Tag: PFI

How the establishment have engineered the NHS crisis

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By Daniel Margrain​

A century or so ago, the Russian Marxist Nicolai Bukharin understood that the growth of international corporations and their close association with national states was symptomatic of how both aspects hollow out the parliamentary system. It is now widely recognized that the power of private lobbying money draws power upwards into the executive and non-elected parts of the state dominated by corporations. Consequently this leads to a reduction in democratic accountability and public transparency.

Internal markets, market testing, contracting out, privatization, encouraging private pensions and all the rest, are mechanisms that are intended to depoliticise the process of social provision, so making it easier to refuse it to those deemed not to deserve it on the one hand, and to clamp down on the workers in the welfare sector on the other. This ethos became established in the late 1980s under Margaret Thatcher during her third term in office.

Removing the foundations of the welfare state

Following the advice of the then chief executive of Sainsbury’s, Sir Roy Griffiths in 1987, the Thatcher government set about removing the foundations upon which the welfare state had been built. Camouflaged in the language of ‘public-private partnerships’, Tony Blair’s New Labour took this one stage further as a result of his envisaging the state as the purchaser rather than direct provider of services. Whole entities within the public sector have increasingly been outsourced, health and social care services privatized and competition and the business ethos introduced into public services in the form of managerialism and New Public Management.

Thus, within residential care, patients have been recast as customers. The aim is to ensure the domination of the market by a small number of very powerful multinational corporations whose primary concern is not the welfare of the residents in care homes which they own or patients in hospitals but with maximizing profits.

The carving up of the NHS opens up one of the worlds biggest investment opportunities. Indeed, its exploitation by private interests is proceeding at a pace. This is hardly surprising given the 2014 revelation that 70 MPs have financial links to private healthcare firms while hundreds of private healthcare corporations have donated to Tory coffers.

There exists a symbiotic relationship between privatization and what Noam Chomsky refers to as a policy strategy of “defunding”. In line with Chomsky’s notion, the aim over the last three decades has been to shrink the NHS and bring it to the point of collapse as the basis for then claiming the only solution is more privatization. In Orwellian terms, health under-funding is portrayed in the media as “unprecedented levels of overspending by hospitals and NHS trusts.” 

Health and Social Care Act

The 2012 Health and Social Care Act removes the duty on the Secretary of State for Health to provide a comprehensive health service and requires that up to 49 percent of services can be tendered out to “any qualified provider.” As early as 2013, between a quarter and a half of all community services were run by Virgin Care. Three years later, the corporation had won £700m worth of NHS and social service contracts.

The retreating by the state from the principle of universal health care provision, free at the point of delivery, can be pin-pointed to 1988 when Tory politician, Oliver Letwin, wrote a ‘blueprint’ document called ‘Britain’s Biggest Enterprise’ where he set out the stages governments’ would have to go through to achieve a US model of health care without the public noticing. The New Labour government under Tony Blair adopted Letwin’s principles. But prior to the 1997 General Election, Blair had to disguise the strategy by using dissembling language in order to get elected.

Once in power, Blair took several steps towards privatization. For example, he broke up the hospital network into foundation trusts which are essentially separate business entities. He also deliberately saddled hospitals with Private Finance Initiative (PFI) liabilities which involved the government borrowing £11 billion from private banks and financiers in order to justify the sale and breakdown of the NHS further down the line.

This culminated with the New Labour government introducing in 2009 what was termed the “unsustainable provider regime” which is a fake bankruptcy framework to justify closing hospitals. The £11 billion of PFI public money borrowed from the banks and injected into the NHS is, in the words of ‘Save Our NHS’ activist Dr Bob Gill, intended to “set up the infrastructure for the whole scale hand-over of our NHS to American corporations.”

