fortune”.

Consider great historical examples such as NPfIT in the NHS, ID Cards, privatisation of probation, FireControl, Universal Credit, most PFI programmes, the aircraft carrier programmes … etc.  Maybe it would also help if we didn’t give PPE contracts to friends of friends and then waste billions because of over-buying and not checking the specification.

But back to the new “efficiency programme”. We’ll know quickly if it really means anything when we see if and how it is to be resourced, and how often this committee is going to meet. The methodology of measuring “savings” is also key. I’m sure the DHSC will find a way of showing Treasury that it made the “savings”, yet somehow it managed to overspend its budget at the same time… and yes, I am deeply cynical about all this!

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CMA Report on Social Care for Children Highlights Market and Procurement Issues

Life goes on despite the temptation to doomscroll Twitter and Facebook all day for the latest news on Russian atrocities.  But there hasn’t really been much else to cheer, and some news that should have generated more attention in normal times passed almost unremarked.

The Competition and Markets Authority (CMA) published a report last week on the provision of children’s social care (fostering and children’s homes) to UK local councils.  The CMA looks at issues from an economic point of view rather than as procurement experts, but their worrying findings in this case clearly indicate some major procurement (and market) issues.

The final report “found there is a shortage of appropriate places in children’s homes and with foster carers, meaning that some children are not getting the right care from their placement. Some children are also being placed too far away from where they previously lived or in placements that require them to be separated from their siblings. This shortage also means that high prices are often being paid by local authorities, who are responsible for placing children in appropriate settings, with these costs picked up by taxpayers”.

The CMA also commented on the risk of providers going bust – and yet in some parts of the market, providers are making what we might call “excess profits”, with margins of 20%.

“For the children’s homes providers in our cross-GB data set we have seen steady operating profit margins averaging 22.6% from 2016-20, with average prices increasing from £2,977 to £3,830 per week over the period, an average annual increase of 3.5%, after accounting for inflation”.

As an example of the sort of supplier that plays in this market (accepting of course that not all are of this nature), the Guardian recently featured a report about Robert McGuinness, who was paid £1.5m by two local authorities between 2015 and 2020. He owned a “community interest company” (CIC) which provided vocational training to children from 14-16, excluded from mainstream schools.

“The owner of a children’s home in Bolton shut down for “serious and widespread failures” spent thousands intended for educating marginalised children on drinking, foreign trips and his pub business, the Guardian can reveal”.

He siphoned money out of the CIC through a “director’s loan”  to invest in another of his businesses (running a bar).  The bar has since gone bankrupt and the liquidator says “there is currently no prospect” of the CIC settling the £100,000 loan repaid.  He also drives a Lamborghini – just the sort of public-spirited person you’d want to see running sensitive social services for youngsters.

The market failure evident in this sector has a number of causes. One ironically arises from the attempts to regulate the market. Even though that is well-meaning and certainly necessary to some extent, it creates more barriers to entry. Well-functioning markets see new entrants coming in and competing all the time, and also firms can exit the market relatively easily. Buyers can also switch suppliers easily in well-functioning markets; not the case here given the nature of the services.   

There are other barriers to entry in this case, such as the need for capital investment.  Over the past 20 years or so, the amount of public sector provision of such services has disappeared, replaced by private provision. One reason has been the need for investment in council-owned facilities. Rather than finding the money for that, as central government grants to local government have declined, councils have increasingly closed down their own facilities such as children’s homes and care homes  and bought those services from private providers.

That has weakened competition further. Then we can see a failure of procurement and contract management too. Do buyers know what margins are being made by their providers?  And how well are providers managed? I suspect because the users of the service are kids, there isn’t a lot of connection between the providers, the users and the commissioners (and budget holders) for the services.  Councils have seen headcount reduced in areas such as contract management too as income was squeezed.  The report on the gov.uk website agrees that something needs to be done.

“The CMA’s analysis finds that the main reason for this is the fragmented system by which services are commissioned, which means that local authorities are not able to leverage their role as the purchasers of placements or to plan properly for the future”.

To address these issues, the CMA recommends that the UK Government, Scottish and Welsh Governments, “create or develop national and regional organisations that could support local authorities with their responsibilities in this sector. These would improve commissioning by carrying out and publishing national and regional analysis and providing local authorities and collective bodies with guidance and by supporting them to meet more placement needs in their local area”.

I am no lover of aggregation of spend and centralisation of public sector procurement.  But this does seem like an area where a national “category strategy” and some serious procurement talent needs to be brought to bear.  

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Ukraine – Some Procurement and Supply Chain Thoughts

I’ve caused some controversy on LinkedIn by asking questions about how Russia seems to be able to afford so much more military equipment than the UK for about the same level of expenditure.  That generated some interesting comments and also some people feeling this isn’t the right time to ask such questions. 

