Last week, David Cameron felt the need to deny that the Transatlantic Trade and Investment Partnership (TTIP) – a controversial free trade deal being hammered out between the US and EU behind closed doors at the moment – would open up the NHS to cash hungry US firms that want to make money out of your broken leg. It's weird, then, that the head of "NHS England" was determined use the deal to do exactly that until very recently.
NHS England is the money side of the NHS. It handles the budgeting and commissioning of health services. That makes its boss, Simon Stevens, one of the most important people in the whole NHS operation.
Stevens was appointed in April, but his past has led people to fear that he'll oversee a new era of privatisation in the NHS. Stevens worked for US health giant UnitedHealth from 2004 to 2013. In that role he became a founder member of a US lobby group explicitly trying to use TTIP to force state-run health systems, including the NHS, to employ private health firms from the US.
In 2011 UnitedHealth helped found the "Alliance for Healthcare Competitiveness" (AHC). Stevens personally launched AHC at a "Congressional Briefing" before top US politicians. He was put forward as one of the group's press spokesmen.
I've looked over the documents of Stevens's lobby group and they show that just two years ago, it was trying to force NHS privatisation by using the trade deal to override any objections to US corporations taking over slices of the NHS.
Stevens has tried to dodge the question of his commitment to NHS privatisation, but his involvement in "TTIP" lobbying shows just how deeply he is committed to US-led health privatisation. With Stevens at the helm, AHC wanted the US government to create a "Special Negotiator for Health Industries" who would use trade talks to create business for US health firms. AHC papers explicitly say trade deals should break open state-run health systems like the NHS to US companies.
Stevens launched an AHC "White Paper" on "trade" in "health" In 2011. It was full of business school jargon. According to Alliance's own summary of their paper, it was arguing for the removal of "Foreign government policy measures favouring state-owned enterprises (SOEs) and state-supported enterprises (SSEs)".
In a rare moment of clarity, the paper explains what SOEs and SEEs actually are. "In the health care sector State Owned Enterprises and State Supported Enterprises may take the form of hospitals". So: Governments shouldn't be allowed to favour their own hospitals above private ones. If a dodgy health company with a bad track record wants to muscle in, you'd have to treat them as an equal.
This is an extension of the privatisation that took place under Tony Blair. Funnily enough, Stevens was Blair's health adviser until 2004. Under Blair and Stevens, the NHS handed over hospital buildings, along with their cleaning and catering staff, to private firms under ruinous "Private Finance Initiative" deals that are part of the reason for the financial crisis in the NHS today. They also handed batches of NHS operations to private sector companies.
But under Stevens's plan for TTIP, Britain would not be able to even choose which parts of the NHS to privatise. They would have to let all NHS hospitals compete with US corporations on a "level playing field". The NHS would not be allowed to favour NHS hospitals when deciding who should do NHS operations. Stevens's White Paper said governments must "not offer advantages" to their own health services "at the expense of private capital, including foreign or foreign-invested competitors". He wanted trade rules to force the NHS to give contracts to firms like UnitedHealth, his then employer.
The White Paper covered trade deals in general, but his AHC soon looked specifically to TTIP – the one Cameron just insisted definitely won't privatise the NHS – as the deal to crack open the market. In February 2012, the AHC wrote directly to the US official negotiating TTIP with the European Union saying he should focus on "open markets" in healthcare. Stevens told the US negotiator to ensure, "Competitive government procurement systems and disciplines on State-owned Enterprises, to ensure access and avert discriminatory purchasing requirements in goods and services".
He's a snappy communicator, clearly. What he's saying is that the TTIP should include opening up the NHS to US corporations. Stevens wanted to use TTIP to privatise the NHS long before most people had even heard of the deal.
Central to Stevens trade proposals was the removal of "market distortions posed by State Owned Enterprises and State Supported Enterprises". So while most people might think of the NHS as something reassuring, to Stevens it's a "market distortion" – an aberration stopping the free market from working its magic, and something to be removed by TTIP.
Of course, Stevens doesn't work for UnitedHealth or AHC any more, but still, I called to ask NHS England if I was right to worry that the new head of the NHS used to be involved in lobbying. After two days, an NHS England spokesperson told me they could not answer this question because it was "political". He said I should ask the Department of Health. So I did that. They didn't give any answer at all: they said nothing. I guess until they allay my concerns, I'll have to keep worrying about the NHS's head of budgets and contracts being a former US corporate health lobbyist.
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