Thursday 9 August 2012

The Telegraph: Pushing Circle’s Agenda

Hitchingbrooke Hospital
If we are to believe the content of the Daily Telegraph’s recent editorial, titled ‘Hope for the NHS’*, then we can all breathe a sigh of relief, pack up your placards, the NHS it would appear, is saved. At least that’s the message being propagated in an extraordinary campaign being run by a so-called ‘quality paper’ on behalf of Circle Health.

In February this year, Circle became the first company to start running a NHS hospital, after it was given a 10-year contract to run Hitchingbrooke hospital in Cambridge.

Six months into its tenure, Circle produced a press release telling us how they have cut waiting times, improved care and delivered savings.

This announcement was enough for the media and the Telegraph in particular, to move into action, to hail the hospital a success despite only 5% of the tenure being complete.

Thanks to a document written by David Worskett, the director of health lobby group, NHS Partners Network, we now know about a network of individuals attached to think tanks, lobby groups, newspapers and parliament who worked together to ensure ‘competition’ remained in the Health bill. 

This same network is now pushing the agenda to hand over NHS hospitals into the pockets of private companies like Circle.

The Telegraph acting as publicist for Circle is unsurprising, given that according to David Worskett, he, alongside right-wing think thank Reform, were able to orchestrate the paper’s editorial during the Health bill ‘pause’.

"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 20th May 2011

Getting to work – The network’s early push for private hospitals
In that same period, on May 16th 2011, David Cameron gave a speech, which brought to an end the so-called ‘listening exercise’.

In amongst the audience was David Worskett, who had ‘received an invitation to the PM's big speech’. Mr Worskett, who had worked tirelessly throughout the Health bill ‘pause’ on behalf of the NHS Partners Network, was delighted to hear that Mr Cameron had ‘specifically added a sentence about the importance of patients being able to attend private hospitals if they wanted to…’

Circle would also have been pleased, especially as they are members of the NHS Partners Network.

On the same day as Cameron’s speech, Reform produced a report, titled: ‘It can be done’. The short report contained a series of six case studies on the involvement of private companies running public services, one of which, focused on Germany and how they are increasing the amount of hospitals run by for-profit companies.

The case study was put together by the co-founder of Reform, Andrew Haldenby, who stated: ‘
The shift to private hospitals is one of the key ways in which German healthcare has controlled its costs over recent years.’ He informs us how ‘health care expenditure in Germany as a percentage of GDP has only increased moderately, from 10.3 per cent in 1999 to 10.5 per cent in 2008. In comparison, in the UK, starting from a lower level, health care expenditures have risen significantly from 6.9 per cent of GDP in 1999 to 8.7 per cent in 2008.’ Not mentioned, was the fact that this period was making up for a severe underfunding by the pervious Conservative rule.

Even so, these stats failed to include data from 2009, which would have been available to them at that time, and showed Germany’s expenditure leaping a whole 1% increase in expenditure that year. This all means the UK (9.6%) spends 2% less on Health out of a total of our GDP than Germany (11.6%).

Reform, like many think tanks call themselves ‘independent’, yet such a claim is clearly false, when we see that their corporate partners include multiple healthcare companies including BMI Healthcare, who have a nationwide group of hospitals. BMI Healthcare is part of General Healthcare group, who along with Circle are members of the NHS Partners Network. Such clear interests are ignored by the Telegraph.

The report written by My Haldenby was highlighted in an article appearing in the Telegraph during the ‘pause’, written by the deputy director of Reform, Nick Seddon, titled: ‘David Cameron is getting it wrong on NHS reform’.

Mr Seddon who was formally the head of communications for private hospital company Circle, complained about the rejection by Dr Steve Field, the Chair of the NHS Future Forum of ‘Andrew Lansley’s plan to compel hospitals to compete for patients and income’. A decision, which Mr Seddon saw as undermining the ‘conclusions’ made by Sir Stephen Bubb, who was in charge of the competition review.

Here we go again - The Telegraph continue their corporate role

Although private hospital’s did get a mention in Cameron’s speech. The job was far from complete.

When Hitchingbrooke was outsourced to Circle, the Telegraph continued with their promotion. Public Policy journalist, Andrew Porter, wrote a comment piece titled: ‘private takeover of Hinchingbrooke Hospital is the shape of things to come’, a claim repeated 8 months later by MP Mark Simmonds in his speech to the Hitchingbrooke Trust. Mr Porter puts words into the mouth of Tory MPs, perhaps correctly that: ‘Many Tory MPs will welcome today’s move and…install private firms which, while maintaining high standards of patient care, can get to grips with a public sector culture that has failed.’

