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 turned out 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 called for 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 uncovered by 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.

NHS Partners Network response to Telegraph article

 

The NHS Partners Network have responded to the article linking them to Reform, and the Daily Telegraph. The statement is written in full below along with the quote, which I used from the document written by the director of the NHS Partners Network. I will be contacting them back in due course in which I will be expecting honest answers.

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.

NHS Partners Network – who are they?

The start

The NHS Partners Network formed in 2005 to provide a voice for private health companies, and was initially made up of organisations involved in the government’s Independent Sector Treatment Sector programme (ISTC). The ISTC initiative was to open up non-emergency treatments to the private sector that would operate (no joke intended) from treatment centres based within NHS hospitals.    

When a leaked document from the Health care Commission raised questions over the quality standards within the ISTCs, the NHS Partners Network used its influence to make sure a report on ISTC’s was less critical than otherwise would be.

In 2007, they were voted on to the NHS confederation, the main representative organisation for organisations offering NHS services.  Since the initial ISTC days, the Network has expanded to include companies and organisations providing services to the NHS.

Social Investigations conducted Lords research

Why do they have influence?
The NHS Partners Network is largely made up of private healthcare companies, with a couple of non-profit organisations thrown in. Their current members list contains 7 companies with financial connections to MPs, Lords or former MPs.

A few examples of this are:

Alliance Medical Limited: 
www.alliancemedical.eu.com – Alan Milburn Alliance Medical runs diagnostic services for the NHS, including in Birmingham and Falkirk. UNISON reported that services were giving patients sub-optimal care, losing the NHS money because of below-capacity uptake, and pressurising hospitals into using private sector treatments.

Care UK: 
www.careuk.com – Andrew Lansley John Nash the Chairman of Care UK gave donations of £21,000 to run Lansley’s office when he was shadow health minister. Bridgepoint who have Lord Patten of Barnes on their books purchased Care UK.

Circle: 
www.circlehealth.co.uk – Mark Simmonds MP is a strategic advisor - the self-styled “social enterprise” that became the first private company to take over the management of an NHS hospital, is owned by companies and investment funds registered in the British Virgin Islands, Jersey and the Cayman Islands. See Corporatewatch ‘An unhealthy business’

The full list of members is below.

How have they used their influence?

When you have connections like they have it certainly provides a platform to being able to obtain high-level meetings.

According to their 2007/08 annual report, they held ‘Major high-level’ meetings with

• Andy Burnham the Minister of State for Health. 
• Mark Britnell, who was then the Director-General of Commissioning and System Management for the Department of Health. Mr Britnell has since moved to the private sector as Global Head of Health for business service giant KPMG, He famously said in 2010, while discussing reforms to a private healthcare conference: “In future, The NHS will be a state insurance provider not a state deliverer”, and that “The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years'.
• Mark Simmonds as Conservative junior minister for Health Spokesman

The latter raises some serious questions as to what part of the draft bill was influenced by the network. In addition to this according to their 2007/08 Annual Report, in October 2007, they held 'informal conversations with Andrew Lansley' and the Conservative party conference, and perhaps more importantly, held a 'meeting with Lansley on the Conservative party's draft bill.'

The latter suggests that they had advanced warning of the bill and parts of its content which they may have influenced. When we consider who their members are (listed below) this might be considered to be giving them an unfair advantage and certainly more notice that the public were given.What was said? Did they put in anything to do with competition? Lansley had competition in mind when writing the White Paper, he just didn't bother telling the public who he is meant to represent.

Health and Social Care bill

In 2008 they had a Meeting with then shadow health secretary, Andrew Lansley, on matters to do with the Conservative party’s draft bill.

In October 2010, Simon Burns (the Minister for Health), Earl Howe, and Andrew Lansley’s Special Advisor, Bill Morgan, attended two meetings with David Worskett, the director of the NHS Partners Network. In the meetings, the ministers reassured the lobby director that opposition to parts of the bill increasing competition would soon ‘dissipate’.

A further meeting head with Earl Howe and Simon Burns on the 19^th May, 2011, went well. 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’.

Competition in the bill

A newly discovered document has revealed the lobby group held a ‘lengthy’ discussion with the chair of choice and competition of the NHS Future Forum Sir Stephen Bubb, during the Health bill ‘pause’.