But a foreign policy expert from the Atlantic Council (and an eastern European himself), Damir Mirusic, says this “ It’s time for Europeans to stop watching in sorrow and guilt, and start watching with furious anger. Stop eulogizing your dreams about a better world. Wake up”.

That comment has been playing in my head for a couple of days now. I’ve felt “furious anger” since Thursday, anger that we have allowed ourselves to be “played” by Putin. We’re almost all complicit in this – me included.

Russia is not an economic powerhouse. But we’ve run down our military capability, wasted money on military equipment that doesn’t work. We’ve offered succour to every Putin crony and Russian crook who wanted to launder their money through London and enjoy our lifestyle. Russian money has funded political parties and the Brexit campaign. (No, I wasn’t a Remainer, actually).  London lawyers get rich suing journalists when they get too close to the truth about the oligarchs.  Absolute di****ds like Arron Banks and Farage have spouted their nonsense in support of Putin (and don’t get me started on the equivalent in the US). And I haven’t been out on the streets or even out on Twitter making enough noise about these issues.

So it feels like a time to ask difficult questions, and not just in the UK, I should say. I heard a German commentator say that the entire German foreign policy approach of the last 20 years “lies in tatters”. Angela Merkel carries some responsibility here, as she does for Brexit.  Her reputation is slipping away. Many European countries have failed to spend enough on defence, relying on the US to protect us from our foes. Energy dependence was another mistake. That has to stop now, and the amazing response of many countries including Germany in the last couple of days suggests that we have entered a new era at incredible pace.   

Anyway, trying to be calm… there are going to be many more difficult questions for businesses over the coming and months. That will apply on the revenue side – if Russian assets are frozen in Europe and the US, what might happen to factories owned by “our” firms in Russia, or stakes in Russian firms e.g. BP now trying to offload its 20% of Russian oil giant Rosneft.  But of course there are also major supply chain and procurement implications. This isn’t by any means an exhaustive list, and things will change daily or hourly, but issues are going to include;

Materials / products sourced from Russia – sanctions will certainly restrict some trade and buyers will have to be aware not just of first tier issues but what happens down the supply chain. Some may not even be aware that a material or component is of Russian origin and is important for a supplier’s supplier or even a supplier’s supplier’s supplier… etc.  40% of the world’s supply of Palladium comes from Russia, for instance.

Suppliers in Ukraine – not just raw material or products are affected. Ukraine has a pretty large international services sector now. For instance, I have friends who have been working with very capable software development firms in that country. I have no idea what is going to happen to that sort of trade, or whether those young programmers are currently out in a trench somewhere with a rifle. It’s a terrifying thought. 

Shortages of some products and consequent inflation – we’ve already seen major price increases for a number of commodities (oil, grain etc).  Whatever happens it seems likely that some of these issues won’t be reversed quickly. There will no doubt also be shortages of some manufactured goods too, whether because of sanctions or reduced production levels.

A desire to improve supply chain resilience – I’ve been speaking about this via various webinars and articles for some time. The pandemic, alongside geo-political tension, has already led many organisations to look at reducing dependence on “global sourcing” and instead consider re-shoring, insourcing and local / regional sourcing.  That is only going to increase in pace, I suspect given what is going on now, meaning more work for procurement teams. 

Shipping – I’m far from being a deep logistics expert but just reading about the strategic importance of the Black Sea makes you realise that there may well be consequences of the conflict in terms of transportation costs, timings and availability of capacity.  Air space restrictions will have an impact too.

I’m sure there are major issues I’ve missed. But that’s enough for now and that list will I’m sure keep many of my professional colleagues busy for some time to come.  Finally, I have made a donation to the UNICEF Ukraine fund. It feels like the most useful and tangible thing I can do right now.

PS the importance of good logistics management is being demonstarted very vividly by the Russian advance …

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NHS Digital Breaks the Rules, Shows Naivety

The vexed question of conflict of interest in public sector procurement came up the other day with reports that a senior executive in the National Health Service digital team had been doing rather well out of that organisation.

The HSJ reported that NHS Digital (NHSD) paid over £3 million to a small technology firm, Axiologik, one of whose owners was working as a Board-level interim director in the organisation.

“The money was paid to Yorkshire-based tech support company Axiologik, whose co-founder and director Ben Davison also served as NHS Digital’s executive director of product delivery – for which he received annual pay of £260,000, working as a contractor, in 2020-21.”

A number of issues arise from the HSJ investigation. Firstly, it appears that no other candidates were considered for the position when Davison was appointed. That seems odd, to say the least.

Then nine months after his appointment, Axiologik was appointed to provide programme management support for the Covid booking service, followed by more work (according to HSJ)  “to lead NHSD’s “tech and data workstream” which involved “portfolio level executive leadership across citizen-facing digital services” run by NHSD such as the NHS App, NHS.uk website and 111 Online”.