The Telegraph then offered their health section to Reform’s Andrew Haldenby, who tells us ‘NHS patients would profit from a dose of enterprise.’

More was to come in an unrelenting barrage of articles reinforcing the message that private hospitals are good for us…

The editorial ‘Hope for the NHS’, allowed Ali Parsa Circle’s Chief Executive to say his belief that ‘Hinchingbrooke could act as a template for the rest of the NHS, pointing out that in Germany private companies manage far more hospitals than the state’. We all know where that research came from.

Medical Correspondent Stephen Adams played his part, repeating the corporate line that we need more hospitals run privately. At least he had the decency to admit that the information he was repeating was the claim of the company and not fact.

In other words none of these journalists actually double-checked the facts to see if they were true and as of yet these still haven’t been confirmed. Either way, to claim success to a hospital turnaround 5% of the way through a 10-year tenure is truly worrying.

This hasn’t stopped Andrew Cave writing an article following an interview with Ali Parsa, who is now asking for more contracts. It’s almost as if it was all planned. “I hope the success of Hinchingbrooke allows the Government to be bolder and to go further than it has gone so far. I think it is time to do something.”

Chris Skidmore the MP for Kingswood jumped on the bandwagon, informing us that: ‘It is, in particular, a victory for those who have backed reform’. Mr Skidmore, who sits on the health committee, also sat on a panel in June, where the discussion was: ‘Should we abolish the NHS?’

What is remarkable about all these articles, aside form the blatant attempt by the paper to promote private healthcare interests, is the failure to recognise anything negative about Circle.

What’s the problem?
Circle could do with all the help they can get. A report by the Bureau of Investigative journalism, highlighted how Circle had a net debt of 42.4m, an operating loss of £17m with a fall of total revenue of 2.4% from 2010. Not mentioned in any of the articles.

Nor did any highlight the fact that Circle are owned by companies and investment funds registered in the British Virgin Islands, Jersey and the Cayman Islands. Corporate Watch, a research group monitoring large corporations, produced a report, titled ‘An unhealthy business’ revealed how companies registered in the British Virgin Islands ‘do not have to make their accounts public.’ Indeed when Corporate Watch asked to see their accounts, they were met with silence.

As Corporate Watch so clearly reveals, ‘Circle Health Ltd’, who are the company that actually provides healthcare, is ‘50.1% owned by a company called Circle Holdings, with the other 49.9% owned by Circle Partnership. Circle Partnership is part-owned by Circle employees and is the social enterprise part. But while this may mean some of its staff benefit when the company starts making a profit, as it is registered in the British Virgin Islands, these benefits will not be shared. Companies registered in the Caribbean island do not have to pay tax on dividends from investment in a UK company.’

If Circle became the way hospitals were run, as Mr Parsi would like, then what we would see is money leaving the company through the ownership of its hospitals. Corporate Watch highlighted Circle's Bath hospital, which is ‘owned by Health Properties Bath, another Jersey-registered company, which Circle pays £3.2m a year in rent.’ Health Properties is ‘owned by Circle Holdings (39%) and Health Estates Fund Ltd (58%), a “related party property fund advised by the [Circle] Group”, which is also registered in Jersey.’ And, to top it all off, the remaining 3% is owned by Lehman Brothers, which originally loaned money to build the hospital.

Circle are well-connected
So Circle have a former employee as a deputy director of Reform, they are a member of the NHS Partners Network, and they are able to have influence into the very heart of our parliament via MP for Boston and Skegness, Mark Simmonds.

Mr Simmonds is an employee of Circle, and is paid £50,000 per year as a ‘strategic advisor’ for 10hrs work per month.

Mark Simmonds, who is meant to be a public servant lest we forget, was forced to apologise in February for failing to mention his interest in Circle when speaking in favour of the Health and Social Care bill content.

Incidentally, Mr Simmonds is the Vice chair of the Associate Parliamentary Health Group, who according to their website, is ‘recognised as one of the preferred sources of information on health policy in Parliament…’ You can see more on them here.

Another connection to Circle comes in the form of Baron Higgins of Worthing, who holds in excess of £50,000 worth of shares in Lansdowne UK Equity Fund, who are financial backers of Circle Health. Financial interests that didn’t prevent either parliamentarian from voting on the bill as it passed through both Houses into becoming an Act.

