The Department of Health must provide rationale for the £6,526,000 spent on external Consultants
December 27th 2025
Consultancy Costs on the Rise
Recently released figures from the Department of Health in Stormont show that in 2024-25, the Department and several of its arms-length bodies, including the five main health trusts and the Public Health Agency (PHA) spent £6,526,000 on consultants, which is almost double the outrageous £3,054,000 spent on consultants in 2019-20.
The response also broke down the number of people involved in providing these skills by their areas of expertise, with the largest number (215) falling under ‘Recruitment and Selection”.
As the Belfast Telegraph reported, “194 [consultants] are experts in ‘Facilitation’, while there are 179 engaged in ‘Reviews’. A further 176 are consulted on investigations and grievances, while some 196 are engaged in change management.” Change management indeed.
Consultancies During Covid
The Belfast Telegraph implies that this doubling in consultancy services was connected with post-Covid management practices and indeed across the UK and elsewhere, the consultancy racket made a fortune as a result of the epidemic. In their 2023 book, The Big Con: How the Consulting Industry Weakens Our Businesses, Infantilizes Our Governments and Warps Our Economies, left social democrats Mariana Mazzucato and Rosie Collington note that while the broader UK economy contracted during the pandemic, the management consultancy sector grew by 2.5% in 2020 and 16% in 2021, fuelled largely by government contracts for core operational tasks like PPE procurement. By April 2021, consultants made up nearly half of the "Test and Trace" program's central staff, and Deloitte alone was earning up to almost £1 million per day for operating a system which failed to meet its primary public health goals. A parliamentary inquiry criticized the program for being "overly reliant on expensive contractors".
Stormont and Its Consultants
Although there is no doubt that consultancy profits in Northern Ireland grew during the pandemic, the biggest rise was seen in 2024-25, when MLAs returned to work and the worst of Covid was behind us. The virus cannot be held responsible for this continued keenness to outsource expertise.
Indeed, the outsourcing bug has bitten many Stormont departments over many years. For example, in December 2024 it emerged that the Department of Infrastructure was planning to spend £100 million as part of a three-year contract for road improvements. When asked by the SDLP in November 2025 to detail the amount the Department plans to spend on consultancy companies, related to the A5 Western Transport Corridor scheme in the 2025-26 financial year, the Sinn Féin minister replied that "as a result of ongoing appeal on the A5, all scheme costs in relation to the project are currently under review". We shall see what happens but, in the absence of workers raising their voices, we can expect Stormont’s addiction to outsourcing to continue.
Mazzucato and Collington note that under the Conservative administrations of 2010-2024 local government authorities and NHS bodies in GB were given greater responsibilities while at the same time their budgets were reduced and as a result money spent on management consultants increased dramatically “as spending cuts forced [public sector] managers to look to short-term, private sector solutions for support”. The outsourcing of expertise consultancies undermines the public sector and slices up knowledge transforming it into various privately operated commodities.
In relation to Northern Ireland, the facts are obvious but bear repeating: to spend millions on so called expert consultants is outrageous at a time when our health and social services are at breaking point and the department is seeking to redefine services to facilitate efficiency savings and have plans to reintroduce prescription charges and charging for home care services.
Given the number of senior executives employed across all the Trusts and arm’s length agencies, the public are entitled to know why the health service needs more than 300 associates to provide input.
We Want Answers
The breakdown of the expertise is quite staggering as is the areas in which these consultants are required, the public are entitled to much more clarification and justification. It is important to know why there seems to be a skills deficit within the healthcare system. For example, why would the service need to bring in outside consultants on recruitment and selection, investigations and grievances and change management. Have those with the necessary skills all been given early voluntary retirement or been made redundant?
Other areas of concern are estates and engineering: given the number of problems with new buildings, where have all the in-house staff gone? The existence of ‘mentors’ and ‘actors’ as consultants on panels is mind boggling. The Department also needs to explain if these 300 Associate Consultants are made up largely of former health service senior managers who have left the service on full pensions. Because if their expertise is needed, why were they allowed to leave in the first place?
The Workers Party will be seeking a much fuller explanation from the department of health on this issue because it would seem on the face of this limited information that we have a service depleted of inhouse skills and expertise, and a very unhappy working environment with the numbers engaged on investigations and grievances. What has happened to Human Resources departments? Have they also disappeared? This expenditure on associate expertise and all existing structures now needs to be reviewed while the NHS’s primary purpose, i.e, the delivery of high-quality services to patients and service users free at the point of demand, needs to remain central.