ACEVO: Not Neutral Over Health Bill Outcome

EMAIL FROM ACEVO TO MONITOR

A new set of communications has brought into question the neutrality of the Association of Chief Executives of Voluntary Organisations (ACEVO), on the outcome of the Health and Social Care bill.

When the Health and Social Care bill came to a shuddering halt following widespread rejection across the medical profession, the government paused the process to set up a Forum in what turnedout to be a faux ‘listening exercise.’

The head of the ‘Choice and Competition’ element to the Forum was Sir Stephen Bubb, the Chief Executive of ACEVO. Sir Bubb’s preference for competition in the NHS was no secret; he openly calledfor the “health and social care market to be opened up” and consistently voiced his support for more competition.

However, throughout the period of the farcical‘listening exercise’, ACEVO said they did not take a position on the Health and Social Care bill, and were neither for it or against it. This view was repeated in March 2012 when they said "ACEVO has not taken a position on the controversial health bill as a whole."

The email
However, a Freedom of Information request has unearthed an email written on the 17^th August 2011, just after the ‘listening’ period that brings this statement into serious doubt. The author of the email is unknown because the name was redacted. The person thanked David Bennett, the head of the NHS regulator Monitor, for a ‘roundtable summary.’ It stated how it was good to see…that so many participants…place ‘choice’ at the top of priorities for Monitor.’ If ACEVO were not taking a position on the Health bill, then why are ACEVO in an email to Monitor saying it is 'good' people at the meeting were placing 'choice' as a priority for Monitor. Surely, if they do not take a position such a priority would be neither good nor bad as far as ACEVO are concerned.

Furthermore, the author of the email also suggested Monitor hold a 'desecrate' (discreet) meeting with ACEVO members to 'bounce ideas off and sound them out on reform and competition'. Why was it suggested to make this meeting discreet?  What did they have to hide?

ACEVO did indeed attend a roundtable meeting with Monitor hosted at the offices of the Royal National Institute for the Blind, with representatives from voluntary organisations that included CEOs from Asthma UK, Action on Hearing loss and Diabetes UK. The purpose of the meeting was to discuss the new regulators' new role and purpose'.

Lobbying letter

This email follows on from the recent revelation uncoveredby Social Investigations that Sir Stephen Bubb had teamed up alongside private healthcare trade and lobby group, the NHS Partners Network to urge Jeremy Hunt not to water down the secondary legislation, S.75 privatisation regulations. The letter carried the ACEVO logo, which strongly suggests this lobbying letter was in agreement with ACEVO and not Sir Stephen Bubb acting alone. Acevo are not ambivalent to the outcome of the the Health and Social Care bill, but have actively lobbied to ensure competition remains a key component of the new NHS.

ACEVO have twice been contacted to answer questions on their neutrality and have so far refused to answer.


Questions
The questions are below and we welcome a response at any time.

1) If ACEVO were not taking a position on the Health bill, then why are ACEVO in an email to Monitor saying it is 'good' people at the meeting were placing 'choice' as a priority for Monitor. Surely, if they do not take a position such a priority would be neither good nor bad as far as ACEVO are concerned?

2) Also, the names are redacted - who wrote the email?

3) The author of the email also suggested Monitor hold a 'desecrate' (discreet) meeting with ACEVO members to 'bounce ideas off and sound them out on reform and competition'. Why was it suggested to make this meeting discreet? 

4) The letter is sent with the ACEVO logo on it. It is therefore logical to assume, this position is that of ACEVO and not Sir Stephen Bubb. Is this the case?

5) Was this letter written by both Sir Stephen and David Worskett?

6) By sending this letter out on behalf of ACEVO, is it right to assume members of ACEVO were contacted about this before the letter went out? If not, then is it normal practice to send out lobbying letters on behalf of the membership without consent?

7) Finally, I have looked for your membership list but it appears to be hidden. Why is this, given the moves towards transparency? In http://www.acevo.org.uk/Page.aspx?pid=2150

Unhealthy influence: The rise of the NHS Partners Network

The transformation of a small private healthcare trade association into a powerful and influential lobby group provides a clear indication of the direction the NHS has taken.  Today the NHS Partners Network has some of the most powerful private healthcare companies as members and is a trustee on the NHS Confederation board. Social Investigations journalist Andrew Robertson examines the development of one of the best-connected and most persuasive privatisation cheerleaders.

