How McKinsey infiltrated the world of global public health
vox.com
vox.com
The article continues to talk about how WHO hires consultants to do jobs that consultants are typically hired to do, and then states "how these secretive businesses, which mostly profit from serving corporate interests, are shaping global public health is an open question — and one that’s hard to answer."
Next breaking story on Vox: "How are these shadowy, secretive [insert private held company in any industry] typically profiting from corporations impacting [other big thing they also do work in]." Hard pass.
EDIT: None of the above is saying that consultancies are the best use of this money to achieve impact, of course, or that this model yields out-sized results, or an endorsement. It's on the person that hires them as to what they do with the advice and let them do within your org. My comments are rather an indictment of the tone of the argument for click bait and distraction from the main issues that are really important, like how to effectively eradicate disease with a pile of money.
Speaking from personal experience, the problem with large public institutions (maybe any institution?) hiring these consultancies is that there's enormous intrinsic pressure to accept their recommendations.
Say, public institution X spends exorbitant fees on consultancy Y. Now they're going to choose to ignore the recommendations?
If the recommendations are bogus, there will be hellfire about why the public institution is transferring huge quantities of funds to a private organization that is incompetent or sketchy. If the recommendations are not, then there will be hellfire about why the public institution is ignoring the recommendations.
As a result, a lot of times there's suspicion that these consultancies are just cover for administration or management making decisions that would be unpopular, controversial, or self-serving. At least in my experience, they're seen as a power grab for those already in positions of power. That is, the consultancy comes in, asks management/admin what they would like to see, and then they put it in the recommendations. Then admin can say "look, we didn't tell ourselves to [do incredibly controversial thing Z, like cut basic staff and give administration big raises], this fully independent third party said to do this."
As a result, I think hard questions about what you're getting from consultancies are actually apropos of the Vox article, and relevant to the perception that shady constituencies are somehow hijacking public services for their own benefit. When you pay large sums of money to a consultancy, whose methods are unclear, and have unclear scientific support, and assumes that, e.g., management of publicly traded for-profit companies and management of non-profit government organizations can be treated similarly, it leads to legitimate questions about whose motives are being served.
The WHO would have been better off imho convening a special strategy or reform committee made of inside and outside members than something like McKinsey.
That is to say, another way of looking at this is that tough decisions require extraordinary evidence. If a neutral third party comes to the same conclusion, a cynical way to characterize that is it gives you "cover" to do what you wanted to do anyway. But an equally true way to characterize it is that if you weren't sure before, it allows you to be more confident that that was really the right decision.
If I were going to say, fire 20% of my staff, i'd want a neutral third party to come in and evaluate that decision before I just went off and did it too.
I think you have a queer idea of "neutral".
Do you call the consultancy firm telling them:
1) I don't know what to do, please tell me what I should do?
2) I know that I have 20% people that I should lay off, what do you think of this?
3) My personnel costs are too high, how can I solve this issue?
Expect as a result:
1) Some bogus advice about marketing and growth AND some apparently good, reasonable, data and very good looking graphics leading to a suggestion to reduce personnel by 10-30%.
2) Some apparently good, reasonable, data and very good looking graphics justifying a reduction of personnel by 20%.
3) Some apparently good, reasonable data and very good loking graphics suggesting to cut personnel by 30%.
Sure, but the point is that you call them becase you believe you have not enough profits (or are losing money).
Now, there are generically speaking three ways to fix that issue:
1) increase the efficiency of the organization (really increasing it) which is something that sometimes is possible, sometimes isn't and anyway needs time and dedication by really expert people and produces - maybe - results in two/three years time or more, and often comes at an additional initial cost (investment in new technologies, machinery, etc.).
2) increase the income (i.e. produce and sell more) which again it is something that sometimes is possible, sometimes isn't and anyway needs time and dedication by really expert people and produces - maybe - results in two/three years time or more, and often comes at an additional initial cost (investment in new technologies, machinery, etc.).
3) a mild reorganization of the current processes AND reducing workforce by 20-30%, which takes little time and produces results immediately or almost immediately.
What they advice is usually #3, mainly because it is "easy" and "fast, and by the time you can see the possible overall long period adverse effects of the "cure" they have been already paid and are happily consulting some other firm.
Mind you it is not that many organization are perfectly efficient and actually very often workforce is larger than really needed, and as well a "spending review" can often solve part of the issue, so - when they propose the 20-30% cut on workforce, and remove each and every possible "fringe benefit", etc. they are not doing anything particularly "wrong", still they will be paid an (usually very high) amount of consulting fees to provide what amounts to some "obvious" measures and confirmation of your intuition/gut feelings.
I.e. all in all very often they are "an excuse" (the consulting firm has determined that ...) for whatever unpleasant you will be doing to your personnel.
Your company, your money, your freedom to spend it as you prefer.
I agree that there is pressure because rates are high and there is a social penalty for being wrong at high expense in public organizations, but that does not mean that by being in the door suddenly the only responsible party is the consultancy because "who could ever say no to a Harvard MBA!"
I also agree with the article's thrust about transparency and accounting for such a global org to provide a good check on what is happening. I also agree that to manage successfully you have to have enough people on staff to adequately advise these efforts and help sort the good ideas from the bad. That said, the article didn't dive into WHO operations, just the fact that they hired consultants.
Your second paragraph essentially parallels the well known "no one was fired for buying IBM" fallacy. How is buying advice from a Harvard MBA any different?
It happened in Canada as well, privatization of public monopoly corporations did not return fair gains, and instead increased costs. Ditto in the US in various places, for example look at private prison with guaranteed profit-performance clauses (originally secured under the seemingly 'reasonable' concept that private companies wouldnt take a risk if there was no backstop/floor to financial performance).
