In the Scotland edition of the i today, we read that Patricia Hewitt, a former Labour (New) minister has recommended, in a review, that NHS England just abandon targets. They’ve been ignoring a few, such as hospital-onset Covid figures, and fiddling others, such as A&E waiting times, for years now, so this is a the logical conclusion to their strategy.
That a former Labour (New) minister chaired the review, tells us that Labour shares the Cons’ desire to just hide the collapse of state-provided health care, and will say nothing.
The BBC, not even BBC Health, and UK press (not even the Guardian), other than the i (below), are not covering this review sneaked out when the Con Government think no one is watching.
Imagine such a thing in Scotland where BBC and other MSM health reps will insist NHS waiting times failures (only failures) are in the public interest and must be headlined.
Talking-up Scotland 
I think Ms Hewitt, who as Health Secretary, received several barrackings from various organisations to which she was invited to address, moved to a highly remunerated job in the private health sector.
She and one of the education-education-education advisers, “Sir” Micael Barber are advising the current Conservative government.
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Wonder why they don’t work for the health unions?
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It’s ‘interesting’ that the Tory government chose a former New Labour cabinet minister to lead this review! What might have attracted the Tories to Patricia Hewitt? Her Labour credentials as set out in the following perhaps?
From the online campaigning health website ‘The Lowdown’ (profiled later): ‘Jeremy Hunt’s decision (in November 2022) to bring in former Labour MP and cabinet minister Patricia Hewitt to help his government ‘reform’ the NHS has brought her record as health secretary from 2005-7 sharply back into focus.
‘Shortly after taking up the health secretary post in 2005, Hewitt INVITED PRIVATE TENDERS FOR A ROUND OF ‘INDEPENDENT SECTOR TREATMENT CENTRES’, WORTH AROUND £500M A YEAR, BUT EXCLUDED NHS HOSPITALS FROM THE BIDDING PROCESS. Publicly-owned NHS treatment centres, meanwhile, were deemed likely to be handed over to private operators.’ (my emphasis)
‘Around £400M-WORTH OF SCANS, BLOOD AND PATHOLOGY TESTS WERE ALSO TO BE HIVED OFF, all part of plans to double the volume of private sector work purchased by the NHS, with AT LEAST 10 PER CENT OF ELECTIVE OPERATIONS HANDED OVER TO THE INDEPENDENTS.’
‘These and other proposals naturally proved controversial, and in November that year, in a speech to community health chiefs at the NHS Alliance annual conference, HEWITT HAD TO APOLOGISE FOR PUBLISHING PLANS WHICH WOULD HAVE FORCED PRIMARY CARE TRUSTS (PCTS) TO CONTRACT OUT ALL DISTRICT NURSING, FAMILY PLANNING CLINICS AND OTHER LOCAL HEALTH SERVICES. She also had to reassure delegates that a forthcoming white paper would water down proposals to create competition between NHS GPs and private clinics across England.’
‘Such contrition proved short-lived, however, as the following January saw THE LAUNCH OF A WHITE PAPER WHICH SOUGHT TO PUSH PCTS TO OUTSOURCE ALL SERVICES. Hewitt went on to tell A PRESS BRIEFING THAT THERE WAS “WIDESPREAD ENTHUSIASM” AMONG STAFF TO LEAVE THE NHS AND WORK FOR SOCIAL ENTERPRISES INSTEAD. And later in 2006, PRIVATE INSURANCE COMPANIES WERE INVITED TO BID FOR A LARGE SLICE OF THE £64BN NHS COMMISSIONING BUDGET THEN CONTROLLED BY PCTS, and public sector procurement body NHS Logistics was carved up in order to award a contract to Texas-based Novation.’
‘Back in 2008, while still an MP, Hewitt may have benefited from her time as health secretary when she was offered consultancy roles with both Cinven, a private equity company that had just bought up BUPA’s UK hospitals for £14bn, and pharmacy chain Alliance Boots. One newspaper report at the time suggested these two roles would have netted her at least £100,000 a year.’
Then, two years later, a Channel 4 Dispatches investigation into political lobbying claimed that Hewitt had appeared to suggest she was being paid £3,000 a day to help a client get a seat on a government advisory group. That allegation led to her being suspended from the Labour Party.’