As if these connections weren’t enough, Circle recruited a former aide to health secretary Andrew Lansley as head of communications. Christina Lineen, replaced Nick Seddon, having spent two years working for Lansley when he was shadow health secretary. Clearly moving from Lansley’s office into a private healthcare company is a natural career progression.

No doubt therefore of Ms Lineen’s involvement in the latest PR pitch for the Hitchingbrooke hospital 6-month update, so loyally regurgitated by the Telegraph and unthinkingly by the BBC in yet another shameful episode of their coverage of the NHS attacks.

It is early days, and it will be a few years before we can see if this company is truly making a good job of running the hospital. By then, cuts may have come to the fore, Circle’s debt may be rising.

The corporate press however doesn’t care for such concerns; they are a shame to the profession of journalism. They will claim editorial independence, and yet a document has appeared, which suggests just the opposite. Just as Reform, NHS Partners Network and the Telegraph promoted the interests of the private healthcare during the Health and Social Care bill. One press release from Circle, and they are at it again, coming together in editorial synchronicity.

A reader of a paper wants to know that what they are reading is covering a topic fairly in all areas of the subject matter and for the Telegraph to omit such important information such as a company’s financial situation, connections to think tanks and parliament, is cheating their readers.

The Telegraph’s Pro-private hospital articles - Nick Seddon 16th May 2011 – on the Prime Ministers speech made on May 16th – this speech is what Worskett was talking about in the document – - Produced by Reform on 16th May 2011. Contains section about German hospitals by Andrew Haldenby. - Nov 10th 2011 - Andrew Porter - Comment: private takeover of Hinchingbrooke Hospital is the shape of things to come - Written by Stephen Adams - 3rd May 2012 – First private company to run NHS hospital could bring in ‘eye-watering cuts’ - Andrew Haldenby Co-founder of Reform – July 5th – NHS patients would profit from a dose of private enterprise - Editorial Hope for the NHS 1st of August – no question mark – By Telegraph view - Written by Chris Skidmore MP – 1st of August - Hitchingbrooke shows what private companies can do for the NHS - written by Stephen Adams – medical correspondent – August 1st 2012 – Hitchingbrooke hospital turned around by Circle in six months - Written by Sean Worth a former special to the Prime Minister and currently runs the Better Public Services Project at Policy Exchange – August 2nd – A revolution in the wards that could heal public services. - written by Andrew Cave 4th August - Ali Parsa: Government should not be running hospitals


* Note how the title ‘Hope for the NHS’ has no question mark.


  1. These days I suspect people are basically NHS outed fed up of politicians telling us one thing while actually nodding in agreement with the Tories.

    Labour is saying hospitals built in other countries for private patients is a step to far, yet it was them that put this forward.

    If circle can run these hospitals make a profit who am I to say no. If they make a loss well little lost really because they are in the main failing anyway.

    I sick and tired of battles from politicians over the NHS and education, really have just become tired of it all.

    Three parties all full of well off middle class pratts.

    1. "hospitals built in other countries for private patients is a step to far"

      Are you are referring to Moorfield building a hospital in the Middle east and shipping their NHS-trained and paid surgeons out there? If so, how can *anyone* justify doing that when there are waiting lists here? My opinion is that NHS hospitals should only be allowed to treat private patients in the specialities where they have an NHS waiting list less than 8 weeks. Otherwise, the hospital will be using the waiting list to generate business, which is disgraceful.

      "If circle can run these hospitals make a profit who am I to say no" you had better say a big NO. Indeed, Spend the whole day saying NO, NO, NO, NO. You see, Circle as a company has NEVER made a profit. Its private hospitals are loss making, and would be even more loss making if they didn't do NHS work. Two years ago Circle's debts and financial state were so bad they went to shareholders and begged for another £46m telling them that if the shareholders didn't provide the cash the company would be insolvent with no return on the shareholders investment. (Remember, Circle do not own their private hospitals, they rent them off Ali Parsa.) Hinchingbrooke itself is still bankrupt. The agreement is that if the aggregated debt generated under Circle exceeds £5m then either Circle or the NHS can cancel the contract. The debt is so close to this figure that it will be breached in the next financial quarter.

      "I sick and tired of battles from politicians over the NHS"

      I don't believe this, since you appear to know so little about the NHS, I doubt if you've had more than a thought in the last four years. Please, do some work, go to some CCG and NHS trust board meetings, go to a Health and Wellbeing Board - do all of this and you'll find out the huge problems that the NHS has with an aging population and real term cuts, yet all of this is made more difficult by the government's diktats telling commissioners to privatise as much as possible before the election.


Note: only a member of this blog may post a comment.