You couldn’t make it up could you? Simon Stevens, the CEO of NHS England appointed by David Cameron, has said that Labour’s call for an end to competition in the NHS would be unlawful as it would conflict with aspects of EU and UK legislation. To be precise, he is calling a blanket ban unlawful which at least seems consistent with the situation under Labour when limited competition existed with clear limits which were lawful.
With the passing of the Heath & Social Care Act 2012 (H&SCA) by the Tory/Lib Dem Coalition, competition is now legally at the heart of the NHS and ensuring a competitive market is the prime duty of Monitor within the new structure. And with each passing month, billions of pounds worth of NHS business is being contracted out. Should Labour win the next general election in May 2015, unravelling these contracts will be tough but necessary. And there is no doubt that Labour must go ahead with repeal of the H&SCA, at the very least returning to the strictly limited level of competition prior to 2010 and ensuring that the Transatlantic Trade & Investment Partnership (TTIP) treaty, currently under negotiation between the EU and the USA, doesn’t make things worse. As it stands, TTIP does not exempt the NHS (& other public services) from competition by the private sector. It also provides for corporations being able to sue governments for restricting competition.
I have no doubt that a majority of UK voters would wish to return to a wholly publically-owned NHS. All the polls suggest so. I also have no doubt that most would be horrified that the big health corporations currently taking on NHS contracts (whilst they donate to the Tories) might be able to sue a democratically elected UK government that had a clear mandate to restrict or eliminate competition.
Once again we have to beware the messenger – this time Simon Stevens – and ask what agenda lies behind his statement that a future Labour government cannot act on a clear and popular mandate without breaching the law. He has a background as a Lambeth Labour councillor and as a health manager in the NHS and internationally, as a top executive with private health care firms, principally United Health Group, one of those busy tendering for contracts in the NHS. He was also a key advisor to Tony Blair at the early stage of Blair’s market reforms of the NHS.
In October 2013, Simon Stevens’ speaker biography for a health networking conference read, “His responsibilities include leading UnitedHealth’s strategy for, and engagement with, national health reform, ensuring its businesses are positioned for changes in the market and regulatory environment”. In other words, he is using his past experience to return to the NHS and open it up as much as possible to competition under the Coalition’s H&SCA. You can read his declaration of interests here: http://www.england.nhs.uk/wp-content/uploads/2014/05/dec-interest.pdf. Lots of sections marked “none” but it’s hard to believe that he hasn’t put previous interests into a blind trust whilst he is CEO. Perhaps he has no such interests but either way, we ought to know.
Which brings me to another NHS challenge a Labour government will face: getting rid of a set of Tory placemen at the very top of our NHS and appointing people who really believe in public service and that governments make the law, not health corporations.