"We can't go on like this" - Cameron Hires Lobbyist Into the Heart of Government

Number 10 today welcomes Nick Seddon, former lobbyist and private healthcare advocate, into Downing Street to lead on health policy formation. What does this say about Cameron’s real attitude to the lobbying game he has publicly decried? And what kind of policies will Seddon be pushing now? There are good reasons to be concerned.

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Just beforethe general election, David Cameron declared his opposition to  lobbying, saying “we all know how it works. The lunches, the hospitality, the quiet word in your ear, the ex-ministers and ex-advisors for hire... It arouses people’s worst fears and suspicions about how our political system works, with money buying power, power fishing for money and a cosy club at the top making decisions in their own interest...We can't go on like this”

Today, Number 10 will welcome former lobbyist Nick Seddon into the heart of Downing Street, as his health adviser. Seddon’s last role was as deputy director of ‘Reform’ - a free market think tank extensively funded by healthcare and insurance companies. He has openly called for an end to the NHS as we know it, and promoted the idea of an insurance-based system.

Before joining Reform, Nick Seddon was head of communications at private healthcare company Circle - the first company to take over the running of a NHS hospital. 

His role during the passage of the Health and Social Care bill was to lobby key people to defend competition in the bill. His reward? A place in Cameron’s health policy unit,  developing  policies for the 2015 general election.

Private policy Unit
When work begins in the number 10 policy unit, Seddon will find himself working under a team that has both financial connections to private healthcare interests, and a long standing ideological commitment to a system of private health insurance. He told the Evening Standard “The exact work I do will be for Jo Johnson and the PM to clarify.”

Jo Johnson MP, brother of Boris, was recently appointed Parliamentary Secretary at the Cabinet Office to help 2015 Tory manifesto. In July 2010, he received £6,000to his constituency office from Robin Crispin Odey, investorin the aforementioned Circle Health.

In turn Jo Johnson will be under the experienced hand of Conservative policy guru Oliver Letwin, who famously wrote a reportfor the Tory think tank Centre for Policy Studies titled ‘Britain’s Biggest Enterprise, ideas for radical reform of the NHS’. The document, written when Letwin was an advisor on ‘privatisation to overseas government’ asked:

 ‘Might it not, rather, be possible to work slowly from the present system towards a national insurance scheme?  One could begin for example, with the establishment of the NHS as an independent trust, with increased joint ventures between the NHS and the private sector; move on next to the use of ‘credits’ to meet standard charges set by central NHS funding administration for independently managed hospitals or districts; and only at the last stage create a national health scheme separate from the tax system.’

Reform – Tory Think Tank

Nick Seddon’s transfer from Reform to the No10 policy unit is merely the latest example of close links between the supposedly ‘non-party’ think tank, and the Conservative Party. Reform is often used to trail Conservative policies. Seddon’s predecessor at Reform, Elizabeth Truss, wenton to become a Conservative MP, as did its founder, Nick Herbert.  

Reform appears to exist principally as a way for companies to influence the policy agenda. It is part-funded by 35 corporate partners– nearly half of whom are involved in private healthcare, health insurance, and associated businesses - donate at least £8,000 annually to the charitable Reform Research Trust. In 2011, Reform received  the sum of £770,000 from its corporate partners and other sponsors.  In return for the cash, they are involved in research reports, able to sponsor key events with policy-makers present and have their agenda represented in newspapers.

Seddon’s role in the Health and Social Care Act

At Reform, Seddon played a leading role in helping the government push through the Health & Social Care Act  2012. At the end of the so-called ‘listening pause’ granted after massive outcry, David Worskett (director of  healthcare lobby group the NHS Partners Network), produced a memorandum for their members that was obtainedby Social Investigations:

'the whole sequence of Telegraph articles and editorials on the importance of 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.’

Two days earlier, Mr Seddon had appearedin the Telegraph criticizing Clegg for saying that "instead of having a duty to promote competition, Monitor's main duty should be explicitly to protect and promote the interests of patients".  Seddon claimed “the two are not in conflict and competition is actually in the best interests of patients.’

Another Telegraph articleby Seddon highlighted a Reform report, titled ‘It can be done’, praising the increased involvement of private companies in running hospitals in Spain and Germany. Seddon also criticised opponents of the ‘plan to compel hospitals to compete for patients and income’.  

