Communications reveal 2020 Health working with Lord Howe to make the NHS a"UK Plc Asset"

Documents released by the Department of Health under the Freedom of Information Act reveal a healthcare think tank with multiple links to coalition peers wants to turn the NHS into an “asset” of “UK Plc” - and which suggests the government needs to “charm” private healthcare “international corporations”

2020health calls itself an ”independent, grass roots think tank” whose purpose is to “create the conditions for a healthy society through research, evaluation, campaigning and relationships.”

Correspondence between the health minister Earl Howe, former patron of 2020 Health, and the think tank’s founder Julia Manning reveals some of the nature of these ‘relationships’.

At Julia Manning’s invitation, Earl Howe was a guest speaker at a ‘high-level discussion breakfast roundtable’ with key clinical and industry leaders back in February 2011, during the ‘listening pause’ in the passage of the Health & Social Care Act through parliament. After the meeting, Ms Manning wrote to thank Earl Howe. In the letter, which has been obtained by Social Investigations, she noted that Earl Howe had told the meeting that the message of the UK health being open for business was “not getting through.”

Manning had asked what should be done to attract “global companies to the UK.” She pushed for a “radical message” to make the NHS part of the “UK PLC”, an “asset” and “driver of economic growth.”


Manning warned that historically, the NHS had been good at “repelling business” and that investment in healthcare was “much easier in the USA.”

She laid the blame for the lack of movement at the door of the last Labour government, who she said had gained a reputation for “bureaucratic obstructions to market access.”

Such correspondence adds to the concern that the Health and Social Care Act was less about improving services and more about opening up the public-funded health service to big business. In other words, the ‘UK PLC’ Ms Manning envisages and has so earnestly promoted to Earl Howe. Throughout the progress of the Health and Social Care bill, Manning acted as a champion for private healthcare involvement in the NHS and wrote several articles that promoted the ‘benefits’ they bring into the NHS

In order to open up the NHS to a market, Julia Manning also advised Lord Howe that ”international corporations” should be met with a “charm and diplomatic offensive by high level officials.”

Many may baulk at the idea that our elected government should beg for corporate attention within the NHS. But prior to the Health bill being passed into law, Earl Howe told a forumhosted by healthcare market researchers Laing and Busisson that ‘‘The opening up of the NHS creates genuine opportunities for those of you who can offer high quality, convenient services that compete favourably with current NHS care… There will be big opportunities for the private sector”.

In later correspondence, Julia Manning went on a charm offensive of her own. In March this year she asked Earl Howe to become a member of 2020health and to ‘join us and share in this adventure’. Whether Earl Howe accepted her offer is currently unknown. (Update, 2020health have recently released their supporters and funders). Click here.

2020 Health already has strong links to both the Conservative Party and the health insurance industry. Ms Manning herself was a formerConservative parliamentary candidate and has a background in health insurance. 2020health’s former chairman was Tom Sackville; a former Conservative minister under the Thatcher government is the Chief Executive of the International Federation of Health Plans, which represents one hundred private health insurance companies in 31 countries.

Aside from Earl Howe’s former patronage, four other peers are listedas current patrons - Lord Clement-Jones, Baroness Cumberlege, Lord McColl and Lord Rennard have connectionsto companies or organisations involved in private healthcare. The popularity in patronage might be because the House of Lords rules allow for patronage to take place without this having to be registered in their personal interests. But this patronage is used by 2020health to attract corporate members, who can become ‘Silver’ or ‘Gold Partners’ and receivean “opportunity to network with 2020health staff, patrons and associates”.

The identity of companies that have taken up this offer is as yet unknown, but what is known is that - despite their claims of independence - many of their reports are funded by big business. The policies these reports promote to “create a healthy society” may raise a few eyebrows.

In January 2010 - when Earl Howe was still both a patron of 2020 Health and opposition health spokesperson - 2020 produced a report sponsored by Bayer healthcare entitled‘Responsibility in healthcare: changing the culture’. The report advocated the end of free treatment for minor or for ‘repeat offenders’ under a section on ‘lifestyle’ illnesses. It suggested that electronic records could facilitate a penalty system for those who repeatedly turn up to A&E drunk or ‘high’. In addition, the report bemoaned that “the culture of people being deterred from seeking help because they are worried about ‘being a burden’ is fast fading”.

