Health reform backers’ agenda: Cut the front line, introduce upfront payments

The real agenda of the backers of Andrew Lansley's ill thought out health reforms is to cut the front line and introduce upfront payments, writes Daniel Elton.

The official line on the health reforms from David Cameron, Andrew Lansley and Nick Clegg is that the proposed changes keep the principle of an NHS free at the point of delivery, reduce bureacracy and protect frontline staff. Obviously health and social care bill cheerleaders free market think tank Reform – who are, for some odd reason, a charity – missed the memo.


In its submission to the government’s listening exercise it castigates the coalition for its rhetorical soppiness over the NHS bill and insists that ministers stop arguing: 

“…that management costs are too high. In fact good health systems depend on good management. The real inefficiency in the NHS is elsewhere. [The Government also] argues that the “front line” of NHS services should be protected from change, in particular the “front line” of services and hospitals.

“In fact the “front line” accounts for over 80 per cent of NHS staff and hospitals account for around 60 per cent of the budget. “Protecting” these areas amounts to a veto on any real change at all.”

Most provocatively of all, Reform want to introduce upfront payments into the NHS:

“Deliver a sustainable NHS by combining taxpayer and private payment, again on the model of most other countries.”

This, despite all the talk of the need for increased NHS efficiency, the UK having  one of the lowest health spends in the developed world.

This could be dismissed as the wild-eyed dreams of a turbo-thatcherite think tank, except Reform is rather more important than that. As previously reported on Left Foot Forward, it is part of a web of think tanks, lobbyists, health corporations and politicians who have been driving the NHS reform process.

Reform sub-group ‘Doctors for Reform’ is chaired by Dr Paul Charlson, who is also chair of Conservative Health, formerly known as the Conservative Medical Society and directly affiliated to the Conservative Party.  Another sub-group of Reform, Nurses for Reform, is headed up by Dr Helen Evans who has called the NHS a ‘Stalinist abhorrence’ and a ‘sixty-year mistake’ was invited by the David Cameron for a one-on-one meeting before the election where she expounded such ideas as:

 “…the view that the state should not own or have any of its agents manage hospitals,[and] a world of widespread health advertising (to overcome problems of patient ignorance through trusted brands).”

In fact the revolving door never stops: Reform’s deputy director Nick Seddon was previously communications director for private hospital firm Circle, where he was replaced by ex-Andrew Lansley aide Christina Lineen.  Reform itself has received thousands of pounds of donations from the private healthcare industry including General Healthcare Group, whose Chairman, Sir Peter Gershon, David Cameron appointed to advise the Conservatives on how to cut the public sector.

When you see whose for the the NHS health reforms, its not hard to see why so many are against them.

Update 1625hrs:

Nurses for Reform is not linked to Reform, but does have deep links to the equally anti-NHS Adam Smith Institute. Further investigation has found that Reform is also funded by private healthcare providers GE.

9 Responses to “Health reform backers’ agenda: Cut the front line, introduce upfront payments”

  1. Underthebed

    Health reform backers’ agenda: Cut the front line, introduce upfront payments – //bit.ly/jlj3r0

  2. Dave Citizen

    The best explanantion I have come across for understanding the constant pressure to privatise is set out in Prof. David Harvey’s book “The Enigma of Capital”. Harvey describes how capitalism requires the economy to deliver at least 3% growth each year if it is to remain stable (i.e. not risk heading into recession). This creates a constant demand for new investment opportunities to absorb the returns on investment so as to create the 3%+. Traditionally it was the productive industries like manufacturing that soaked up the returns but in economies like Britain’s, such industries struggle to provide enough opportunies. Thus, the pressure mounts elsewhere, especially in low risk, high value areas such as the NHS.

    If Harvey’s right, the education budget is likely to be next! Even more worrying, once bits of the public sector get drawn into the profits growth economy, the demand for more next year and the year after just keep getting bigger, locking the stability of our economy into privatised and profitable public services. Watch out if the rest of the economy takes a nose dive!

  3. Mr. Sensible

    As we go further and further on in this listening exercise things get more and more revealing.

  4. London IWW

    Health reform backers’ agenda: Cut the front line, introduce upfront payments //dlvr.it/T9h2l | #SaveTheNHS #NHS #KeepOurNHSpublic

  5. Pro-cuts think tank Reform takes public sector sponsorship | Left Foot Forward

    […] public sector contracts, and then advocate for ever greater outsourcing – for example, in the NHS. (Although how that qualifies Reform to charitable status is […]

  6. So who backs Lansley's health reforms then? | Left Foot Forward

    […] once again we have the ridiculous spectacle of supporters of the bill speaking in favour of up-front costs, which the government has promised […]

  7. mittfh

    Surely the whole point of “consultations” and “listening exercises” is to give the illusion that the public have a voice, while the politicians responsible vow to do what they were planning to do anyway, and most likely will ignore all negative / critical comments.

  8. The future of the Conservative Party: Big-state Toryism | Left Foot Forward

    […] may explain why Reform have a track record if backing co-payment – where services are paid for by users and subsidised by the […]

Leave a Reply