A glimpse of the future?

So what policy ideas can we expect from Nick Seddon?  He is no fan of Clinical Commissioning Groups (CCGs). In another Telegraph article, which appeared the day after Andrew Lansley’s 2010 White Paper - he wrote ‘There is no evidence to suggest that they [GPs] have the skills needed, which makes it unlikely that they'll be any good at trying to make hospitals improve what they do and cut their costs…’ However, he would like to see GPs charge for appointments.

Such criticism may be surprisingly welcome to the ears of his new boss, Letwin – whose original post-election blueprint for the NHS did not include Clinical Commissioning Groups, according to Nicholas Timmins' book on the battle over NHS reform.

Seddon’s article goes on to say that ‘all is not lost’, because CCGs could be used as the basis to  move towards a ‘mixed funding insurance model. The £80 billion budget could be allocated to insurers in professional alliances with GP groups…those who can afford to would be encouraged to contribute more towards their care packages’.

Such a move would surely please the corporate partners of Reform, who include the Association of British Insurers and Aviva. A greater role for insurance seems to be Seddon’s key theme – last December he toldthe All Party Parliamentary Group on Primary Care and Public Health that the NHS could learn a 'great deal from insurers in other countries especially those in the private sector.'

He recommended too that the NHS should trial the U.S. system of Accountable Care Organisations (ACOs), which work together to reduce costs. Once services are fragmented, such  schemes could act as a way to bring them back together, but not under public control, rather, under the potential control of insurers.

In the U.S, the ACOs are funded by private health insurance, employer health schemes or the government. According to a report by the leading journal of health policy in the U.S, ACOs have produced mixed results. High set up costs mean ACOs have experienced difficulty in balance the books. There have been concerns that a few ACOs will gain a ‘large share of the market, increasing their bargaining power with private payers and reducing the potential for savings.’

Seddon’s appointment clearly shows Cameron’s hand. It shows yet again the corporate interests driving  the dismantling the NHS, whether through lobbyings like Seddon and Reform, or through their extensive linkswith parliamentarians. Let us not forget, one in fourConservative Lords and 58 Conservative MPs have recent or present financial links to companies or individuals connected to private healthcare. Over twenty of the companies who are listed as corporate partners of Reform also have recent or present financial links to Lords and MPs.

The voices calling for insurance schemes are no longer shouting from the wilderness, but are now at the forefront of Conservative party policy-making. The Health and Social Care Act was a façade. Behind it lay the legal mechanisms that will fragment services and see NHS providers lost forever as increased numbers of services and public resources move into private hands. Will these be the new organisations that make up the ACO system that Seddon wishes to promote? 

This article was cross-posted on Open Democracy

Cameron Accepted NHS Future Forum’s Recommendations before the Report was Finished

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Just in case you were left with any doubts that the so-called ‘listening period’ was a genuine attempt to er…listen, then another dose of evidence has come to light, that will surely cure such crazy thoughts.

The evidence comes in the form of a post written on the blog by the head of the ‘Choice and Competition’ working group of the NHS Future Forum, Sir Stephen Bubb.

Posted on the 7^thJune 2011, under the title ‘Of one mind!’ Mr Bubb was announcing the end of the working group’s role in the Health bill ‘pause’, by producing the ‘Choice and Competition report.

In the opening paragraph of the post, Bubb produces this extraordinary confession:

‘Just as I was signing off our Panel's report on " Delivering real choice" I get sent a copy of the PM speech announcing he is accepting many of our key recommendations (although we haven't actually given him the report yet!) His comments on the role of competition which can drive choice and better quality is spot on. As also are the comments on the need for integration of services in health and social care and on the role of Monitor.…I am unclear why he thought it was a good idea to pre announce acceptance of much of our Report, but it is welcome.’

Readers of this blog, will already know that the so-called ‘listening exercise’ was a sham thanks to the appearance of a document emanating from a private healthcare lobby group called NHS Partners Network (NHSPN). The memo, which was meant for the network member’s eyes only, revealed how Sir Stephen Bubb met in secret with the director of the NHSPN, David Worskett. At the meeting Worskett and Bubb had ‘agreed on the approach he (Bubb) would take, what the key issues are, and how to handle the politics.’ According to the memo, ‘he had not deviated from this for a moment.’

