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.

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.

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."

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, G4S and see why this makes them a conduit to 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 links to 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 quote from 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.

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.

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.