2020 Health is also a leading advocatefor ‘telehealth’ - the replacement of face to face contact with telephone and electronic monitoring devices. Its report, Healthcare without Walls was published just after the government had published its White Paper “Liberating the NHS” states that ‘the White Paper creates the environment in which the demand for telehealth-enabled services can be fostered”. The report was sponsored by private healthcare corporations including Tunstall (a leading provider in telehealth), Accenture, Vodafone, Pfizer and others. Despite 2020 Health’s stated emphasis on “research” and “evaluation” there have been a number of reports highlighting safety and cost problems with the telehealth model. The same report also pushes the use of personal health budgets…’ a move seen by manyas a step towards privatisation and an insurance model.

Manning’s letter to Howe reveals how she and her “consultative authors” lobbied Oliver Letwin hard on the point that David Cameron should be known as the “Technology PM”. This attempt to label Cameron “didn’t succeed” but Ms Manning is unperturbed. She ended her letter to the Earl by stating “we have to start firing up radical flares to attract investment and ensure resistance to change in the NHS is not tolerated.”

Such support for both big business, which funds their reports and Manning’s suggestions for David Cameron’s image suggests 2020health are anything but independent. Furthermore, the message turning the NHS into an economic arm of ”UK PLC” brings an end to the illusion that the Health and Social Care Act is about improving patient care.

This was co-published on Our NHS here.  

The 2020health membership just published and highlighted to me on 25th September 2013

Earl Howe - A Former Patron of Pro-Market Health Think Tank

The Parliamentary Under secretary for Health Earl Howe, who led the Health and Social Care bill proceedings in the House of Lords, was listed as a patron for pro-market think tank 2020health, just before the elections.

Knowledge of the Earl’s patronage has only just appeared after the discovery of a policy paperwritten by 2020health for the Spanish right-wing publication ‘Sanifax.’ The ‘Dosier Especial’ titled ‘a healthier nation’, was a Green policy paper produced in January 2010 and introduced in Spanish as having been created with the ‘support of David Cameron’ on the ‘necessary reforms.’

At the time of the report, the Chairman of the think tank was Tom Sackville, a former Conservative minister and Parliamentary Under –Secretary for Health who is the Chief Executive of the International Federation of Health Plans, which represents one hundred private health insurance companies in 31 countries.

2020health is now led by founder Julia Manning a former director of the UK Institute of Optometry and Conservative candidatein the 2005 election, has been vociferous in her supportof an increase in private health into the NHS.

2020health reports

The self-called ‘independent’ think tank has produced multiple reports funded by health corporations, which includeone titled ‘Responsibility in healthcare: changing the culture’. The report sponsored by Bayer healthcare was produced in January 2010, when Earl Howe was still a patron and advocated the end of free treatment for minor or for ‘repeat offenders’ under a small section on ‘lifestyle’ illnesses. Electronic records, the report suggested can facilitate a penalty system for those who repeatedly turn up to A&E drunk or ‘high’. In addition, the report recommendations bemoaned ‘the culture of people being deterred from seeking help because they are worried about ‘being a burden’ is fast fading’.  At the time, Earl Howe was the opposition spokesperson for Health and Social Services and still a patron.

Promoting Telehealth

A further reportwritten in the same period was published just after the government had produced its White paper Equity and Excellence: Liberating the NHS. The focus of this report was on the area of telehealth and was titled ‘Healthcare Without Walls’. This report was also sponsored by private healthcare which included Tunstall, a leading provider in telehealth, Accenture, Vodafone, Pfizer and others. The opening summary states how ‘the White Paper creates the environment in which the demand for telehealth-enabled services can be fostered…through personal health budgets…’

2020health is a leading advocate of telehealth technology, and have claimedthe technology can make huge savings. However, all is not clear about the benefits of ‘telehealth’. A trial in the UK run by the British Medical Journal revealed costs of running telehealth were higher than without and the technology failed to improve ‘quality of life’. Furthermore an analysisin the US suggested the telemedicine, which is part of a telehealth programme, ‘tripled’ the death rate in elderly patients.

2020health’s support for private healthcare involvement and sponsorship from big business for their reports may well indicate who makes up their membership. However, despite several requests by Social Investigations, 2020health have so far refused to publish their membership list and denied it contains health insurance companies.

Lords interests
The dedicated promotion of telehealth by 2020health no doubt pleases Conservative peer Lord Patten, who is a senior advisor for Charterhouse Development Capital Ltd - who purchased leading telehealth provider and sponsor of the 2020health report, Tunstall. Further parliamentary interest in the new technology comes in the form of Conservative peer Lord Flight, who is the Chairman of Arden Partners plc, an investorin Deltex Medical Group who produce a telehealth productadopted by the NHS.