Simon Stevens

Arguably, the most influential individual currently working in the NHS is former Labour councillor, Simon Stevens, chief executive of NHS England. After having served under the Blair government, Stevens went on to work for the US private health care provider, United Health, where he campaigned against Obama Care prior to campaigning for the Transatlantic Trade and Investment Partnership (TTIP) to be included within the UK health care remit. Those encouraged by the election of Jeremy Corbyn are still waiting to hear something from the shadow health team about this troubling development.

Controversially, Stevens introduced NHS England’s ‘Sustainability and Transformation Plans’ which form part of the annual HHS Planning Guidance. ‘Sustainability and transformation’ is Orwellian-speak for the move towards the total reorganization of the NHS predicated on more privatizations and cuts.

Two years ago this month, Dr Bob Gill attended a meeting to get some insight into what the position of the then Shadow Secretary of State for Health, Heidi Alexander, was in relation to the direction NHS England was moving in under Stevens. What he heard were narratives that fitted into the ongoing privatization agenda. According to Gill, Alexander expressed support for Simon Stevens, despite his appalling track record. There is no indication that neither the Labour leader, nor current Shadow Health minister, Jon Ashworth, intend to take Stevens to task.

This is extremely worrying given that Stevens appears to be less committed to ethics and patient care, and more concerned with perpetuating the notion that medicine is a profit-based ‘conveyor belt’ service. Could it be the case that Corbyn has underestimated the extent to which the corrupting influence of corporations and the power of lobbying money have hollowed out the parliamentary system as outlined by Bukharin a century ago?

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Why Owen Smith is a Red-Tory

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By Daniel Margrain

Last week a prominent independent journalist claimed on Twitter that my assertion Owen Smith was effectively a Tory was “intellectually lazy”. Coincidentally, a few days later on Thursday’s (September 8) edition of BBC’s Question Time during the Labour party leadership debate between challenger Owen Smith and incumbent Jeremy Corbyn, a studio audience member and Corbyn supporter accused Smith of “being in the wrong party”.

Smith responded angrily to this suggestion by denying this was the case and asserted that the claim amounted to a term of abuse. Smith’s view was supported the next day (September 9) on Twitter by Smith supporter, John McTernan who said that such a suggestion was “ludicrous”. Of course, nobody is claiming that Smith, in the literal sense, is a Tory, but his voting record in the House of Commons and his commercial activities outside it, would indicate that he might as well be.

So let’s take a look at his record. Since at least July, the public relations professional, Smith, has pitched himself as a ‘soft-left’ anti-austerity alternative to Corbyn. This implies that Smith is first and foremost concerned with image and branding as opposed to adopting a principled political and ideological position.

The ‘soft-left’ Smith had previously given interviews supporting PFI and, as chief lobbyist for the U.S multinational Pfizer, he actively pushed for the privatization of NHS services. Commenting on a Pfizer funded ‘focus group’ study as part of a press release, Smith referenced and promoted the notion that the precondition for greater availability of healthcare services was the ability of the public to be able to pay for them. This is one of the significant passages from a section of the study that Smith was keen to promote:

“The focus groups… explored areas of choice that do not yet exist in the UK – most specifically the use of direct payments and the ability to choose to go directly to a specialist without first having to see the GP.”

In other words, Smith favours direct payments from the public to doctors as a replacement for current NHS services. This policy strategy is consistent with the 1988 Tory ‘self-funding’ privatization blueprint for the NHS drawn up by Oliver Letwin and John Redwood. In the document ‘Britain’s Biggest Enterprise: ideas for radical reform of the NHS’, Letwin and Redwood suggest that the aim of charging is to “replace comprehensive universal tax funding for the NHS.”

Smith’s conflation of greater choice with an ability to pay, represents one more stage in the execution of Letwin and Redwood’s plans. The implementation of these plans were accelerated by Blair and Brown as documented by Leys and Player in their book The Plot Against the NHS. Smith intends to continue where Brown and Blair – then Lansley and now Hunt – left off as part of the final stages of the wholesale Letwin-Redwood privatization blueprint of which the 2012 Health & Social Care Act  is a major component part.