The early days

The NHS Partners Network (NHSPN) came into existence in 2005 to provide a voice for private health companies involved in Labour’s Independent Sector Treatment programme (ISTC) which opened up non-emergency treatments to the private sector.

This programme provided a foothold for private companies in the NHS and the NHSPN quickly started playing a protective role for its membership. Its 2007 annual report boasted of using its influence to downplay the significance of a leaked document from the Health Care Commission that raised questions over quality standards within the ISTCs.

’Blending’ with the NHS

In the same year it was voted on to the NHS Confederation, the main representative for organisations offering NHS services, a move that gave it increased legitimacy. Now, as part of the agreement for all networks in the confederation, the NHSPN is represented at trustee level, currently through the Chief Executive of Care UK, Mike Parish.  In addition to this, David Worskett the director of the NHSPN, is also a director within the Confederation. 
The influence of the network has now increased well beyond its original remit.. As part of its membership package, the NHSPN promises ”regular dialogue with ministers and senior level decision makers within the main political parties”, and ”good contacts with the media to promote the role of the independent sector within the NHS”.

You can judge a club by its members…
In 2008, the network’s membership stood at just ten companies, which included Care UK, Circle and Ramsay Healthcare UK. Yet, it now held considerable influence. The 2007/8 annual report informed members how in October 2007, the network had held a meeting with Andrew Lansley “on the Conservative Party’s draft bill”.  This ”bill” went on to become the infamous ‘Equity and excellence: Liberating the NHS’ white paper and in turn the even more infamous Health and Social Care Act of 2012. The report also described “briefings aimed at furthering the interests of members with shadow health secretary Andy Burnham, Conservative MP and advisor to Circle Health Mark Simmonds, and multiple other key personnel and advisors at the Department of Health.

To become a member of the NHSPN, an annual payment of £35,000 is required, which includes a membership fee to the NHS Confederation, which is a registered charity. The sum of money is clearly seen as money well spent and by 2009 the network’s membership had grown substantially to 17 companies, which led to a total income of £347,500 from subscriptions for the year. Two new entrants to the NHSPN stable for this period were UnitedHealth UK and the new GP out of hour’s services provider Harmoni, since bought by Care UK.

The latest annual report lists 26 members, with additions including Bupa and General Healthcare Group. Membership income now stands at £434,000. 

Oliver Letwin led negotiations

Dates for the diary

By 2009, NHSPN staff were moving among the highest political circles.  In the 2009 annual report shows how they had held a NHS board meeting with Andrew Lansley, hosted breakfast meetings at all the party conferences, had a meeting with new industry regulator, Monitor and met with the free market think tank Reform. In control of the network’s marketing and promotional activities at this time was David Worskett, who would soon go on to take over the reigns as director.

The NHS Partners Network was indeed going places, made possible by the Labour party and encouraged still further by a Conservative party intent on shaking the very foundations of the NHS. In May 2010, it was back in power, albeit in coalition with Liberal Democrats. Less than two months after the coalition had formed, Andrew Lansley, now new health secretary, introduced the ‘Liberating the NHS’ white paper.

The remarkable speed with which this hitherto unknown policy appeared was of course no coincidence. The plan had been hatched many years before. However, having failed to win by a clear majority, the Conservatives had to negotiate more than they would have liked. ‘Never Again?’, a book  by Nicholas Timmins from the Institute for Government, describes the deal made behind closed doors by Oliver Letwin and Danny Alexander, who had agreed to support the government’s changes to NHS in exchange for Lords reform. This reckless and deeply undemocratic move allowed the wheels of Conservative policy to begin rolling.

Behind closed doors
Three months after the white paper had come out - and before parliament had even seen the bill - David Worskett, now director of NHSPN, met with the then minister for health, Simon Burns and Earl Howe, who was responsible for commissioning and primary care. A document written by Mr Worskett following the meeting, explained how they would make it clear to (the new) healthcare commissioners what the Any Willing Provider (AWP) policy meant for them, and reassured Mr Worskett that opposition to the GP commissioning plans was likely to be “short-term” and “dissipate” in the future.