Other patronage

Patronage of 2020health is popular amongst peers. Liberal Democrat Peer, Lord Clement-Jones is a 2020health patron and a partner for DLA Piper, who provide lobbying, public affairs and trade policy services as well as advice on how to get access to public service delivery contracts. Another Peer and patron is Baroness Cumberlege, who runs her own training and consultancy company called Cumberlege Connection. The Conservative Peer moved herself into an alliance led by PwC, developing the new Clinical Commissioning Groups, prior to the Health and Social care bill becoming an Act. When a complaint was placed with the Commissioner for Standards she responded by saying 'Disappointingly since joining the alliance Cumberlege Connections has not earned any income through the alliance.'

Pushing the market

Earl Howe, a former banker has recently been threatened with expulsionfrom his advisory position at the Royal College of Physicians for having ‘mis-sold’ the health reforms. Earl Howe’s support for more private healthcare involvement is clear. When speaking at a forumhosted by healthcare market researchers Laing and Busisson prior to the Health bill being passed into Act, he told the audience ‘‘The opening up of the NHS creates genuine opportunities for those of you who can offer high quality, convenient services that compete favourably with current NHS care… There will be big opportunities for the private sector’.

His recent connection to 2020health is not severed and he remains a frequent guest speaker at events hosted by the think tank such as this one on further cuts to the NHS, an invitationonly event.

In his opening speech on the opening day of the Health bill in the Lords, Earl Howe said “We will support an active role for the independent sector working alongside the NHS in the provision of care” This ‘active role’ included his attendance at a top-level meetingwith a healthcare lobby group one year before his opening speech in the House of Lords.

In October 2010, Earl Howe, alongside Simon Burns (the then Minister for Health), and Andrew Lansley’s Special Advisor, Bill Morgan, attended two meetings with a private healthcare lobby group, the NHS Partners Network (NHSPN). These meetings one of which included a Care UK representative came to light following the discovery of a documentwritten by the NHSPN, which revealed the discussions took place three months before the Health and Social Care bill was introduced to parliament.

The purpose of the discussion, according to the document, was to give members an opportunity to ‘express their support for the policy of ‘Any Willing Provider’, which became ‘Any Qualified Provider’, and to give those present a chance to express any ‘concerns about whether a level playing field would truly be created’. Furthermore, the lobby group was informed that the government felt as if opposition to the ‘independent’ sector from GP commissioners would likely be ‘short-term’ and ‘dissipate’ in the future.

What was said is unclear, although meeting notes were taken and although visible from the NHS Partners Network’s website they were security protected for their corporate health membersonly. This restriction meant the members had privy to a key meeting in which information was discussed before both parliament and the general public.

Rules – not fit for purpose

The rules that the Lords have to abide by are plentiful, but under their Code of Conduct, it states that patrons ‘should not be registered’. Although it continues ‘There may however be occasions on which such interests should be declared.’ The Code of Conduct also states that Members must “declare when speaking in the House, or communicating with ministers or public servants, any interest which is a relevant interest in the context of the debate or the matter under discussion.”

However, if his patronage was not a conflict of interest worth mentioning, then why give it up upon the general election? The rules may be lax on this matter but surely his patronage of an organisation headed at the time by an individual in charge of a private health insurance body, which openly supports increased private healthcare involvement in the NHS warrants registration in his interests. Earl Howe was instrumental in aiding the pro-market Health and Social Care bill into Act. Lord Warner, the Labour former health minister, said“his silky skills got the bill through”.

What difference would it have made if his fellow peers had known about his patronage is unclear but they deserved to know; as too did the public. Thanks to flaws in the rules, his omission it would seem was one of choice, as was his decision to go to a meeting with private healthcare to reassure them before parliament saw the bill. All this raises further questions about what Earl Howe’s true intentions were behind his support for the Health and Social Care bill and may well bring his expulsion from the Royal College of Physicians back for discussion.  

Chris Skidmore states he will defend NHS in abolition panel discussion, but will he?

Abolishing the NHS is a provocative turn of phrase, and one that would not pass the lips of any Conservative politician in public, even if that is their ultimate intent. Yet, a Conservative MP is attending an evening panel discussion today June 13th, with that very theme: ‘Should we abolish the NHS?’