In the current year, turnover of the firm is set to grow from £6.5 million to £15m, not surprisingly. NHSD say that they put measures in place to avoid conflicts of interest – Davison had no involvement in the procurement process, or delegated authority for contracting or spend approvals. But as a top-level interim executive, how could he hold a supplier to account in any meaningful way if he was also a director of that supplying firm?  

Another issue arose because Davison was paid in the £260,000 – £265,000 band in 2020-21 according to the NHSD accounts, making him the highest paid person in the NHS.  But there is more. The Treasury then got involved because his appointment broke the rules on getting approval for contractors who work for more than six months!  (The engagement of two other NHSX contractors also broke the rules). That led to Treasury withholding £645,000 of allocated funding to NHSD because they have been such naughty boys and girls.

But perhaps the most important question is this. Was Axiologik appointed after a competitive process?  The HSJ does not make that clear – presumably because they do not know – although they report that the firm was appointed from the government’s G-Cloud framework.

There are many frameworks used in the public sector covering a wide range of goods and services. They enable users to bypass much of the formal “legal” public procurement process and can be very useful when used properly, retaining the ability to achieve value for money but simplifying the process. The Cabinet Office’s Crown Commercial Services (CCS), which runs G-Cloud, is the biggest manager and promoter of such contracts.

But too often, frameworks are being used today to award contracts without any real competitive process, leading to potential shortcomings in terms of value or even corruption.  In most cases, for example, users should (legally) run some sort of competitive process between at least some of the firms on any given framework to select the supplier that can provide best value. But in practice, users at times just pick their favourite and justify it on spurious grounds that “they are clearly the best…”

Some framework managers don’t really have an interest in whether the process is run properly either. They make their money as a percentage of the spend through their frameworks paid by the supplier, so CCS for instance is targeted on increasing its “sales”. If they put controls on usage, or police this issue of further competition too strongly, then users might just switch to another framework and CCS loses income. Indeed, the funding of CCS and other major framework managers leads to a range of perverse incentives in terms of ultimate taxpayer value – something I’ve been saying for many years.

Anyway, to be fair, we don’t know whether Axiologik was engaged without a competitive process, so maybe all this is irrelevant here. But in any case, someone at NHSD was very naïve about conflict of interest issues, and very ignorant when it comes to Treasury rules on interims. So definitely a contender for the next volume of Bad Buying!

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MOD Versus Guy Hands – Seconds Out for the Big Fight!

After our last article featuring criticism of the UK Ministry of Defence (MOD), there has been more positive news in recent days, even if it relates to past failure. The development relates to the organisation gearing up for a legal battle with a private equity firm headed by billionaire businessman Guy Hands.

Twenty-five 25 years ago, MOD sold off houses that were used for military families. The deal was controversial at the time and has continued that way, as it became more and more obvious that it was a lousy deal for the taxpayer and indeed for many occupants of these properties. As The Guardian described it,

“In 1996, the Conservative government sold 57,400 properties in the so-called “married quarters estate” to Annington Homes, which was then bought for £1.7bn by Nomura, a Japanese investment bank that employed (Guy) Hands. He later left Nomura to found the Terra Firma private equity firm, and bought Annington for £3.2bn in 2012”.

An odd aspect of the deal was that the MOD retained responsibility for maintenance and refurbishment of the properties, whilst paying what was supposedly a discounted rent on a 200-year lease. In other government PFI-type deals of the period (including a vary large one that I was personally involved with), the buyer of the property took on full responsibility for maintenance, so at least the taxpayer was transferring a significant element of risk.  In the MOD case, the aim was to use the money raised from the sale to renovate the properties – but of course that would benefit the new owners too.  But in any case, the MOD has not done a great job of maintaining the estate in the intervening years.

The commercial naivety shown by MOD has enabled the buyers of the property to make huge profits on the back of house price inflation, with an annual return averaging over 13%, according to the National Audit Office.  That gain included Annington issuing debt last year (against the property income stream) that enabled it to pay a dividend of £794m to its parent company. Here is what I said about the deal in the Bad Buying book.

“A National Audit Office (NAO) report in January 2018 laid out failings in terms of the buying and contract management process. The Department’s own calculations suggested retaining ownership would be cheaper – but for fairly nebulous “policy benefits”, the sale went ahead anyway. It then made very cautious estimates about future house price inflation and failed to build any mechanisms into the contract to claim a share of windfall gains. Of course, house prices rose faster than MOD’s cautious model, and the rate of return for Annington and its investors has been far higher than expected.