Since the 2015 general election, the Tory government have explicitly admitted that the NHS should be modelled on US-style “accountable or integrated healthcare” which is where Smith’s connections to Pfizer come in. In addition to his Policy and Government Relations role for the giant US corporation, Smith was also directly involved in Pfizer’s funding of Blairite right-wing entryist group Progress. Pfizer gave Progress £52,287 while the latter has actively pursued the agenda of PFI and the privatisation of NHS services.

So while Smith’s image is largely predicated on his attempt to convince the Labour membership that in policy terms he publicly supports Corbyn’s position that the NHS should remain a universally free at the point of delivery service, in reality nothing could be further from the truth.

Smith also supported Blair’s city academies that have continued under the Tories as well as assiduously courting the arms industry of which his support of Trident is a reflection. Arguably, most important of all, is that Smith effectively lined up with the Tories, alongside another 183 Labour MPs in July last year by refusing to vote against the Conservative governments regressive and reactionary policy of welfare cuts to some of the most vulnerable people in society.

In an Orwellian rejection of socialist values, Blairite Iraq war apologist and establishment gatekeeper, John Rentoul, affirmed his support for the policies of Owen Smith on Twitter:

As the graphic above shows, and as Craig Murray correctly posits:

“There is no evidence whatsoever that Smith is a left winger. There is every evidence that he is another New Labour unprincipled and immoral careerist, adopting a left wing pose that he thinks will win him votes.”

The graphic below highlights the hypocrisy of Smith and, by extension, his total contempt for ordinary Labour party members.

 

 

Smith’s acquiescence to corporate power is indicative of a wider democratic deficit within the liberal democracies of the West in an era of globalization more generally. But his close relationship to the PLP and the Tory-Labour establishment consensus that they represent, reflects a relatively recent historical pattern in which governments of both the left and the right have prioritized the interests associated with private capital over and above that of labour.

Thus the first serious attacks on the welfare state in Britain came not in 2008, or even with the election of Margaret Thatcher in 1979, but several years previously, with that of a Labour government in 1974. Contrary to popular belief, dismantling the welfare state was not a key priority for Thatcher following her election in 1979. It was not until her third term of office in 1987 that Thatcher and her advisers (notably the Sainsbury’s chief executive Sir Roy Griffiths) began to develop the neoliberal ideas of the Chicago School.

These ideas were subsequently picked up and developed by New Labour under Tony Blair following his election victory in 1997. It was during this point that the introduction of competition into public services, ideas about the state as purchaser of public services and the outsourcing and privatization of health and social care services, became the norm.

The privatization of the NHS, made possible by the 2012 Health and Social Care Act, arguably poses the most immediate threat to the welfare state in the UK in its totality in which the outsourcing of services becomes the default position. The functioning of a welfare state that increasingly serves the minority interests of capital at the expense of fulfilling the needs of the majority of the population, is a process driven by a neoliberal-driven ideological consensus rather than any pragmatic attempts at ameliorating deficits and the encouragement of socioeconomic and environmental sustainability.

It’s the continued satisfying of minority elite interests rather than the wider public good that Owen Smith and the establishment – of which he is a part – are embedded. That’s fundamentally the reason why there is nothing that separates Owen Smith from the neoliberalism of Blair, Brown, Miliband, Major, Thatcher and May.

Whether one agrees with Jeremy Corbyn’s politics or not, he at least offers a genuine alternative to the consensus view that Smith represents. Even the right-wing commentator, Peter Hitchens, recognizes that the emergence of Corbyn is important to the adversarial nature of political discourse and, by extension, to democracy itself. If the UK was a healthy democracy instead of an effective corporate-political-media oligarchy, this development would be welcomed. Instead, Corbyn is demonized and smeared at almost every opportunity.

 

The British establishment corrupt? That’s not cricket, old bean

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By Daniel Margrain

A year ago last week (30 July) the then Prime Minister David Cameron met with Prime Minister Najib Razak of Malaysia to talk about corruption in the wake of allegations that nearly US$700 million ended up in the latter’s personal accounts. This followed on the heels of Cameron’s stated commitment to clamp down on corrupt money in the UK.