All of these extremely shady transactions are seemingly greased by a whole army of well paid business consultants. At a certain level, if you aren't skeptical of their history, isn't you who are being naive?
I have a different personal experience. Roughly ten consulting hires for big public orgs. Small stuff and a big one: a dozen of researches working for months to produce the best result.
It was shaped to produce the result they wanted to hear. Or simply ignored.
- Healthwise, should I drink Coke or Pepsi.
- Neither, they have too much sugar to be regularly consumed.
- I am asking which of two options I should stick to?
I'd also add that most traditional businesses rely on some sort of "secret recipe"... The other question is whether these recipes are so interesting anyways
https://www.nytimes.com/2019/02/19/reader-center/mckinsey-he...
> *The most basic question we set out to answer was this: Did McKinsey’s pristine reputation as the foremost purveyor of “best practices” match its record? After nearly a year of reporting, we found that the answer was often no.
Every recent ICE investigation is related to an ongoing major story:
- Chinese global economic policy: https://www.nytimes.com/2018/12/15/world/asia/mckinsey-china...
- The opioid crisis: https://www.nytimes.com/2019/02/01/business/purdue-pharma-mc...
- ICE: https://www.nytimes.com/2019/12/03/us/mckinsey-ICE-immigrati...
- Rikers Island prison: https://twitter.com/i_m_m/status/1204793794975141890
The more recent spate of McKinsey articles are related to the fact that Pete Buttigieg has entered the top tier of presidential candidates, and McKinsey is his third other job on the resume.
It's not tough to believe if the investigative hypothesis is correct: that McKinsey is the goto consulting firm trusted by the world's most powerful governments and companies when it comes to decisionmaking.
He was at McKinsey working for Loblaws (canadian grocery store) on pricing strategies, and afterwards Loblaws was convicted of price fixing.
Of course Mayor Pete wasn't responsible, but it's still not a good look for McKinsey.
They are kids doing school projects. Nothing more, nothing less. And you know what - they're smart kids! But still kids.
The more sinister aspect is that management consultancies are the equivalent of basic training for the elite. It's a club, an extension of elite university, which by now is basically just a club too [1]. It's simply the next level in the game.
The truly rich don't need to pass this level but the general managerial class does. After that, they're loosed on the world, with predictable results.
[1] Which is more desirable, a Harvard degree without the education, or a Harvard education without the degree?
This description matches perfectly my own (brief) experience on a project with Deloitte.
Some organization hires a consulting firm, no coercion or anything. Organization gets output and either acts on it or not.
Some consulting firms produce great work, some produce terrible work.
How is this news?
Maybe my question would be - why is it news now?
So maybe the better question is: why was it newly discovered now? The Internet makes the details of investigations and court cases easier to disseminate and systemically track, for starters. Another factor may be that the company has recently entered an era when it has significantly expanded its influence, and/or has trended toward the kind of performance that becomes controversial and litigious:
https://twitter.com/i_m_m/status/1202641126362091523
Some excerpts from this Twitter thread:
> The first crack came in 2009 when the SEC charged a colleague I liked, Anil Kumar, with insider trading. Anil was a partner; the partners fired him immediately. The following year he pled guilty, paid a huge fine, but never seriously repented.
> The Firm went into crisis mode. In 2014, Dominic Barton became Managing Director. He set out to clean up the scandal and fix the professional culture that tolerated felonious behavior among senior partners. How has that worked out
> As he took over, a book exposed bad McKinsey advice. At Enron, a former partner was in jail. The Firm-advised Time Warner AOL merger was a disaster. The advice to GM re Japanese competition had failed. The Internet? Mobile Embarrassing.
Anand G's "Winners Take All" summarizes the problems with this approach and his arguments in that book are slowly becoming more mainstream. On top of that, Pete Buttigieg's status as a McKinsey alum running for President makes it particularly salient.
Democrat politics at play.
A significant progressive faction is trying to take down Buttigieg, tarnishing his good guy image. Lazy Journos buy-in.
It has all the elements of a great story-- an Elite, Secretive Consulting firm doing the dirty work of evil Corporate America. Classic Fear, Greed, and Power stuff.
The less nefarious answer is that these big investigative pieces follow a pattern. The original journalists publish a series of articles, then start writing a book. Meanwhile, other journalists pick up the thread. Sometimes this happens simultaneously because other journalists hear about the investigation and talk to the same sources.
Here is a fact that many people don't want to admit but is widely acknowledged within the public health sector: UN organizations like the WHO are indispensable, but also among the most bureaucratic, ineffective, and inefficient entities on the planet. There is a reason that the impetus for hiring McKinsey came from inside the WHO itself. Private-sector organizations like Gates Foundation have been welcomed into the field not only because of their resources, but because of their effectiveness and organizational capabilities.
The second point is that governments in developing countries are corrupt and direct aid money is quickly siphoned off and dissipated.
The third point, following from the first two, is that the United States' foreign aid efforts have always relied heavily on consultants and public-private partnerships, and have been extremely effective. Say, for example, USAID wants to address infant mortality in Bangladesh. It doesn't give money directly to Bangladesh. It gives money to a consulting firm, which hires "boots on the ground" (doctors, etc.) and secures supplies. USAID and the consulting firm then work closely with the health ministry in Bangladesh to execute the vaccine program. This structure works quite well: in Bangladesh, for example, it has been instrumental in reducing infant mortality and improving family planning.
The issue with McKinsey, etc., is not that they're "secretive" or "for-profit entities." It's that they have little experience in the sector compared to specialized consulting companies who have been doing that sort of work for decades.
It's just a company going after a market, same as their competitors are. You might as well say "Apple infiltrated the world of cell phones" or "Warren infiltrated the presidential race".
Totally irresponsible. Shame on Vox.