The NAO identified other problems – for some reason, MOD retained responsibility for maintaining the property, which it hasn’t done well, and there has been little collaboration between MOD and Annington to seek further benefits. Overall, it’s an example of failure that could comfortably sit in several different chapters here, but a lack of commercial understanding and negotiation skills in MOD were certainly amongst the issues; the NAO report estimated that the Ministry of Defence would have been between £2.2 and £4.2 BILLION better off if it had retained the estate”.

But the government is now taking an interesting stance. Defence Procurement Minister Jeremy Quin is trying to take back ownership of the properties through exercising “statutory leasehold enfranchisement rights”, a somewhat obscure legal manoeuvre. The MoD has sought to take two houses initially to test whether Annington can be forced out, whilst as you might expect, Annington claims the government has no right to do so and is behaving badly.  This may end up in court; but the firm has now offered a one-off payment of £105 to contribute to refurbishment if the MOD backs off from the legal route.

So that suggests Annington knows there is some chance it might lose in court; and arguably that is already a potential £105 million “procurement benefit” for MOD. Not bad on Andrew Forzani’s end of year savings report… But maybe there is more if the Minister has the appetite for a fight.

And just to complete the story, the chair of Annington is Baroness Liddell, an ex-Labour Party MP and now a Labour peer. It’s quite amusing hearing her now justifying the unfettered capitalism that Hands has always propounded, whilst it is the Conservative Party that tries to claw money back from the billionaire’s firm …

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Dossier of Defence Waste Published – But Who has the Answers?

Our attention bandwidth has been pretty much occupied by Covid for the last two years now, with some small space left for assimilating news about trips to Barnard Castle, Downing Street parties and maybe the goats in Llandudno for a bit of light relief.

That has led to many of the usual issues that might have got more media coverage slipping through the net, including some that might have been featured here as Bad Buying cases studies. Outside pandemic-related stories, government procurement has not really hit the headlines. Yet huge sums are still being spent, including in the defence arena.

The UK Labour Party recently published a “Dossier of waste in the Ministry of Defence 2010 – 2021”, a report looking at the projects that have cost the taxpayer “at least £13B in taxpayers’ money since 2010”. Many were fundamentally procurement-related and the report is a depressing litany of write-offs, overspent procurements and contract cancellations.  Often this sort of report is light on the analysis and heavy on the politics, but I must say that this one is worth reading – it appears to be thoroughly researched, using reputable source material and non-sensationalist analysis.

However, although the report covers the period starting with the election of the Tory-led coalition in 2010, the truth is that Labour has not historically had a great record on defence spending either. It has been a challenge for every government. Indeed, programme lead times are often so drawn-out, it is virtually impossible to pin the blame accurately on anyone – politician, official, consultant or supplier side.  

For example, the Nimrod maritime patrol and attack aircraft  “waste” of £3.7 Billion quoted in the report, based on 2013 MOD accounts and arising from final contract exit in that year, relates to contracts let way back in 1996 in the dying days of the John Major Tory government. But the significant issues and problems through the development phase happened under Labour, before the coalition finally (and probably sensibly) pulled the plug in 2010.

The other issue with this new report s that it is much stronger on putting numbers to the problem than it is in terms of offering solutions. The final words from John Healey, Labour’s Shadow Defence Secretary, are these;

This Government shows no serious intent to get a grip of these deep-seated problems. So as our first steps from day one, Labour in Government would:

  • Commission the NAO to conduct an across-the-board audit of MoD waste
  • Make the MoD the first department subject to our new Office for Value of Money’s tough regime on spending decisions.

Reforming the department will not be easy, but this report takes a crucial first step in revealing the unacceptable scale of waste in the MoD.

Well, he is certainly correct to say reform won’t be easy. But I’m not sure what an NAO “across the board audit” will achieve.  NAO can do little more really than verify the numbers. The organisation does on occasion also offer recommendations for performance  improvement, but has no resource to follow that through into implementation. And it is far from clear what the new Labour  “Office for Value for Money” is actually going to do that Cabinet Office, Crown Commercial Services, NAO and Treasury can’t already. (Although I am polishing up my application to be its CEO, of course).

We’ve had (and still have) some very capable procurement leaders in MOD and people such as Bernard Gray –  who had his foibles, but possessed a first-class brain – have had a go at running the totality of Defence Acquisition. They haven’t managed to improve matters much, because the issues are clearly deeply engrained in the whole of the military ecosystem. Problems go way beyond “acquisition” or “procurement” into very high level and fundamental issues such as the three services split, uniformed/civilian tension, the pressure on military leaders to lie to secure budget, arguments over domestic industry capability, and the unhealthy proximity of the buy-side and the supply-side in UK defence.

If these tough challenges aren’t addressed – and they probably won’t be given the short-term nature of British politics – then I’m afraid “waste” and “procurement failures” will continue. That applies whichever political party is in charge and whichever Defence Minister has his or her couple of years pretending to run things.

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