The discussion, will be hosted by the Institute of Economic Affairs, (IEA) as part of their ‘big steps to a smaller state series.’ The IEA, is a free market think tank, and have already made their feelings on the NHS clear, in an article written by their deputy editorial Director Richard Wellings, titled: ‘How to abolish the NHS.’ The article, published in January this year, bemoans the ‘strong support’ that the public has for the NHS, and suggests that the powers that be ‘bypass the NHS by liberating the private healthcare sector so that the NHS became less and less relevant as more and more people opted out of state provision to avoid long waiting lists and substandard care.’

Panelists

Leading the debate will be 5 panelists all of whom come from a position of supporting Andrew Lansley’s Health & Social Care bill, which is now an Act.

Panelist No1, is Dr Stephen Davies, who is the Education Director at the IEA. He has spoken widely on the benefits of privatisation in the NHS, including on BBC One’s the Big Questions, in February this year, explaining the ‘advantages’ of healthcare ‘liberalisation’. According to the IEA website, he claimed more commercialism in healthcare provision means ‘greater control over costs’ and that profit incentives lead to more efficient use of resources.’ The BBC has come under fire for their lack of coverage and challenging on the NHS and MPs vested interests, and they didn’t disappoint here, failing to demand the evidence to back up Dr Davies’s claims.

Panelist No2 is Professor Julian Le Grand of the London School of economics, and is also a fan of the bill, having spoken widely in favour of the changes. In a letter to the Guardian, in February this year, Mr Le Grand, stated: ‘With respect to the NHS bill, it is important that even those who generally prefer to rely upon their intuitions should avoid muddying the waters by accusing the bill of doing things that it does not, like privatising the NHS.’ The professor must be horrified then, when he sees companies like Serco becoming the single bidder for NHS support services, and the private companies controlling the CCG development process.

Panelist No3, is Mathew Sinclair, the Director of the right-wing, lower tax campaign group, the TaxPayers’ Alliance (TPA). ‘Britain’s non-partisan’ and ‘independent’ tax lobby group were the author’s of a 2008 report titled, ‘Wasting Lives’, in which it states the priority the government should place on private involvement in healthcare: ‘Perhaps the most important priority for reform of British healthcare is to increase the amount of competition within the health service.’  The TPA are consistently cited in newspapers, highlighting negative efficiency in the NHS, offering competition as the solution. For more of the TPA, view Spinwatch powerbase page here.

Panelist No4 is Julia Manning, the Chief Executive of another self-proclaimed ‘independent’ think tank, called 2020health. However one look at their list of patrons quickly reveals what side of the healthcare fence they are on. In total, they have 4 patrons, all Peers from the House of Lords, and all with financial links to companies involved in private healthcare. In one case, one of the Peers, Baroness Cumberlege, put her company into an alliance led by accountant giant PriceWaterhouseCoopers, who were winning bids to develop the new Clinical Commissioning Groups before the Act had been passed.

Just in case you have any lingering doubts about their independence on NHS matters, then a blog article in the Daily Mail written by the think tank’s Chief Executive Julia Manning, should dispel any of those thoughts. The article titled: ‘Andrew Lansley must spell out the importance of private enterprise to the NHS’, tells us how ‘a significant problem for the economy is that confidence for investors in healthcare in the UK is being massively damaged both by the short-sighted, protectionist opposition to competition that is being driven by the health unions…The NHS has a track record of making flawed policy work, and it wouldn’t be where it is today without competition and private investment.’

Public servant Chris Skidmore

We can be grateful at least that panelist No5 is a public servant, who by definition will be standing up for the people and their NHS. In fact, that’s exactly what Chris Skidmore the MP for Kingswood told me via a Twitter on my account. He replied in response to a request I put asking someone in his constituency to contact him to see if, ‘he wants NHS abolished?’ His response was reassuring: ‘I will be defending NHS during debate and its vital principle of free at point of use regardless ability to pay’.

Given the other panelists in attendance someone will need to; however, I question his authenticity. After all, Mr Skidmore voted for the Health and Social Care bill, which included an increase of up to 49% of NHS hospital bed and theatre time being given to private patients. On a personal level, he received a payment of £3,500 for 4 hours work - giving speeches to STAC Consultancy which specialises in the launch of pharmaceutical products, strategic branding and medical education. Chris Skidmore's family also owns a company called Skidmore Medical, which appears to be solely selling a physiologic Vascular testing equipment. The company made a donation to him of £7,500 in June 2010.

