By Tony Robson 12/12/2012

A leaked document reveals how the private health care lobby worked through back channels with the Conservative/Liberal Democrat coalition to ensure that the competition element of the Health and Social Care Act remained intact as it passed through the legislative process.

The blog Social Investigations has published an internal briefing by NHS Partners Network. David Worskett, director of the group, produced the five page briefing as an update for his clients which include Circle Health, the first private health care company to take over the running of a National Health Service hospital last year at Hinchingbrooke.

The document is particularly compromising as it refers to lobbying in April/May 2011, when the government had temporarily placed the Health and Social Care bill on pause after passing an initial vote in parliament. This was ostensibly to hold a “listening” exercise to address mounting opposition within the medical profession and the public at plans to carve up the NHS and hand it over to the private sector. The plans advanced under the slogan of providing more “choice” for patients had no electoral mandate and did not appear in either the Conservative or Liberal Democrat 2010 General Election manifestos, or the post-election Coalition Agreement.

Prime Minister David Cameron declared at the official launch of the two-month listening exercise, “Let me be clear: this is a genuine chance to make a difference. Where there are good suggestions to improve the legislation, to improve the changes, those changes will be made.”

Even this sop was viewed by the private health care lobby as an unwelcome disruption and even a potential threat. The language of the internal document by NHS Network Partners exposes the antipathy felt by the private sector to any oversight of the legislation from which they stood to gain so much. Titled “NHS Partners Network: Director’s update”, the briefing states:

“At our AGM on 19 April we agreed on how best to handle the considerable threats posed for the sector by the ‘pause’ in the legislative process because of opposition to the NHS reforms and to return to levels of hostility towards the independent sector not seen or heard for some years. The essence of the strategy was to recognise that if the report by the NHS Future Forum to the Prime Minister went the wrong way for us, retrieving the situation position would be almost impossible. Therefore the tactical imperative had to be to influence the forum members directly and to concentrate other activity on those who have most influence of the forum.”

The steps taken to ensure an outcome favourable by the private lobby, though not represented on the NHS Future Forum, meant they were able to exert considerable influence via Cameron, other government ministers and advisors and the media.

Worskett explains how the campaign of the lobbyists included:

  • Worskett briefing the new No.10 [prime minister’s residence] health policy adviser and clearing all the public statements from the group with him, as well as holding regular ‘stock take’ phone conversations. The chief lobbyist describes being thanked personally by No.10 for arranging publication of a letter signed by clinicians working in the NHS for the private sector which was favourable to the reforms. He was also invited along to a speech given by the Prime Minister in which the latter included an additional sentence about the importance of patients being able to attend private hospitals. Worskett also refers to the fact that he was able to liaise with Norman Lamb, a close advisor to Deputy Prime Minister Nick Clegg.
  • How he had “one lengthy, very early discussion with Sir Stephen Bubb,” chair of the competition work group on the NHS Future Forum, “at which we agreed on the approach he would take, what the key issues are, and how to handle the politics. He has not deviated from this for a moment throughout the period.”
  • How he met with government health ministers Earl Howe and Simon Burns at the Department of Health. Worskett states that in Howe’s summary of the government’s position, “he could have been delivering a précis of our briefing notes (which of course he had already seen.)”
  • Worskett praises the “good coverage” they had received on the BBC website and in reference to the Daily Telegraph notes that “the whole sequence of Telegraph articles and editorials on the Government not going soft on public service reform, including some strong pieces on health, is something I have been orchestrating and working with Reform to bring about.”

The section of the briefing headed “The Politics” reveals the lobbyists and government ministers shared contempt for the electorate. According to Worskett at his meeting with ministers Howe and Burns they emphasised the need to distinguish between the “the high level ‘noise’ around coalition politics” and a “real risk”. What was being said for public consumption by government representatives had no bearing on reality. At the time Deputy Prime Minister Nick Clegg was proposing changes of a cosmetic nature to the legislation in order to justify his party’s endorsement.

Worskett was able to conclude that “my analysis is that the aim is to use the authority of the Forum’s report and the listening exercise to improve and make more acceptable the policy… Meanwhile Nick Clegg is, frankly making noise in order to persuade parts of his party that he is really driving the changes to ‘save the NHS’.”

The Observer newspaper ran a piece on the leaked document quoting Labour’s Shadow Health Minister Jamie Reed stating that it “confirms what many have long suspected to be the case–that the echelons of government were in talks with cheerleaders for private healthcare on how to ram the privatisation of the NHS through parliament.”

However, the Labour Party is in no position to expose such a conspiracy due to its own track record of working with the same cheerleaders of private healthcare in opening up the NHS to profiteering.

The NHS Partners Network came into existence in 2005. According to Social Investigations, the group consisted of organisations involved with the Independent Sector Treatment Centres (ISTC). The Labour government established the ISTC’s in 2003, contracting private companies to conduct non-emergency treatment funded by the NHS. Its lobbying activities expanded from there. In an annual report from 2007/8, the group claimed to have held “Major high level” meetings with then Minister of State for Health Andy Burnham.  The ISTC’s and the extension of the Private Finance Initiative by the Labour government undermined the NHS and paved the way for the full scale privatisation envisaged in the Health and Social Care Act. While the list of some 200 parliamentarians who have financial ties to private health care companies is dominated by Tories, it includes a significant number of Labour MPs and Peers.

The level of collusion between the political establishment and the private health lobby provides a refutation of the claim that the NHS stands above politics and can be defended by applying moral pressure. It requires an independent struggle waged by the working class based on a social programme against the government and its allies in the Labour Party and the trade union leaders who are allowing its dismantling to proceed unopposed.


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