The remarkable courtesy shown to Mr Worksett confirmed the Network’s rising status  and this was the time to truly make its presence felt.  Its 2010 annual report described discussions with David Bennett, chairman of the new industry regulator Monitor, and Steven Dorrell, the chair of the health select committee. The self-titled ‘partners’ of the NHS now had the law on their side and were acting less in partnership and more in direct confrontation. Under the title of ‘Main activities’, the Network stated how it had  “defended members threatened by anti-competitive behaviour” and, more intriguingly, influenced “the development of the NHS reforms”.

The Future Forum
This latter statement was not a boast from a lobbying group trying to impress its members but a true reflection on the way the Network was able to maintain competition in the bill despite a near total rejection from both the medical profession and the public. The rising resistance forced the government to set up the NHS Future Forum in order to ”pause, listen and reflect”.

Much to its dismay, the NHSPN found itself locked out of the forum. To allow a private healthcare representative in would have been too politically sensitive at the time. This didn’t mean the network wasn’t involved. The person that would open the door for them turned out to be Sir Stephen Bubb, the Chief Executive of the Association of Chief Executives of Voluntary Organisations, who Cameron had accepted as head of the ”Choice and Competition” part of the Forum.

A memorandum written by David Worskett to his Network members, unearthed by Social Investigations in July last year, revealed how Mr Worskett had held one lengthy, very early discussion with Sir Stephen Bubb 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.” The memorandum also revealed how “several members have used their own ’routes’ to gain access to key players within No.10 and have been able to report back that the stance there is supportive.

The competition part of the Forum turned out to be such a sham that Bubb announced on his website: "Just as I was signing off our panel's report on 'Delivering real choice' I get sent a copy of the PM's speech announcing he was accepting many of our key recommendations (although we haven't actually given him the report yet!)”.

Financial links to MPs and Lords
The ability of NHSPN members to access the highest levels of government was surely not hindered by the fact that many of the Network’s members employ MPs and Lords. Baroness Bottomley is a director of Bupa for example, while John Nash, now a Lord, was the Chairman of Care UK when Lansley received a donation to run his office when he was shadow health minister. Circle, the first company to win a contract to run a NHS hospital, have Conservative MP Mark Simmonds as an advisor and Baroness Ford is the Chairman of Grove Ltd, a holding company for care home company Barchester Health.

Still so much to do…
The Health and Social Care Act is now passed but the NHSPN’s efforts on behalf of its members is far from finished. Monitor recently opened up a consultation on creating what they call a ‘Fair Playing Field review’, to make sure that when service providers fight it out against each other for contracts the ‘field’ is as even as possible. The NHSPN made a submission highlighting tax, pensions and the NHS Brand as a barrier to equal competition. The irony that the Network itself is allowed to use the NHS as a prefix to its name is apparently lost on its members.

A recent report by healthcare market analysts Laing & Buisson, revealed how services obtained from private providers has increased by 10% in the last year. In less than two weeks the NHS budget will be placed into the hands of the Clinical Commissioning Groups, which will accelerate the outsourcing of services still further. The private healthcare industry is on the rise and so too the NHS Partners Network. 

This article appeared in Corporate Watch

Union pass Motion to ask Chief Executives to leave ACEVO in protest at Head's behaviour During Health bill 'pause'

This text below is from an Emergency motion passed by Unite on the behaviour of Sir Stephen Bubb, the Head of Choice and Competition in the NHS Future Forum, which was set up during the Health bill's so-called 'listening exercise'.

Stephen Bubb, the Director of the Association of Chief Executives of Voluntary Organisations, has played a major role in imposing the doctrine of “Any qualified provider” on the NHS.

He referred former Health Minister Andy Burnham to the Cooperation and Competition Panel when Burnham publicly stated that the NHS should be the “preferred provider” of NHS services, forcing Burnham to back down publicly on this principle. A document recently discovered by online journalist Andrew Robertson shows quite clearly how he used his role as chair of the NHS Future Forum to ensure that the interests of private healthcare companies were served in the carrying through of the Health & Social Care Act.