Source: https://lowdownnhs.info/analysis/why-has-hewitt-been-given-the-latest-nhs-review-brief/
In an earlier, detailed account of Labour’s record in government in The Lowdown (October 29, 2021) entitled ‘A history of privatisation part 7: A flurry of contracts and “reforms”’, the author notes: ‘In October 2006 the Department of Health implementation document Making it Happen stressed the need for “better partnership working with third and independent sectors”.
‘In July a policy paper from the “Third Sector Commissioning Taskforce” emphasised that: “delivering health and social care services is no longer the preserve of the public sector … third sector as well as private providers have a valuable role to play ….”
‘Health minister Lord Warner warned that local NHS hospitals would have to “face up to the need to reconfigure services” to enable new “independent sector providers” to enter the NHS market.
‘The logic was simple enough: TO MAKE ROOM FOR THE DEVELOPMENT OF A BRAND NEW PRIVATE SECTOR, HEWITT, WARNER AND BLAIR HAD TO SLASH BACK EXISTING NHS SERVICES.’
We need to know more about where Streeting & Starmer stand on the future of the NHS? From 17 December in there Mirror: ‘Wes Streeting plans to slash NHS waiting lists by an extra 233,000 a year by beefing up partnerships with private hospitals when Labour comes to power.’
About The Lowdown: ‘The Lowdown is an evidence-based website that tells you about what’s happening to your NHS. Our journalists and researchers produce regular news, investigations and analysis that are available for free, to help you keep track and understand policy.
‘Who are we?: Paul Evans of the NHS Support Federation and Dr John Lister (London Health Emergency, Keep Our NHS Public and Health Campaigns Together), with almost 60 years combined experience between them as researchers and campaigners are leading this project to build a news and investigation unit to inform NHS supporters and workers.
‘We have small staff and a growing community of freelance contributors. We are committed to helping to train and support the next generation of health journalists as they are an essential tool in holding our politicians and health leaders to account and getting to the truth.’
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There is corruption.
Then there is graft.
Then there are Labour and Tory politicians.
And upholding the whole rotten system is the media.
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There is a lot of ‘politics’ around the NHS, especially in England as the Labour Party marks out it policy positions in advance of the next General Election! Much of this may have little public profile in Scotland as yet. This needs to change as whatever Streeting & Starmer decide, should Labour form a government in Westminster, will have a major effect on the resourcing of NHS Scotland for as long as Scotland remains dependent and with limited agency in this Union.
The campaigning health website, The Lowdown reviews the current state of Labour’s position in an article entitled ‘Streeting races up blind alley’ (20 December, 2022)
See https://lowdownnhs.info/private-providers/streeting-races-up-blind-alley/
The critique in this article includes the following:
– Wes Streeting has repeatedly made statements that are ‘widely seen as – at best – LEANING TOWARDS FURTHER USE OF THE PRIVATE SECTOR IN PREFERENCE TO EXPANDING AND IMPROVING THE NHS. On December 8, Streeting was again banging the drum for more use of the private sector in an Opinion piece in the Guardian, arguing: “If Labour were in government, we would be pulling every lever available to bring down NHS waiting times, including negotiating to avert strike action. We would also be using spare capacity in the private sector to bring down waiting lists. Private providers have capacity for 130% of the procedures they were doing for the NHS before the pandemic, but the government hasn’t utilised it.” (my emphasis)
– it argues this stance is ‘compounded by HIS REFUSAL TO DEMAND ANY INCREASE IN THE NHS BUDGET, despite the clear evidence that after a decade and more of real terms cuts in funding it is desperately lacking in resources and capacity: his most recent speech (one to the right-wing think tank Policy Exchange) for example, included his assertion that: “We cannot continue pouring money into a 20th-century model of care that delivers late diagnosis and more expensive treatment”.
– according to The Lowdown, Streeting has been accused on Twitter by veteran left wing MP Diane Abbott of TRYING TO PUSH “INCH BY INCH” FOR A PRIVATISED/INSURANCE BASED NHS.
The article also refers to a ‘well-argued response’ to the call for more use of private hospitals in a Guardian article written by David Rowland of the Centre for Health and the Public Interest (CHPI). It includes this:
“You can only assume that Wes Streeting’s recent embrace of the private hospital sector as a solution to the current health crisis stems from naivety about how UK private healthcare works, or is part of the Labour leadership’s attempts TO TURN IT INTO A PARTY OF THE CENTRE RIGHT. It is certainly not based on evidence.”