Mr Skidmore often cites former New Labour MP and secretary of State for Health, Alan Milburn, for his support of reforms, as a way of suggesting other Labour MPs and in particular current shadow health secretary Andy Burnham, are opposing the reforms for the sake of it. What he never mentions, are the connections Alan Milburn has in private healthcare. In 2008 his registered interests included being a member of Lloydspharmacy's Healthcare Advisory panel for which he was paid in the region of £30,000. In addition, Mr Milburn was a member of the European Advisory Board of Bridgepoint Capital Limited, the private equity firm which acquired Care UK, whose chairman John Nash bankrolled Andrew Lansley’s office just prior to the takeover. Mr Milburn, is hardly a flag-waver for a public sector NHS.

The changes imposed by the Health and Social Care Act, which had no mandate from either of the coalition parties, not only weakens our democracy, but speaks volumes about the attitude of today’s politicians. Sidling up to Murdoch, abusing their expenses, has done nothing to humble them. Now we are told the increase in private healthcare is necessary for the NHS to survive, and now Chris Skidmore is attending a panel discussion loaded with pro-reform panelists, where the debate is whether to abolish the NHS.

Do you believe Chris Skidmore will stand up for the NHS as he says he will?


Quotes on the bill: "One of the best bits about the Bill for me was the element of Any Qualified Provider"

Watch this space…

2020health Patrons and their vested interests

2020health claims to be an 'independent', think tank. It isn't. In total, they have 4 patrons, all Peers from the House of Lords, and all with financial links to companies involved in private healthcare. In one case, one of the Peers, Baroness Cumberlege, put her company into a position to make money from the reforms before the Act had been passed.

2020Health Patrons

The Four Peers are Conservative Peer, Lord McColl, was a paid a fee as a consultant to a new private healthcare company that provides a fee-paying rival to the National Health Service’s family doctor service. Endeavour Health, which was set up by two hedge fund advisers, and claims to be Britain’s first comprehensive GP network, offering opportunities to ‘beat NHS queues’ and have appointments at any time they want.’  

Baroness Cumberlege, who will be familiar to readers of this blog, runs her own training and consultancy company called Cumberlege Connections, the Conservative Peer moved herself into an alliance led by PwC, developing the new Clinical Commissioning Groups, prior to the Health and Social care bill becoming an Act. In addition, the former health secretary is chair of the Associate Parliamentary Health Group, which holds meetingsunder the Chatham House rules, which means no minutes are taken, even though the quarterly meetings are attended by multiple private health companies.

Liberal Democrat Peer Lord Rennard is another patron, who is also a Director of British Healthcare Trades Association, (BHTA) a trade association set up to ensure the market for healthcare and assistive technologies is competitive, profitable and well-regulated. They work in partnership with industry, government, and other stakeholders. The Coalition Peer set up a communications company with his wife called Rennard & McTegart Ltd, and through this company they provide public affairs advice to the BHTA.

Lord Tim Clement-Jones, and Liberal Democratic Peer, is the final patron, of the ‘independent’ think tank, who is a partner in DLA Piper, a global law firm providing lobbying services to “clients in the health and social care sectors”. DLA Piper counts Southern Cross amongst its clients. Lord Clement-Jones nominated Lord Hameed for his peerage, a nomination supported by Lord Dholakia. Lord Hameed sits on the board of Alpha hospitals, part of the Alpha Healthcare (C&C Alpha/C&C business solutions) group. The Alpha group has made significant donations to the Liberal Democrat party. In 2008, Lord Clement-Jones was the party treasurer. The Times exposed Lord Clement-Jones as being the man who nominated Lord Hameed, after the peer had originally said he had 'no idea.'

Just in case you were in any doubt about the independence of 2020health’s position on NHS matters, then a blog article in the Daily Mail written by the think tank’s Chief Executive Julia Manning, should dispel any of those thoughts. The article titled: ‘Andrew Lansley must spell out the importance of private enterprise to the NHS’, A significant problem for the economy is that confidence for investors in healthcare in the UK is being massively damaged both by the short-sighted, protectionist opposition to competition that is being driven by the health unions… The NHS has a track record of making flawed policy work, and it wouldn’t be where it is today without competition and private investment.’ Andrew Lansley is a fan, endorsing the website with this quote: 2020health '"Providing valuable impact on policy."

Finally; former 2020Health Chairman, Tom Sackville– a former Conservative minister – is the current CEO of the International Federation of Health Plans, which represents one hundred private health insurance companies in 31 countries. Not only this, they also have a hidden membership list, which I have suggested contains health insurance companies. They haven't denied this and despite repeated requests for them to publish their members, they have not.

'Independent' eh!