To quote NHS Partners Network/NHS Confederation Director David Worskett in the document: “I had one lengthy, very early discussion with Sir Stephen Bubb at which we agreed on the approach he would take [on the Health & Social Care Act], what the key issues are, and how to handle the politics. He has not deviated from this for a moment throughout the period.“ (NHS Partners Network/NHS Confederation is the major confederation covering private healthcare companies looking to profit from commissioning for NHS services).

David Worskett also says in the same document: “I also have the impression that the arguments in favour of choice, competition, plurality and economic regulation [i.e. privatisation] put forward by the small handful of like-minded members ably led by Sir Stephen Bubb have often carried the day and won more support than we might have expected.”

He has done this on the basis that the voluntary sector (as well as the private sector) who could gain financially through bidding to carry out public services. All the evidence now emerging shows that voluntary sector groups are being driven out of the bidding wars for the provision of public services – for example the Work Programme – in favour of the private sector, thus proving the truth of the prediction made several years ago that the voluntary sector simply serves as a “stalking horse” or a cover for private companies in the privatisation of public services.


This conference resolves:

1. To ask Unite to publicise the activities of Stephen Bubb in pushing forward the break-up and marketisation of the NHS to all our members in the organisations which make up the membership of ACEVO.

2. To ask Unite to publicise his activities to all the member organisations of ACEVO (including their Chief Executives and Board members), and call on them to leave that organisation in protest.

Note 1: The Futures Forum was the body which oversaw the carrying out of the Coalition government’s so-called listening exercise when the outcry against the Health & Social Care Bill forced a pause in its high-velocity passage through parliament.


APPENDIX 1

More information on Stephen Bubb’s role in the “pause” and listening process forced on the Coalition government by the outcry against the Health & Social Care Bill

Stephen Bubb is head of the voluntary sector organisation “Association of Chief Executives of Voluntary Organisations (ACEVO).

He is convinced that the way forward for funding for voluntary sector organisations (in the face of spiralling funding cuts to the sector) is through voluntary sector organisations bidding to provide public services. (NB: there are some elements of state funded provision e.g. legal advice which have historically been supplied by the voluntary sector).

He is oblivious to the fact that voluntary sector organisations cannot compete against private companies in these bidding wars, and that even if voluntary sector groups win such bids they soon find that the money they get does not cover the provision of a good quality service. They either have to abandon the quality of the services (by driving down wages and conditions of workers, as well as the service itself) or abandon the service to private sector companies (witness what happened with the government’s Work Programme. All the voluntary sector groups initially involved have now been forced to walk away).  

Bubb has therefore consistently fought to open up public services to the voluntary sector – and in so doing he has also been more than happy to open them up to the private sector also. Successive governments have tried to sweeten the poison of public service outsourcing by featuring the fact that it is not only private companies who will be bidding, but also the voluntary sector. The voluntary sector which bids is of course something which take on more and more the characteristics of private companies.

Andy Burnham and the NHS as “Preferred Provider”

In 2009 Secretary of State for Health Andy Burnham ( in the face of mounting union protests over NHS privatisation) said that “the NHS should be the preferred provider” in any tendering process.

Stephen Bubb reported Andy Burnham to the Cooperation and Competition Panel, and Burnham was forced into a humiliating reversal of his position. See this article http://www.wavocc.org.uk/department_of_health_principles_and_rules_for_c

Private companies recruit Bubb to push through the privatisation provisions of the Health & Social Care Act

After a huge outcry from health professionals and health campaigners as the Health & Social Care was forced through in 2011, the government arranged for an unprecedented “Listening pause” while a carefully selected group was appointed to run the “Futures Forum”. (This carefully selected group chose to ignore the array of valid criticisms of the Act which emerged even from their carefully selected forums - including the policy of “Any Qualified Provider” which has resulted in the taking over of £100s of millions worth of health services by the likes of Virgin Healthcare, and Care UK.)

Simon Burns (health minister 2010-12) requested the okay from David Cameron to make the appointment of Sir Stephen Bubb as chair of “Choice and Competition” on the NHS Futures Forum^.1This was revealed in the book ‘Never Again?’ by Nicholas Timmins of the King’s Fund.

Early on after his appointment as chair, Bubb met with NHS Partners Network’sdirector David Worskett and  ‘agreed on the approach he (Bubb) would take, what the key issues are, and how to handle the politics.’ NHS Partners Network includes the likes of Assura, Circle (which took over Hinchingbrooke, the first NHS hospital to be privatized), Care UK (see information in this article on Care UK) and many more predatory private equity company owned private healthcare companies.

