I could give you my top 4 in no particular order :-)What you'll find though is that the Big4 are neck-and-neck and the answer varies from quarter to quarter. For example, through last year PwC were regularly taking large NHS contracts away from DC. This year, DC sorted out some of the internal problems, made a big play with discounting NHS rates, and stemmed the outflow. Meanwhile KPMG have been making a steady play off the back of their DH relationships. Although the KPMG slice of the pie is smaller it's been closely matched to the growth in resource (healthcare specialists, etc.). So if you were working for KPMG, you would have been busier and felt like things were steadily growing. Although both KPMG and E&Y are probably level-pegging in terms of NHS market share right now, there would have been a contrast if you'd been at E&Y. Here, healthcare has been slipping in and out of focus for the public sector team. Everytime a pitch is lost it's suddenly because we didn't want it in the first place; every time a pitch is won, it's a strategic coup for the firm's ambitious healthcare technology plans. All in, it's been a much more chaotic and depressing experience.The pharma side of the equation is a fairly moot point as spending has been so depressed that none of the Big4 consulting divisions have any significant business to speak of right now (unless it's related to statutory assurance activities). It's probably fair to say that we won't know who really has the clients until the market's ready to spend money again.
