Government proposes inquiry into moving to a ‘pay NHS’



First posted 15.07.15 by Open Democracy – Our NHS

Last week the government quietly announced a review into the biggest political hot potato of all – and almost no-one noticed.

Imagine for a moment that you are the newly re-elected Conservative Prime Minister, and you want to launch an inquiry into whether the NHS should be paid for in future through user charges and insurance, not through tax.

But you’ve got a problem – you’ve just won an election without breathing a word that you were considering such a fundamental change to the funding of the NHS.

So how would you make such an announcement?

Very quietly, of course.

Last week the government did just that.

If David Cameron, or his Chancellor or Health Secretary had announced such an inquiry to re-consider a principle that has been sacrosanct since 1946, you’d expect front page headlines and Newsnight specials considering the implications. You’d expect a bit of a flurry (to say the least) about whether Cameron was back-tracking from his promises about what voters said was their number one issue.

But the launch of this inquiry has not been reported in the mainstream media, at all.

Why? Because it was casually announced by a little known minister, the newly ennobled “Under Secretary of State for NHS Productivity”, Lord David Prior, in the rarefied atmosphere of a House of Lords debate on the “sustainability” of the NHS, moved on 9th July by crossbench peer Lord Patel.

The principle of how the NHS is funded has (mostly) stood firm since 1946, summed up in clause 4 of its White Paper:

“All the service, or any part of it, is to be available to everyone in England and Wales. The Bill imposes no limitations on availability – e.g. limitations based on financial means, age, sex, employment or vocation, area of residence, or insurance qualification.”

That is, the NHS is available to everyone, whether or not they can afford to pay user charges, or whether they are insurable. The question about whether the NHS could be funded through user charges or insurance is answered here: No it shouldn’t.

But where better to have the sort of debate that no one has voted for, and launch an inquiry that no-one has voted for, than in the House of Lords, which no one has voted for?

Prior – recently elevated to the Lords from his stint as the strongly pro-market chair of the Care Quality Commission, formerly a Conservative MP and deputy party Chair – led for the government in the Lords debate.

Before he seized the opportunity to push his agenda, he said he listened to the “strength of feeling” in the unelected House.

Tory peers like Lord Cormack argued in favour of moving away from tax funding, saying:

“All forms of funding must be looked at. We have to have a plurality of funding if we are to have a sustainable NHS. Whether the extra funding comes from compulsory insurances or certain charges matters not, but it has to come.”

Matters not!? As a true Tory, he says that the funding should not come from taxing the rich (which he does not even countenance), but instead from taxing the sick.

More disappointing were the contributions from Labour peers like (the notoriously pro-privatisation) Lord Warner:

Our tax-funded, largely free at the point of clinical need NHS is rapidly approaching an existential moment. The voices of dissent and outrage will no doubt be deafening but a wise Government should begin now the process of helping the public engage in a discourse about future funding of the NHS.”

Far from endorsing the tax-funded system that is widely acknowledged to be the fairest way of paying for healthcare, here we have Labour peers suggesting the government should “help” the public to think of other ways to pay for healthcare.

Another Labour peer, Lord Desai, suggested bizarrely that patients should be issued with an “Oyster card” which is deducted whenever a patient uses healthcare, and patients should receive a “bill” at the end of the year, saying this would “help make it clear to people that a free National Health Service is not a costless one.”

Shades of Jeremy Hunt’s daft suggestion to put the price on prescription medicines.

But the problem with the NHS is not unnecessary demands, it is the sheer magnitude of people who need healthcare. An “NHS Oyster card” will not reduce the number of elderly people with acute co-morbidities. And if “consumer demand” is a problem, the solution is to turn patients back into patients rather than healthcare consumers, and remove the market.

Once their Lordships had had their say, Prior concluded for the government, saying that though he “personally” liked a tax-funded system,

“if demand for healthcare outstrips growth in the economy for a prolonged period, of course that premise has to be questioned.”

And he announced the ‘way forward’:

“I would like to meet the noble Lord, Lord Patel, and maybe two or three others, to discuss this in more detail to see whether we can frame some kind of independent inquiry—I do not think that it needs to be a royal commission. We are not short of people who could look at this issue for us; there are health foundations, such as the Nuffield Trust and the King’s Fund.”

Prior ignores the fact that the Kings Fund has already recently carried out an inquiry, the Barker Review, which rejected user charges and called instead for more taxes to pay for healthcare, in particular through a review of inheritance tax and national insurance increases. 

Both of which George Osborne has just cut, of course.