Rowland exposes PRIVATE HOSPITALS’ RELIANCE ON ‘LARGELY HIDDEN SUBSIDY AND SUPPORT FROM THE NHS’: “… safety risks include the fact that the vast majority of private hospitals do not have any ICU facilities to look after patients if something goes wrong after an operation. Even at the height of the pandemic, 6,600 patients were transferred to NHS wards after treatment in a private hospital – a fact that suggests that FAR FROM ASSISTING THE NHS DURING THE PANDEMIC, THE SUPPORT WENT THE OTHER WAY. It is also an arrangement that costs the NHS an estimated £80m a year.”
Rowland refutes claims of an “extra” pool of staff in the private sector: “… IN ALL THE PRIVATE HOSPITALS OPERATING IN THE UK, THE DOCTORS ARE NHS DOCTORS, WORKING IN THEIR SPARE TIME. IN COMMERCIAL TERMS, because THE PRIVATE SECTOR CONTRIBUTES NOTHING TO THE TRAINING OF THE 17,500 DOCTORS WHO WORK IN ITS HOSPITALS, this AMOUNTS TO A FREE SUBSIDY TO THE PRIVATE SECTOR of about £8bn.”
The Lowdown piece notes that ‘Rowland does not go on to explore the economics and financial reality of increased use of private hospitals while the NHS, starved of capital to expand its own services and facing a growing £10bn-plus backlog bill even for maintenance of existing hospitals, PAYS FOR PATIENTS TO GET TREATMENT IN OTHERWISE EMPTY BEDS IN PRIVATE HOSPITALS. CHPI and The Lowdown have previously highlighted the costs and knock-on consequences of ill-conceived deals struck by NHS England for use of private hospitals during the peak of the pandemic, that have PROVED ROTTEN VALUE FOR TAXPAYERS, BUT A WINDFALL FOR THE PRIVATE SECTOR.
‘The fact is that the average private hospital is so small (average size just 40 beds) and with such limited facilities they can only treat the most simple elective cases – leaving all of the most costly, complex and of course ALL emergency cases to the NHS. So even while private hospitals can profitably treat patients on this basis at average NHS tariff costs, the reality is that this siphons vital resources out of the NHS, and perpetuates the chronic lack of front line capacity – effectively baking-in dependence upon private providers.’
It goes on: ‘STREETING IS TOO YOUNG TO REMEMBER WHEN NEW LABOUR FIRST SET OUT VIEWS SIMILAR TO HIS, beginning in 2000 with Health Secretary Alan Milburn’s disastrous ‘Concordat’ that sent NHS patients at hugely inflated costs to private hospitals in the winter peak period. Milburn went further in the mid 2000s and squandered hundreds of millions on establishing new “Independent Sector Treatment Centres” (ISTCs) that were given preferential 5-year contracts to treat the simplest elective cases and an average of more than 11% above the NHS tariff rate. NHS trusts and foundation trusts were banned from applying for these contracts, which made only the most marginal contribution to the reduction of waiting lists and waiting times achieved by a decade of investment.’
‘But Streeting who has argued for a big expansion in training of new doctors should be told that the training of NHS doctors was made more difficult by the transfer of so many routine operations to these small new private units – where no training could be given. And only an increase in NHS funding can create sufficient employment opportunities for the additional new doctors. The ISTCS were eventually recognised as an expensive irrelevance by most NHS commissioners and all but a tiny handful have since been brought back into the NHS.’
The context for these discussions is provided by the latest Tory reforms of the NHS in England (- whatever happened to the brave new world of the Lansley marketisation reforms brought in by Cameron’s Coalition Government?) namely the establishment of Integrated Care Boards plus threatened further austerity. And again regarding Streeting and Labour’s stance, the Lowdown piece states: ‘IF HE WANTS TO PROTECT AND RESTORE THE NHS WITH ITS CORE VALUES INTACT HE NEEDS TO START FROM A COMMITMENT TO ADDRESS TODAY’S CRISIS WITH INCREASED RESOURCES – CASH, CAPITAL AND STAFF – RATHER THAN MAKING MORE STATEMENTS THAT RAISE CHEERS ONLY FROM PRIVATE HOSPITAL BOSSES AND THE DAILY TELEGRAPH.’
As things stand, voters in Scotland – likely to reject both the Tories and Labour by a majority at the next General Election – will just have to SPECTATE FROM THE SIDELINES as the future of the NHS is DETERMINED BY THE PREFERENCES OF ENGLAND’S VOTERS AND THE POLITICIANS THEY ELECT. Unless of course…….!
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