14 August 2013 — OurNHS
Who benefits if charity leaders lobby for more competition in the NHS?
Charity boss Sir Stephen Bubb lobbied alongside the head of a private healthcare trade group to persuade Jeremy Hunt to not water down highly controversial “Section 75” privatisation regulations, according to new documents revealed today.
The regulations – made under the Health & Social Care Act just as the bill was coming into force in April this year – were seen by many as confirming the determination of the government to hand over large swathes of the NHS to private companies. The regulations effectively force local health bosses to put all services out to tender unless they can prove there is just one capable provider.
As the debate raged over the implications of the regulations – with the RCGP, the RCN, and the BMA all coming out strongly against them – the Chairman of the Association of Chief Executives of Voluntary Organisations (ACEVO), Sir Stephen Bubb, teamed up with private healthcare advocates the NHS Partners Network to lobby the health secretary, Jeremy Hunt into not “watering down” the regulations.
The letter co-signed by Sir Stephen Bubb and Partners Network director David Worskett raised “deep concern” at reports in the Guardian that the government was “contemplating substantive concessions over these important regulations.”
Bubb and Worskett urged the NHS to “embrace a new culture” to include “opening the way” for the potential contribution of “new providers…We strongly urge the government to stand firm.”
Earlier this year Social Investigations exposed how Bubb was at the heart of a network of lobbying around the Health and Social Care Act itself, along with Nick Seddon (now Cameron’s health policy advisor). The NHS Partners Network’s members include private healthcare companies with multiple financial links to MPs and Lords. These groups were instrumental in lobbying during the supposed ‘pause’ in the passage of the Health & Social Care Act last year, following near total discontent across the medical profession with the Bill’s proposals.
Sir Stephen Bubb was invited by then Health minister Simon Burns to head the Choice and Competition panel of the NHS Future Forum. The appointment made sense to the Conservatives as Sir Stephen Bubb had already been campaigning for a bigger role for the voluntary sector in the public services, a key part of the Conservative party’s ‘Big Society’ mantra.
Partners Network leader David Worskett praised Bubb for his determined approach to opening up the NHS to competition, informing his members of his “lengthy” discussion with Sir Stephen Bubb where they had “agreed on the approach he would take, what the key issues are, and how to handle the politics.” Bubb had “not deviated from this for a moment throughout the period.”
Stephen Bubb’s ability to get the ‘agreed’ message across was appreciated by Worskett and was seen to be so supportive that he “often carried the day and won more support than we might have expected.”
The charity and voluntary sector make up over a third of the UK private healthcare sector, and according to Sir Stephen Bubb represent a ‘bigger player’ than people think. Bubb told a 2010 voluntary sector conference “The third sector could grow by £2bn a year by 2015, just through increased involvement in offender rehabilitation and public health.”
Shortly after coming into power the government met with the CBI to discuss privatisation strategy. Leaked minutes revealed that Francis Maude told the group that transferring services at least initially to “charities, social enterprises and mutuals” would be more “palatable” and carry less “political risk” than “wholesale outsourcing to the private sector”. However in reality charities cannot compete against the financial muscle of the private sector. Research conducted by campaign organisation the NHS Support Foundation shows that since April 1st this year 100 clinical services worth £1.5 billion have largely gone to commercial companies. Last month the Bain Consultancy revealed how private sector companies are now engaged in an ‘arms race’ to win £5bn of National Health Service contracts. Third sector advocates should learn from the experience of Surrey Central Health, where a much lauded transfer of NHS services to a “social enterprise” led within a couple of years to a takeover by Virgin, who were better able to raise bond finance.
Recent failings from private companies such as Serco fiddling data for their out of hours service, or G4S overcharging on their contracts, has done nothing to diminish the speed with which outsourcing is taking place. However, as the list of private outsourcing failures grows, the government will increasingly appreciate being able to emphasise the 3rd sector as a more palatable alternative, even if their involvement is not sustainable. In fact, David Cameron has already turned towards the voluntary sector in his hour of need. When asked by Ed Miliband who supported the government’s legislation he cited Bubb’s ACEVO.
Does Bubb’s vociferous support for privatisation benefit the 1,500 ACEVO membership of charity leaders (the members of whom are currently hidden from public view)? Or does it ultimately benefit the members of the NHS Partners Network, whose membership includes Virgin Care, United Health UK or Care UK?
A recent article in the Guardian by Pam Lewis of CancerCare suggests some charities at least are willing to take part in the dismantling of the NHS. Ms Lewis states how the changes to the NHS will benefit CancerCare and at the same time take the strain off of “traditional NHS care providers.” Echoing Bubb, she says that “while maintaining their charity status”, they can become a “serious and competitive player” in the NHS, which would be a “huge step for their charity.”
Despite the grand ambitions of CancerCare, the evidence so far suggests charities are but a figleaf for the private equity backed corporations who can outbid them or offer them dubious partnerships. The carrot is dangled in front of the charities noses, which has led them to walk hand-in-hand with private healthcare giants.
This article was co-published with Social Investigations.