“Liberating the NHS”: a public relations car crash

It is something of an understatement to say that the Health and Social Care Bill is highly controversial. Substantial and growing opposition has emerged from the country’s medical professionals and policy analysts, based on evidence and theory as well as on principle. Our Prime Minister has not reacted by tackling the problems they identify for patients and taxpayers, which involve loss of service quality at much higher cost.  Rather he intensified his public relations campaign.  From this choice alone we have the measure of this government.

The implementation of his PR strategy has generated some revealing incidents which have had little coverage in the mainstream media. 

On Wednesday 16 February, a series of hospital visits by the Prime Minister to the North-East to highlight health issues surrounding alcohol was announced, for instance here[1],[2] and elsewhere in the Murdoch press. In the event, however, only one visit was made, and the only coverage which emerged initially was a ninety second clip of our Prime Minister speaking direct to camera in a back corridor of the Royal Victoria Infirmary in Newcastle, and a still of the matron walking him around with his police escorts. 

Despite the problems of drunk and disorderly patients that that the PM intended to highlight, the RVI normally only has one police officer on duty, and that only on Friday and Saturday nights.  David Cameron brought at least two police escorts, and his security was reinforced by confining patients to bed for the duration of his visit.  It has been reported by those present that the staff were not informed of his visit (because his previous visit had attracted organised protests, according to a local journalist).  One staff member told him that the Coalition’s NHS reform will be bad for patients and was then hustled away. Staff reported that no-one else was willing to speak to Mr Cameron. The journalists he arrived at the hospital with were locked in a room for most of the visit[3]. 

It would appear from the lack of further news that the other hospital visits on the PM’s itinerary have been cancelled. Presumably the spin doctors felt they might after all not ease the Bill’s passage.

Mr Lansley’s trip to the Royal Free Hospital in Hampstead soon after involved an entourage including at least four police officers and multiple security guards.  The visit culminated in an irate doctor chasing the Secretary of State down a corridor.

A YouGov poll taken four days after Mr Cameron’s Newcastle humiliation records that 60% trust health professionals’ organisations to tell them the truth about the likely effects of the NHS reforms. Only 10% trust David Cameron and Andrew Lansley[4]. A further 16% believe neither source, reflecting a surfeit of spin, disinformation and media confusion concerning the changes, and especially the Coalition’s persistence in accusing health professionals of pursuing their own self-interest in opposing the Bill. Extraordinarily, they argue both that the reform will benefit GPs and that GP opposition derives from self-interest.

In accusing those trying to prevent the commercialisation of our health service of party-political bias or “producer interests”, they ignore all the concerned patients and members of the public, of all political persuasions and none, who value and seek to defend the NHS.

 Simultaneously, they deflect attention from the self-interest of the private health industry, private equity, and financial services firms, all of which stand to gain handsomely from the commercialisation and commoditisation of patient care[5].

The agenda does not include discussion of the influence of corporate interests which have been lobbying and funding Coalition politicians, such as those which have captured leadership positions in Monitor, the body which will regulate the NHS: McKinsey [6]^,[7], McKesson[8] and KPMG[9].

The Conservatives have many donors and other financial interests which will profit from NHS privatisation[10], while the Liberal Democrats have fewer. Just the before the Liberal Democrat annual conference the Deputy PM made an extraordinary statement that whatever his membership decided via its internal democratic process at the Newcastle conference, he was determined that the Bill shall pass.  Last week’s Sunday Mirror[11] may shed light on this stance: the Liberal Democrats’ second largest donor is a family-owned group of care home companies.  They stepped up the size of their donations last year after giving around £1 million in total between 2004 and 2010. A new UK office has been established following the exposure of the dubious legality of past donations because the donor company was based in a tax haven rather than in the UK. Resumed donations from group company C & C Alpha provided the Liberal Democrats with a further £320,000 in 2011.  The Times earlier said about this[12]:

The Liberal Democrats’ main corporate backer is a care home business that has been giving the party nearly half its profits and whose ultimate ownership is secret.

Other major donors to the Liberal Democrats[13]:

• Brompton Capital Ltd[14], dealer in development land: £250,000 in 2010 and the same amount in 2011. The NHS has been instructed to hand over unused land to Andrew Lansley’s “PropCo”, as provided in Clauses 300-302 and Schedule 22 of the Bill, a move welcomed in the construction industry.
• £59,000 was given by Christopher Nicholson, a KPMG partner and a “key advisor to the NHS executive”[15]. He appears to be closely connected with the development of commissioning in the
• Simon B Ruddick gave £25,000. He is a hedge fund manager with private equity interests[16].

Companies require a return on political donations, and businessmen may too. This story implies urgent need for reform of political campaign finance. The NHS is being sold out by the present system.

Last month a second hospital (George Eliot Hospital in Nuneaton) was put up for privatisation through outsourcing, despite previous assurances that the transfer of Hinchingbrooke Hospital to Circle Health was a one-off. Bidders for the Nuneaton contract include Circle Health, Serco, and CareUK, whose chairman and his wife between them allegedly gave £203,500 to the Conservatives over the last five years[17]; his wife gave Andrew Lansley’s office £21,000 just before the last election[18]. 

Perhaps it’s time to commission new spin doctors. None of this looks good.