David Worskett held a second lengthy meeting with Stephen to discuss the position with him, under the auspices of "Reform", with only a handful of other (all like-minded) people present, including David Bennett, the chair of Monitor. David Worskett says: “He has also consistently taken the same line as us throughout.” “A number of members secured individual meetings with him, thus reinforcing and validating the messages.”

There are 17 members of the NHS Partners Network - these include several with financial connections to Lords and MPs, including Circle (Mark Simmonds MP) and Care UK (John Nash the chairman donated money to run Lansley’s office when he was shadow health secretary).

Mr Bubb describes another meeting with the NHS Partners Network on 1 June 2011 in his blogunder the title ‘listening (not?)’. Bubb says: ‘went to a good meeting today with the NHS Confed Partners Network the CEO is the dynamic and amusing David Worskett )’.

Bubb informs his readers how ‘for political reasons the private sector were excluded from the Future Forum so in my area I feel its only right to ensure I hear their views.’ He concludes: ‘And very balanced and sensible they are.’ (The private sector was excluded from the Futures Forum as even the Coalition could see that their naked self-interest would have provided a field day for the media and those opposed to NHS privatisation.)

At the meeting on 1 June according to Bubb himself: ‘David later sends me some polling results they did. Worth repeating it here’. The data refers to a research project done in 2009, which Worskett told Bubb, was ‘fully validated to industry standards.’ The report showed that 74% of respondents strongly agreed (51%) or agreed (23%) that they "don't mind who owns or runs my NHS services as long as the quality of care is right".

This is important as Bubb included this in the Final report produced on 13^th June by his working group even though it was out of date and produced by the NHS Partners' Network. In addition, it was produced before the Health and Social Care bill was introduced. Bubb said it was: ‘in line with a number of other surveys done since’, which unfortunately he couldn’t ‘dig out in the time available, but I am certain that the point which can be made with complete confidence.’ He also couldn’t find any more surveys in time for the final report.

In his book ‘Never Again?’ by Nicholas Timmins of the King’s Fund, Mr Worskett said: ‘throughout the forums deliberations, Bubb was “our only real route in”. He “fought valiantly to ensure that an element of competition remained in the system”, resulting in what David Worskett saw as a “pretty pro-competition…and that was mostly, though not entirely down to Steve Bubb.”

For more reading:
The Unedited document here 
Stephen Bubb's collusion with the NHS Partner's Network here
Lansley meeting with NHS Partner's Network director before parliament had seen bill here

David Cameron is accused of a 'sham listening exercise' on NHS reform after links to lobbyist are revealed

This article appears in the Observer. See Archive in July and August for more details on this research.

The coalition has been accused of presiding over a sham "listening exercise" on NHS reform last year, as a leaked document reveals how the private health lobby worked with Downing Street behind the scenes to ensure that the new legislation went ahead.

David Worskett, the industry's chief lobbyist, cleared his group's public statements with officials and was personally thanked by No 10 for arranging the publication of a letter from clinicians in support of the reforms during the key "pause" period last year, called to reflect on the proposed reforms.

A series of phone calls between the lobbyist and Downing Street's health adviser was followed by a welcome "addition" to a major speech by the prime minister, according to a five-page document written for members of the private healthcare lobby group. The government claimed at the time that it would call a temporary halt to its efforts to introduce more competition within the NHS through its controversial health and social care bill. The prime minister told doctors and nurses: "We are taking this time to pause, to listen, to reflect and to improve our NHS modernisation plans. Let me be clear: this is a genuine chance to make a difference."



But in the document, obtained by the website Social Investigations, Worskett, director of NHS Partners Network, the lobby group representing companies such as Circle and Care UK, wrote: "I did brief the new No 10 health policy adviser very fully, and indeed 'cleared' our materials with him. I have had several other 'stock take' phone conversations with him.

"We are certainly on No 10's radar – I received an invitation to the PM's big speech last Monday and went. (Incidentally, for those who had the pre-event text, he specifically added a sentence about the importance of patients being able to attend private hospitals if they wanted to, provided NHS standards and prices were being met)."