So Prior orders another inquiry, this time using people he has chosen and presumably people who will produce the desired result. Such a fundamental inquiry should involve the public and be held in public, but it appears Prior does not want the public involved.

Is Prior, in announcing an inquiry into so fundamental an issue, acting above his paygrade as an unelected junior health minister?

And are we being nudged towards an inefficient, unfair ‘pay NHS’ in the only way possible – undemocratically?

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Editors’ note:

We’ve been inundated with people asking how they can help fight this. We suggest contacting your MP and pointing out to them that the government health minister, Lord Prior, has just suggested to parliament that he plans to launch an inquiry to consider whether we should move away from a tax-funded NHS towards one funded by insurance and co-payments.

Ask them (if they are a Conservative MP) or ask them to ask David Cameron in parliament (if they are not) whether it is now official government policy to consider such a move to an insurance or user-fee funded NHS, away from the core principles of the NHS that have been in place since 1946?

You might also want to remind them that David Cameron said in 2011:
‘Let me make this clear – we will not be moving towards an insurance scheme, we will not introduce an American-style private system. In this country, we have this most wonderful, precious institution and idea. That whenever you’re ill, however rich you are, you can walk into a hospital or surgery and get treated for free. No questions asked. No cash asked. I will never put that at risk.’

And ask your friends to do the same!

About the author

Richard Grimes is an NHS campaigner.

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This article is published under a Creative Commons Attribution-NonCommercial 4.0 International licence. If you have any queries about republishing please contact Open Democracy

The Puppeteers at the BBC : (More Dishonesty, Disharmony and Broken Strings from the BBC)


 More Dishonesty, Disharmony and Broken Strings from the BBC

Challenging the false consciousness, in which much of the public are suspended has long been the greatest hurdle of the Left.

Even those who are cynical or sceptical of the lies and spin presented by politicians and the media are left uninformed. The break-up of trade unions by Margaret Thatcher made it more difficult to challenge the status quo, to question the propaganda, the pre-written scripts which led to demands for materialism and a rejection for socialism.  The impression endured because of a faith in the BBC.  There endured a respect for an institution, which they felt must be unbiased and truthful because it was publicly funded. The public looked to the BBC, expecting it would serve the public interests, inform, educate and entertain.

If it wasn’t on the BBC’s News, then as far as many were concerned it didn’t happen or was of little importance. Or in any case, anyone disagreeing was in a minority and could do little about it.

Whether that was ever true is questionable.  But it is true that the BBC is publicly funded, and there is a moral responsibility for presentation of facts backed by sound evidence and a balance of opinions, as well as quality broadcasting.


Since the 2010 general election, the BBC has presented the “News” in such a biased way, and  this has been discussed by many including  Think Left .

Last week the BBC (Oct 3rd, 2012)  the BBC reported on a case of benefit fraud (1), a typical report from the right wing media. There is no balance here  of argument, of context  or of relevant statistics. It is, without doubt an inflammatory report and intended to be so. It is just an example of the Coalition’s plan to harden support (2) for its welfare cuts.

The public would be better informed by the DWP’s own figures which show very low figures for fraud. 3)  Better still , considering the fraud of non- tax payers or tax avoidance might be far more informative and educational.

Additionally, a Freedom of Information document (4) from the DWP has revealed that rather than an average of 32 deaths per week as a result of Welfare Reform that figure has now risen to an average of 73 deaths per week.


The coverage of the financial crisis in Europe by the BBC (5) was in the least woefully inadequate. It seems more likely that the BBC had been informed what it should and should not be releasing.

We asked, “Who was pulling the strings at the BBC?” ( 6 ) Why, we might have asked, have we been constantly bombarded with ‘news ‘from the Middle East, if not to obtain broad support for a future war in Iran, even though the wars in Iraq and Afghanistan have now been widely discredited ?   The media and the BBC maintain their status as puppeteers of   the same oil-speculating corporations, who look to manufacture consent for a war in Iran. (7)


Privatisation of the NHS was cynically planned by the Conservatives prior to coming to power. Manufacturing consent for the privatization of the NHS was never going to be straightforward for the Conservatives. After all, not only was the NHS, Labour’s finest policy, it is loved and valued by the British people. It was no accident that Cameron faced the electorate with this promise.  “The NHS will be safe in our hands.” (8)


David Cameron launched a presidential-style election campaign yesterday with a focus on what party strategists believe is their greatest asset: himself.

A close-up photo of the Tory leader’s face will feature on hundreds of 15ft-wide posters as part of a £500,000 nationwide advertising campaign.

The posters – targeted at marginal seats the party must win to take power – were rolled out across the country to promote Tory health policies.