This statement, which clearly implicated Bubb as a collaborator on behalf of the private healthcare group, was just part a series of meetings that were all aimed at increasing access to private health companies.

The NHS Partners Network according to their 2007/08 Annual report, were heavily involved in lobbying early on, having met then shadow health secretary Andrew Lansley in 2007 to discuss the ‘Conservative party draft bill’. In October 2010, before parliament had seen the bill, Simon Burns (the Minister for Health), Earl Howe, and Andrew Lansley’s Special Advisor, Bill Morgan, attendedtwo meetings with Worskett. In the meeting, Earl Howe offered a ‘depiction’ of the ‘Government position’, that meant ‘“choice” was a non-negotiable.’

Some democracy. Not only did a lobby director get reassured on competition remaining in the bill before it had been discussed in parliament, but the head of a forum who was meant to be ‘listening’, had made an agreementwith the same organisation that had aided Lansley with the bill’s draft in the early days. Then to top it all off, we now can see that before the report had even been signed off, the Prime Minister’s speech had accepted the recommendations.

It is not just the so-called ‘listening exercise’ that is a sham, but our democracy too.

Reform - Setting the Agenda with Unknown Others

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Reform is a right-wing think tank that claims to be ‘independent’. Like many think tanks they have charity status, although when you look at their work, it is hard to see where the charitable part exists. They are setting the agenda for our public services in meetings that only they know who was in attendance.

Reform has and continues to be influential in the attacks on the NHS. A document written by the health lobby group the NHS Partners Network revealed Reform’s involvement in setting up meetings with key players of the NHS Future Forum and Monitor during the ‘health bill ‘pause’.

Reform were part of an ‘orchestrating of the Telegraph’s editorial during the Health bill ‘pause’, working together with the director of the NHS Partners Network, David Worskett.

Collaboration between the two makes sense when you look at their ties to the private healthcare industry. The NHS Partners Network has several members who have MPS and Lords on their payroll. These include Circle, who pay Mark Simmonds £50,000 a year for 10 hours a month as a strategic advisor. Another company are Care UK, whose owner, John Nash, donated money to run Lansley’s office when he was shadow health secretary.  Furthermore Care UK were purchased by Bridgepoint who have BBC Chief, Lord Patten of Barnes as an advisor.

Corporate partners

Reform, who remember are a ‘charity’, have multiple healthcare companies as their corporate partners. Current members are:  ABI, Aviva, Balfour Beatty, Benenden Healthcare Society, Bevan Brittan, BG Group, BVCA, Cable & Wireless, Capita, CH2M Hill, Clifford Chance, Citigroup, The City of London, Ernst & Young, GlaxoSmithKline, G4S, GE, General Healthcare Group, HP, ICAEW, KPMG, Maximus, McKesson, MSD, Optical Confederation, PA Consulting Group, Serco, Sodexo and Telereal Trillium.

General Healthcare Group own BMI Healthcare who are the UK’s largest hospital group. When Circle produced a press release showing how they have managed to ‘turnaround’ Hitchingbrooke hospital, Reform were very quicklyonto the case promoting the need for more hospital outsourcing. This is also because their Head of Communications, Nick Seddon used to do PR for Circle. He has since been replaced by Andrew Lansely’s former aide Christina Lineen.

One can’t help wonder what is charitable about this.

Further connections are available to Reform through Lord Carter who acts as Chair for McKesson Information Solutions Ltd, which delivers IT to “virtually every NHS organisation”. Lord Carter is The head of the increasingly influential Competition and Cooperation Panel. McKesson released a statement on this potential conflict of interest to the Guardian, stating: "Lord Carter steps down from any investigation where there is potential conflict of interest.”

Reform are also invited to meetings where minutes are not taken with Parliamentarians present. In April this year, as the government were in their so-called ‘listening period’, Reform hosted an event with Lord Warner as chair.