Intriguingly, Sir Stephen Bubb, whom the government selected to lead a review of the role of competition in the NHS, wrote on his blog at the time: "Just as I was signing off our panel's report on 'Delivering real choice' I get sent a copy of the PM's speech announcing he was accepting many of our key recommendations (although we haven't actually given him the report yet!) … I am unclear why he thought it was a good idea to pre-announce acceptance of much of our report, but it is welcome."

The briefing document also suggests that Bubb, who was chosen by the government to provide an independent report as part of the coalition government's listening exercise, met Worskett to help direct the approach that he would take.

The lobbyist also claimed to have been congratulated on his lobbying by the head of the NHS forum leading the listening exercise, Steve Field.

Worskett wrote: "I had one lengthy, very early discussion with Sir Stephen Bubb 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.

"We organised a letter from our Clinical Forum, on behalf of the 45,000 clinicians who do NHS work from the independent sector, to Steve Field. This was powerful. Steve himself told me how useful and well argued it was and No 10 also thanked me for it."

Shadow health minister Jamie Reed said the document "confirms what many have long suspected to be the case – that the highest levels of government were in talks with cheerleaders for private healthcare on how to ram the privatisation of the NHS through parliament". He added: "We have it in black and white that David Cameron's 'listening exercise' was a sham – he wilfully ignored overwhelming concerns and stuck to his privatisation plans."

Bubb said it was a nonsense to claim that he was "engaged in some sort of conspiracy", adding that it was his role to talk to all parties.

A spokesman for the NHS Partners Network said there was agreement between the government, Bubb and the lobby group, but denied that the process was a sham. He said: "We 'cleared' points with No 10 in the sense that we sought to ascertain the extent to which they were consistent with the government's own thinking, not with the intention or need to secure approval.

"Sir Stephen Bubb has always been wholly independent, so there was absolutely no question of 'telling' him to do anything."

A joint statement from Downing Street and the Department of Health said: "It is nonsense to suggest that the NHS listening exercise was not genuine and robust. This government is committed to protecting an NHS that is universal and free at the point of use.

"Government ministers, officials and the NHS Future Forum met with a large number of representatives from all areas of health and social care during the listening exercise. As you would expect, this included representatives from the private sector."

Further reading:
Over 200 parliamentarians have financial links to companies involved in private healthcare: More
Telegraph's involvement in 'listening exercise' sham. More
Sir Stephen  Bubb and his collusion. More
NHS Partners Network: Who are they? More 
Attacks on the NHS: Article roundup. More

Article Roundup - Attacks on Society, Deceit and Dirty Business

Every now and again I do an article roundup to bring together key articles from a couple of months work.

The first roundup focused on the Lords research and the healthcare takeover of parliament
More...

The second roundup was dedicated to  lobbying following the discovery of a document from a healthcare lobbying group that told the tale of how Sir Stephen Bubb played his part in changing the face of the NHS. In addition it looked at the daily Telegraph’s role in helping promote the message of ‘competition’. More...

This roundup looks at the political connections of two Think Tanks that silently go about producing policy that the government so readily take onboard to leverage public resources into the private companies that fund them. Reform, the BBC, Policy Exchange, Wonga are all in here, as is David Cameron and how the government accepted the recommendations of the ‘Choice and Competition’ working group of the NHS Future Forum before they received the final report. Democracy in this country is in a fragile state.

Please pass on this blog to anyone you know.

1. ‘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!) More…

2. Sir Stephen Bubb was a key figure in ensuring private healthcare remained in the Health and Social Care Act following the so-called ‘listening period.’ Read about how he bumped in Lansley and got briefed before appearing on the Health and Social Care bill Committee. More…

3. Policy Exchange Links to the Conservative Party. They are a think tank with charity status, but predominantly dream up ideas for privatising. They are meant to be politically ‘independent’, but are linked solely to the Conservative party. More here…

4. Reform are according to their website 'keen to involve corporate organisations in our research because their expertise is often left out of the Whitehall policy discussion.’ – See why this is a lie with reports on Aviva, BMI Healthcare, G4Sand see why this makes them a conduitto privatisation. You can also see which of their corporate partners are linked to Lords and MPs. More…

5. The BBC failed the people of the UK for whom they are meant to inform. A new report analyses the key stories they missed including the Lords and MPs research. How the BBC betrayed the NHS. More…

6. A Complaint was sent to the Charity Commission over the free market think tank Reform. The complaint focused on their political independence and their linksto the Conservative party. The second part of the complaint looked at misleading statements made on their website. We await their response. More...

7. The government want to privatise probations, and it is all linked into the Police Commissioner elections, which will act as an opportunity to pressurise local leaders to outsource other areas such as the fire brigade, the police, ambulance services, of which Reform suggest Police Commissioners should be in charge. More…

8. It takes a certain kind of person to run a company that takes advantage of people in desperate times, to squeeze money out of them when they have nowhere else to go. The kind of person who would do such a thing, should be admonished by society for preying on the needy however, this government, who receives money from one of their main funders, sees him as a person to go to for advice and to send senior advisers to lobby on the company's behalf. More…

Choice and Competition Chair briefed by Lansley and SPAD before appearance on Health and Social Care Bill Committee

Just when you though the so-called ‘listening exercise could not be more of a sham, a new quotefrom Sir Stephen Bubb has come to light that reveals he was briefed by Lansley and his Special Advisor, Bill Morgan, before an appearance before the Public Bill Committee meeting on the Health and Social care bill.


We already know that the recommendations of the Choice and Competition working group were agreed and included in Cameron’s speech before their report had been given to No10. Here.

We know too that the Lansley, his special advisor and the NHS Partners Network met to comfort the lobby group that competition would remain in the bill before parliament had even had a chance to debate it. Here.

We know Bubb held secret meetings with the director of a private health care lobby group, the NHS Partners Network. A document revealed he had two lengthy meetings with David Worskett and other members of the lobby group. Here.

We also know that many of the members of the lobby group are the employers of our Lords and MPs. Here.

Now we learn that Bubb was having talks and walks along Whitehall in which he said:

‘Well that was spooky! Walking along Whitehall talking to Andrew Lansley's Special Advisor on aspects of the Health Bill I bump into... Andrew Lansley. So some useful lobbying. I'm speaking to the Committee stage of the Health Bill at the Commons on Thursday so I'm getting briefed on key points we want to raise. We strongly support the "any willing provider" concept, just as we opposed the misjudged "preferred provider" policy of Burnham.'

True to his word or at least the words of Lansley and his advisor, Bubb spoke at the committee on behalf of the third sector stating: ‘we are strongly behind the concept of “any willing provider”...The any willing provider approach actually allows us to get stuck in a way that has not been possible before.’

The so-called ‘listening exercise’ was nothing of the sort when it came to Choice and Competition, and the reward for Sir Stephen Bubb is according to Charity Times to become a Peer for the Liberal Democrats and will be ennobled as Lord Bubb of Charlbury.

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.

Health Minister and Lansley’s Special Advisor held Meetings with Private Health Care Lobby Group to ‘reassure’ Before Parliament Aware of Bill

A newly discovered document has revealed a top-level political trio, held a secret meeting with a private healthcare lobby group to reassure them about the likely calming of opposition to the healthcare reform, two months before the bill was even introduced to parliament.

In October 2010, Simon Burns (the Minister for Health), Earl Howe, and Andrew Lansley’s Special Advisor, Bill Morgan, attended two meetings with a private healthcare lobby group, NHS Partners Network (NHSPN). These meetings have just come to light, following the discovery of another document written 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 Government’s policy of Any Willing Provider (explained below) and moves towards greater patient choice.’ 

In addition, the members could express any ‘concerns about whether a level playing field would truly be created’.

So, the NHS Partners Network were able to access the very top of our political tree before our elected politicians had even been given a chance to debate the bill in the Commons. And no minutes were taken.

The meeting informed the network of a ‘command paper’ that was about to be published by the Department of Health, to set out the ‘principles of the NHS reforms more clearly’. They also ‘received assurances’ that the Government will make it clear to commissioners what the Any Willing Provider (AWP) policy means for them, and that they intend to ‘adhere’ to the reform timetable.