Think Left’s article The NHS will be shown No Mercy  (9) shows clearly that the plan to privatize the NHS was in place well before the election. Yet,  Cameron denied any knowledge of Mark Britnell, yet he had been invited to several very high profile meetings about the future of the NHS before coming to power. Mark Britnell  was advisor to David Cameron, also has connections to the then Health minister, Andrew Lansley.

That the billionaires who own the media will exert influence over their editorials is hardly surprising, but we should demand more transparency and balance from the BBC. Without orchestrated support for the government’s policy on the NHS, it is doubtful that the Conservatives would have nudged into power, albeit without a majority, as they did so on the back on Liberal Democrat voters who would never have supported NHS privatization.

And still it goes on.

The Guardian  (Oct 4th) last week reported of cuts to   NHS services for cancer patients  and heart and stroke patients. 10) This is not reported on the BBC,  but you will reference to a new drug preventing strokes which referred to a small trial by the pharmaceutical company NoNO and Arbor Vita. (11)

Open Democracy have recently completed a in-depth investigation: and published its results.

HOW THE BBC betrayed the NHS:  Two years of censorship and distortion. (12)

In the two years building up to the government’s NHS reform bill, the BBC appears to have categorically failed to uphold its remit of impartiality, parroting government spin as uncontested fact, whilst reporting only a narrow, shallow view of opposition to the bill. In addition, key news appears to have been censored. The following in-depth investigation provides a shocking testimony of the extent to which the BBC abandoned the NHS.

Reading of the article is recommended.

 Download the PDF of this article

 An extract:

Considering the enormity of reactions against the bill, from the public , the press and the medical profession, and considering the NHS is the most highly regarded institution in the country, it would be reasonable to expect the BBC to inform the public that it was being “reformed” without a democratic mandate. Indeed, it was being broken up in direct violation of explicit election commitments. How did the Beeb cover it?

The broken pledge of no more “Top down re-organisations” was mentioned in online articles (analysis and reporting) just six times in nearly two years: twice in 2010, three times in 2011 and just once in 2012 – the year of the bill’s climactic passing. Of those six, half appeared when quoting critics of the bill. Only three times did the BBC independently raise the broken agreement themselves.

In news and analysis articles, the issue was in fact raised just twice in nearly two years, and only once directly on the NHS. Neither example is the BBC’s own analysis; it only ever appears in two quotes. It was cited directly here [13], on an obscure blog as part of a resignation speech. The only other mention was in a general article on critics of the coalition, with their broad “mandate” to govern questioned by both Rowan Williams and Andy Burnham – who mentioned the NHS within that context.

In an unprecedented move, a UK court effectively ruled on the bill’s lack of a democratic mandate, in its judgement on government attempts to withhold the infamous ‘risk register’.  The court’s judgement included the following comments:

“From the evidence it is clear that the NHS reforms were introduced in an exceptional way. There was no indication prior to the White Paper that such wide-ranging reforms were being considered. The White Paper was published without prior consultation. It was published within a very short period after the Coalition Government came into power… Even more significantly the Government decided to press ahead with some of the policies even before laying a Bill before Parliament.”


As with privatization plans for the health service , the Coalition’s plan to break up local  school networks, the stripping of assets and the  of forcing schools to become Academies, seemed almost to pass unnoticed. The lack of, or false reporting by the BBC has muted the dialogue, for the Coalition to pursue their plot.

The Anti Academy Alliance reports: 13)

Anyone who doubts that free schools and academies are about privatisation and will ultimately lead to ‘for profit’ schooling should read this report from the ATL’s Martin Johnson . It tells how IES – a company that has a contract to run a school in Suffolk has seen its parent company sold to a huge US private equity firm. This is the corporate takeover of education!


The stark reality behind Free schools is summed neatly is this publication from the NASUWT

So, who does pull the strings at the BBC?  The close links between the Conservative led coalition and the BBC are revealed in the Open Democracy document, explaining why the BBC chose to represent the government on the NHS.

A number of senior BBC staff have links with the healthcare industry. As Media Lens note , Dr Mike Lynch OBE, a member of the BBC’s executive board, has links to a number of firms in the health sector, including Apax Partners, “one of the leading global investors in the Healthcare sector”. BBC Chairman, Lord Patten, is on the board of Bridgepoint, a private equity firm with substantial healthcare interests. Bridgepoint also employed the Labour health secretary, Alan Milburn.