In the meeting according to the document which was intended for the eyes of the Network’s members only, Mr Worskett had ‘agreed on the approach he (Mr Bubb) would take, what the key issues are, and how to handle the politics.’ He has, he concluded, ‘not deviated from this for a moment throughout the period.’ Perhaps it is this influence that they are referring to in the annual summary 2010/11 report where they say, one of their ‘main activities’ involved ‘influencing the development of the NHS reforms’.

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. The room was full of ‘like-minded’ people. The NHSPN’s press release announcing their submission to the review states: ‘We look forward to working with Monitor throughout the consultation process.’

NHS Partner Network members and connections

3Well Medical: 
alma.3well.info/home

Alliance Medical Limited: 
www.alliancemedical.eu.com – Alan Milburn Alliance Medical runs diagnostic services for the NHS, including in Birmingham[15] and Falkirk.[16] UNISON reported that services were giving patients sub-optimal care, losing the NHS money because of below-capacity uptake, and pressurising hospitals into using private sector treatments 

Alliance Surgical Plc
: www.allsurgical.co.uk/

Assura Medical Limited
: www.assuramedical.co.uk - Baroness Morgan of Huyton Ex-director of failed care home, Southern Cross, is a member of the advisory committee board of Virgin Group Holdings Ltd. Virgin Healthcare Holdings is a subsidiary of them, who took over Assura Medical Limited and renamed them Virgin Care. Vivienne Mcvey is a board member/Director of Virgin Healthcare holdings and has represented NHS Partners Network when giving evidence on behalf of the Care Quality Commission (CQC). Ms McVey is a member of the CQC Providers Advisory Group and was a part of the NHS future forum and is also a member of an 'Independent' Panel set up by Lansley in March  to look at the impact of the NHS Constitution.

Barchester Healthcare: 
www.barchester.com – Baroness Ford – Chairman - Chairman of Grove Ltd, a holding company for for Barchester Health.  Mike Parsons the Chief Executive was voted 2^nd most influential person in healthcare by the HealthInvestor members.

Baxter Healthcare: www.baxterhealthcare.co.uk/

Bupa Home Healthcare: 
www.bupa.co.uk/home-healthcare – Baroness Bottomley is a director, Lord Edmiston has shares, Lord Leitch is a non-executive director, Baroness Liddell is an Associate member

Care UK: 
www.careuk.com – John (now Lord) Nash the then Chairman of Care UK gave donations of £21,000 to run Lansley’s office when he was shadow health minister. Bridgepoint who have Lord Patten of Barnes on their books purchased Care UK.

Circle
: www.circlehealth.co.uk – Mark Simmonds MP is a strategic advisor -

Connect Physical Health: 
www.connectphysiotherapy.co.uk

General Health Group
: www.generalhealthcare.co.uk

Harmoni CPO Limited: 
www.harmoni.co.uk

Healthcare at Home: 
www.healthcare-at-home.co.uk

InHealth
: www.inhealthgroup.com

InterHealth Canada: 
www.interhealthcanada.co.uk

Medical Services: 
www.medicalservicesuk.com

Nuffield Health
: www.nuffieldhealth.com



Oasis Dental Care Limited
: www.oasisdentalcare.co.uk – the recently deceased Baron Newton of Braintree

Pfizer Health Solutions UK: 
www.phsownhealth.co.uk –  Owen Smith: MP for Pontypridd. A former UK lobbyist for the American pharmaceutical giant Pfizer, where he was head of government affairs from 2005-2007. Lord Goldsmith: Partner in International law firm Debevoise & Plimpton LLP, whose clients include Pfizer.

Primecare Primary Care: 
www.primecare.uk.net

Ramsay Health Care UK
: www.ramsayhealth.co.uk

Spire Healthcare: www.spirehealthcare.com - Cinven purchased them and Cinven are connected to Patricia Hewitt

The Horder Centre
: www.horder.co.uk

UK Specialist Hospitals Limited
: www.uk-sh.co.uk

UnitedHealth UK: 
www.unitedhealthuk.com

Vanguard Healthcare Solutions Ltd: 
www.vanguardhealthcare.co.uk

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 editorial aimed 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.