But on the same day he was lecturing the Malaysian’s about corruption, British corporations claimed that the Bribery Act effectively made it difficult for them to bribe people as part of their ‘normal’ export business practices. Thus, business leaders subsequently appealed to Cameron to reverse legislation that is ostensibly intended to prevent corruption.

The then business secretary, Sajid Javid, invited companies’ to comment on whether the ‘tough anti-corruption measures’ are a ‘problem’. Letters sent by the Department of Business, Innovation and Skills invited industry leaders to comment on whether the act has had an impact on their attempts to export. Does the government invite you to comment, dear reader, about regulations that prevent you from making more money? No, I thought not.

Widespread international criticism of the failure of the UK to reform its ineffective anti-bribery laws – which is regarded as one of the most controversial pieces of legislation passed by the last government – soon followed. The coalition boasted that the Bribery Act was the world’s toughest piece of anti-corruption legislation. But the CBI led fierce criticisms of the bill arguing it would restrict business growth at a time of economic recovery.

The potential impact of the legislation is likely to be felt primarily, but not exclusively by, businesses. Why? Because bribery and corruption is an inherent part of big business deal-making.

On Wednesday’s (August 3) edition of the BBC HARDtalk programme, host Stephen Sackur interviewed Nigeria’s Minister for Power, Works and Housing, Babatunde Fashola. During the interview Sackur repeatedly alluded that the Nigerian government was systematically corrupt. At one point Sackur related an ‘off mic’ incident in which Cameron was said to have berated Nigeria, describing the country as one of the two most corrupt countries in the world.

Apparently it hadn’t occurred to Sackur and Cameron that big business in the UK lobbied against the Bribery Act which was intended to undermine corruption, the implication being that corporations would rather be scraping around in the sewer if there was some money to be made among the filth. For the likes of Sackur and Cameron, corrupt practices are something restricted to what African’s and Asian’s engage in. By contrast, the British establishment thinks of itself as occupying the moral high ground.

Three years ago, Cameron visited one of the most corrupt and authoritarian countries on the planet, Kazakhstan. The leader of that country showered him with gratitude and praise. Kazakhstan’s former police chief is linked to the ownership of £147m-worth of London properties which forms part of the UKs status as a safe haven for corrupt capital. Then there was the Straw and Rifkind affair, the ongoing MPs expenses scandal and the long-running PFI saga that’s crippling the NHS.

Simon Jenkins summarized the malaise and hypocrisy at the heart of the British establishment

“The truth is that hypocrisy is the occupational disease of British leaders. They lecture Africans and Asians on the venality of their politics, while blatantly selling seats in their own parliament for cash. I hope some insulted autocrat one day asks a British leader how much his party has garnered from auctioning honours. The government suppresses any inquiry into corrupt arms contracts to the Middle East. And when does lobbying stop and corruption start? The Cameron government is the most susceptible to lobbying of any in history.”

Given these corrupt practices, the fact that the UK is widely perceived to be the world’s 14th least corrupt country in the world would perhaps come as a surprise to many. The gap between perception and reality is clearly indicative of the distorted way in which the media under report the subtle forms of ‘hidden’ systematic corruption that is embedded in the very fabric of the British state, camouflaged by legislation and cushioned by ‘gentlemen’s agreements’.

In bringing together a wide range of leading commentators and campaigners, David Whyte shows that it is no longer tenable to assume that corruption is something that happens elsewhere; corrupt practices are revealed across a wide range of venerated institutions, from local government to big business.

As Penny Green of Queen Mary University of London, contends, “the network of egregious state and corporate corruption in Britain rivals any in the developing world”. By observing our ‘impartial’ corporate-controlled mainstream media, it’s unlikely one would have arrived at the conclusion that one of the most advanced capitalist countries on the planet is also inherently corrupt.