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