Lord Warner is a former adviser to Apax Partners, one of the leading global investors in the healthcare sector. Current director of Sage Advice Ltd. He works as an adviser to Xansa, a technology firm, and Byotrol, an antimicrobial company, which both sell services or products to the NHS” and was “paid by DLA Piper, which advised ministers on the £12 billion IT project for the NHS” projects that he was responsible for when he was a government minister.

The meeting was held under Chatham House Rules, which are a near century old rule that are used to supposedly allow participants to speak freely with fear of their words being highlighted in the media. What it means is that the public have no idea what was said as no minutes are taken and none of the participants can announce to the public who was there. Therefore information that comes out from these meetings is controlled.

Even so, despite this, thanks to a post-meeting feedback by Comunications head Nick Seddon, we know that competition was on the agenda, and that there will be a need for ‘constant political pressure if either competition or integration is to be achieved.’ Not only that, but true to their partners needs, hospitals were discussed and it was considered that: ‘Dealing with failing hospitals will either be through outsourcing, radical reconfiguration, or closure.’

Reform like using Chatham House Rules, which says much about their attitude towards transparency. In February 2012, they held another meetingwithout minutes, which spoke of the need to reform ‘fast and at scale.’ Thanks to the introduction, we know that Julian Le Grand was in attendance. In the same month, 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 instuitions should avoid muddying the waters by accusing the bill of doing things that it does not, like privatising the NHS.’

Thanks to their feedback, we know that they spoke about whether there ‘should any areas of public service delivery be off-limits?’ The answer to this being, ‘in principle…“no”’. A further idea was the need to ‘go back to the idea behind Compulsory Competitive Tendering’. This former Conservative policy was introduced in the UK throughout the 1980s, but was dropped following resistance from local authorities and health trusts. The policy focused on price at the expense of quality and employment conditions, leading to a demoralised staff, that this should be being discussed a possibility is very worrying indeed.

So we know that Reform were holding meetings without minutes with key figures, though who many of them were remains unknown. They were part of the ‘orchestration’ of the Telegraph’s editorial, and were heavily promoting the benefits of outsourcing hospitals of which one of the corporate partners would be a beneficiary. They continue to push for the further role of private companies in the NHS many of whom are the partners and are linked to our so-called public servants. They call themselves a charity, which is patently absurd, and if we are to call ourselves a democracy, the use of organisations like this must not use the Chatham House Rules, which are used widely across political organisations.

Keep an eye out they are influencing the future of our public services.

The Telegraph, the Think Tank and a Very Dodgy Business

"And the whole sequence of Telegraph articles and editorials on the importance of 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.’ - David Worskett – Director of NHS Partners Network – Communication document written on 20^th May 2011

This extraordinary sentence is written by the director of private health lobby group David Worskett, as part of an overall feedback for the NHS Partners Network’s members towards the end of so-called ‘listening period’ in the Health bills passage.

The document, which landed into the hands of Social Investigations, has not only revealed the true nature of the lobbying that took place, during the ‘pause’, but also according to the document, revealed a coordinated response between a national newspaper, a healthcare lobby group, and a right-wing think tank to make sure the government didn’t go ‘soft’ on reforms to the public sector, including the NHS.

In the memorandum under the title: ‘the Media’, Mr Worskett stated how the lobby group had agreed to ‘up’ the profile on ‘key issues’ without ‘inflaming the debate.’ A fine line to tread at a time when the opposition to the bill was near total across the medical profession, and especially so, given the absence of any private health company representatives in the NHS Future Forum, the group set up to in order to ‘pause, listen and reflect’ on the content of the existing Health and Social Care Bill.

So who are the connections at Reform?

One key member of Reform is the Deputy Director, Nick Seddon, who was formally the head of communications for private hospital company Circle. Mr Seddon was very active promoting the benefits of competition in the Telegraph during the so-called ‘listening period.’

Circle is a member of the NHS Partners Network, who employ Mark Simmonds the MP for Boston and Skegness, for £50,000 per year as a strategic advisor. Not only this, research conducted by Social Investigations found all the founders are linked to the Conservative party, and three of the five trustees have given money to the Conservative party. The research resulted in a complaint being sent to the charity commission, in which a decision awaits. 

David Worskett

The Telegraph connection – the ‘listening period’
On 18^th May 2011, just two days before Mr Worskett wrote his feedback to the lobby group members, Mr Seddon appearedin the Telegraph under the title: ‘Why the NHS needs a regulator.’ Aghast at the way Monitor’s role was changing from promoting competition to promoting patient’s interests, Mr Seddon wrote in the paper to express his frustration. ‘As Mr Clegg goes around saying that "instead of having a duty to promote competition, Monitor's main duty should be explicitly to protect and promote the interests of patients", he fails to notice that the two are not in conflict and competition is actually in the best interests of patients.’

This article followed another piece, written two days previously, where Mr Seddon announcedhow Reform had published six case studies on the benefits of open competition in public services. Only one example was to do with healthcare. These were just two examples of many articles in which the Telegraph provided a platform for the NHS Partners Network to promote the interests of its members, and the MPs and Lords working for those companies.

Nick Seddon

If Nick Seddon wasn’t writing an article in favour of competition, then co-founder of Reform, Andrew Haldenby was appearing in the paper promoting the benefits of the cuts to the NHS such as his April 2011, piecetitled: ‘These ‘cuts’ might do the NHS some good’. Other Telegraph journalists willfully joined in. Health correspondent Martin Beckford, and Health editor Rebecca Smith both loyally carried messages from the lobby group director David Worskett in several articles. All of them published during the ‘pause’ period.

At this point it is worth noting that Reform a self-proclaimed ‘independent’ charity has many corporate partners involvedin health: Aviva, BMI healthcare, Capita, GE Healthcare, McKesson to name but a few. Are these a genuine independent charity or more a vehicle to lobby for the handing over of public services into the hands of corporations they appear to represent?

Telegraph editor Tony Gallagher

So David Worskett the lobby group’s director wasn’t exaggerating when he said he was ‘orchestrating’ the material that the Telegraph editorial allowed to go in unchallenged. David Worskett said to Social Investigations that the quote "does not say there was, and should not be taken in any way to imply, "orchestration" with the Daily Telegraph or indeed any other media." 

As head of the ‘Choice and Competition’ within the NHS Future Forum, Mr Bubb was a key person to target for lobbying. It is important to remind you at this point how David Worskett and Stephen Bubb had met early on into the ‘listening period’, where they had one ‘lengthy’ discussion which they had agreed ‘on the approach he would take’, what the ‘key issues’ are, and how to ‘handle the politics’. He hadn’t the document revealed, ‘deviated from this for a moment throughout the period.’

Mr Bubb and Mr Seddon are both on very good terms, as revealed in a postwritten by Sir Stephen Bubb on his blog a week before the official launch of the NHS Future Forum on the 31^st of March 2011.

He gushes: ‘So a somewhat bleary eyed early morning start to get to Canary Wharf for a big Reform conference on the Big Society. I was on the opening panel, chaired by my favourite think tank leader, Nick Seddon.’

The articleBubb ‘wrote’ for the Telegraph tells us with no hint of irony that: ‘There are vested interests’. He wasn’t however talking about his fellow collaborators with whom he made agreements, but meant, ‘principally the health service unions’.  He puts words in their mouth by stating: ‘They (the unions) say the reforms are ideologically driven, essentially privatisation by another name.’ Competition according to the unions he argues ‘will benefit the shareholders of multinational private companies’.

Yes Mr Bubb, that is exactly what will happen, and with your help.

The role of a journalist ought to be to research thoroughly the facts of any subject matter and report the findings based on what is found. A newspaper has a responsibility to provide this information fairly and honestly. What does this say about the current editor of the Telegraph Tony Gallagher?  The very idea that a member of a lobby group orchestrated the Telegraph’s editorial ought to bring shame on the paper, and embarrassment to those associated with it.

The Telegraph are not alone, all papers and media allow differing voices to appear in the media but the opposing voices are not necessarily challenged. Rather they are allowed to sit side by side to leave people to decide what is right and wrong. 

The corporate owned media cannot be trusted, ‘journalists’, who willingly promote the wishes of a private healthcare lobby group with challenge, are nothing more than spokesperson’s for that organisation and their motives. Possibly the Telegraph owners, the twins Sir David and Sir Frederick Barclay, who are worth £1.8 billion and live as tax exiles, will say a job well done.