The update on where the government was in terms of action was backed up with further assurance that opposition to the AWP policy would not last long. The introductory paragraph of the document highlighted that both ministers and Mr Morgan expressed the view that any problems with the implementation of the AWP policy, such as opposition to commissioning of the independent sector from GP commissioners – were likely to be ‘short-term’ and ‘dissipate’ in the future.

However, several months after the meetings the situation had changed, because once the content of the white paper had been realised, a near total rejection from both the public and the medical profession resulted in the government taking a ‘pause’.

The so-called ‘listening exercise’ required a temporary group to be set up, called the NHS Future Forum which had Sir Stephen Bubb, a David Cameron appointment, in charge of competition and choice. We now know that Sir Bubb worked with the NHSPN, who together influenced the direction of discussion. The newly established forum meant a new set of lobbying was required, and the NHSPN made sure they were at the helm, as revealed in their annual 2010/11 summary report: 


‘This (pause) prompted a major new effort to communicate our views to the NHS Future Forum, and to the top-level political decision-makers to whom the forum will report.’

Part of the concerns the lobby firm had now centred on the policy of ‘Any Willing Provider’ (AWP), which had changed to ‘Any Qualified Provider (AQP). It was a semantic difference that was hailed by the Liberal Democrats as a victory. In reality the AWP commissioning procedure is set by an EU procurement directive, and the term ‘AQP’ does not exist in EU law.  

The British Medical Journal highlighted the significance of this change in an editorialaimed at the media, who at the time had failed to pick up on it: ‘If a future government wishes to bring a health or social care service back into public sector provision (say if the consequences of this reform turn out to be bad for patients) any existing or would-be provider may sue under EU law on anticompetitive practices.’

The NHSPN, however, did not want to take chances over any weakening of competition in the bill, and having ‘agreed on the approach’ to take with Mr Bubb in a previous ‘lengthy’ meeting, they turned their attention to Earl Howe, who would be leading the debate in the House of Lords.

On the 19^th of May 2011, David Worskett, the director of NHSPN, set up another meeting with the Earl. A newly discovered document for the NHSPN’s members revealed that ‘Simon Burns also asked to join the meeting’. Mr Burns’ request to be included, according to Mr Worskett, indicated the recognition by the minister that NHSPN were ‘less than happy about things.’

The meeting went well for the lobbyists. The document revealed that although the ministers were ‘necessarily constrained’ by the fact that everyone was supposed to be listening, they gave ‘every signal possible that they understood and sympathised with our concerns and shared our view of the key issues and priorities.’

Indeed this understanding was absolute. Earl Howe offered a ‘depiction’ of the ‘Government position’, that meant ‘“choice” was a non-negotiable.’ This view led Mr Worskett to say: ‘He could have been delivering a précis of our briefing notes (which of course he had already seen)’. No wonder then that later in the day at a National Stakeholder Forum, Earl Howe ‘endorsed [Mr Worskett’s] arguments twice during the session on competition and regulation’.


The NHS Partners Network are not finished lobbying yet, having recently responded to the first stage of the health regulator’s (Monitor’s) review into the fair playing field for NHS providers. They held a meeting under the auspices of the right-wing think tank "Reform" with David Bennett, the head of Monitor who are running the review. A fair playing field has nothing to do with it. If that were the case, then Simon Burns et al would not have offered a reassurance on policy ahead of a debate in the Commons. The NHSPN’s press release announcing their submission to the review states: ‘We look forward to working with Monitor throughout the consultation process.’

I bet they do.

Unanswered questions

So why were the trio of Simon Burns, Earl Howe and Andrew Lansley’s special advisor, Bill Morgan, holding a meeting to reassure a trade and lobby group, before our elected MPs had even had a chance to debate the bill in the Commons?

Did Bill Morgan pass a message back to Andrew Lansley or did Andrew Lansley pass a message onto NHS Partners Network?

Further notes:

The newly appointed special advisor to Andrew Lansley, Bill Morgan. The former private healthcare lobbyist came under the spotlight in March 2011, following an investigation by transparency campaigners Spinwatch. Mr Morgan had received a list of GPs who were in favour of the reforms, who would represent a ‘public relations coup.’ The list was provided by an outsourcing firm called Tribal, who according to Spinwatch, had ‘£150 million worth of government contracts’, and were connected to some of the new GP Pathfinder Consortia.