“One company acquired by Bridgepoint for £414 million in July 2010 is the residential care company Care UK”

That’s the same Care UK who donated £21,000 to the personal office of Andrew Lansley. On BBC links with government, David Cameron’s Director of Communications is in fact Craig Oliver, whose prior job was as a senior news editor at the BBC.

In light of evidence uncovered by the Open Democracy, the British people are entitled to feel betrayed, and to ask what further strings are being pulled at the BBC Barclays chairman Marcus Agius was a BBC director. 14)  He resigned in July.  

It is quite clear that there are procedures in place ensuring that is in the interests of those with influence in the BBC to support the government’s policies. The corruption is not confined to the NHS. The BBC is attempting to keep its employees on strings too. It seems the BBC has actively been supporting people who work for the BBC to avoid paying tax.  The cross-party Public Accounts Committee (PAC) said it was “shocked” to discover how many off-payroll contracts, under which individuals must make their own tax and national insurance payments, were provided by the BBC.

According to the committee, that number includes 13,000 people who appear on television and radio – so-called on-air “talent” – and another 12,000 off-air staff. Some 3,000 are paid via private companies, potentially allowing them to limit their tax liabilities.

This is also reported in the Independent 

A study by Think Left revealed that one third of BBC newsreaders went to Oxbridge,  A Think Left investigation into the profiles of News presenters from BBC 24, Newsnight, Radio 4 Today/News at Ten has unsurprising outcomes. Where information was known, it was discovered that there is inherent sexism. There is and under-representation of women, and where there are women the age profile contrasts sharply with that of men.

Almost exactly two thirds of newsreaders went to private, independent or public schools, hardly representative of the general public.

This pie-chart shows the tertiary education of newsreaders, furthermore, exactly one third have had an Oxbridge education, much in line with MPs, as shown below.

Perhaps ordinary people might have more confidence in the message from the BBC if its newsreaders were paid realistic salaries in line with the majority of other public sector workers. The Director General earns £838,000. Other directors as of March 2011 had salaries of £488,000, £517,000, £467,000 and £452,000.

The personnel employed by the BBC, can hardly be regarded as representative of the people. They are very similar in their range of backgrounds to the MPs, and the same criticisms can be levelled at the news presenters who interrogate the politicians, and issues of the day. For the most part, they can have little personal experience of the lives of a majority of the population, and consequently do not ask the questions or single out the issues which would be of significance for that majority. For example, why would privatisation of the NHS be a priority for a presenter who has always used private medicine? Why would tuition fees of 9K/y seem enormous to a privately educated interviewer when top public school fees are 29K?

It might be forgiven if they showed an understanding of ordinary people’s lives. That was certainly not the case here – this filmed during the riots, and since removed from the BBC website. Darcus Howe , a West Indian Writer and Broadcaster with a voice about the riots. Here is speaking about the mistreatment of youths by police.

This was filmed during the riots, and since removed from the BBC website.

Corrupt politicians, media employees pull the strings in government and at the BBC. They attempt influence people’s understanding of reality. They have snapped the strings of democracy and it is a discordant tune they play.

People, quite rightly expect public servants to be accountable, and freedom of information is designed to ensure that. We ask it of our teachers, of our civil servants and our doctors and nurses. Isn’t it about time that we had accountability, transparency and honesty from our politicians and our publicly owned and funded BBC? It is at the very heart of our democracy. The people did not vote to sell of our NHS and schools. The TV licence is not a Licence for Lies.

On re-election we look to a new Labour government to reverse the privatization of our public services, and to ensure we have a BBC  to provide a quality broadcasting service to entertain, educate and inform as expected in a democratic society.

Let’s have a fair society. We deserve it. Every one of us.




4) Freedom of Information document query  

5) Think Left: Inadequecies of BBC’s coverage of the financial crisis.

6) Think Left: Who pulls the strings at the BBC? 

7) Manufacturing Consent for an Invasion of Iran 

8) Daily Mail report pre -election poster   Cameron  and the NHS is ‘safe in our hands”

 9) Think Left: Who said, “The NHS will be shown no Mercy?”


11. BBC: Drug may prevent stroke damage

12: Open Democracy: How the BBC betrayed the NHS

13: Anti Academy Alliance: Editor’s Blog October 2012

14: Guardian reports Barclays Boss is BBC director

15: Huffington Post on BBC and tax avoidance

16 Independent on BBC and tax avoidance

Think Left: Tom Pride – NHS  Cancer Care privatised (if anyone’s interested)

Think Left: The media has a distinctly Blue Tinge

Think Left Understanding Our World

Think Left: Academisation and the demolition of our Education System

The Guardian: The BBC: Coverage of the BBC Bill, reference to Open Democracy report: