It's now two months since the Labour Party conference voted historically and unanimously for complete renationalisation of the NHS in England and for active opposition from all Labour politicians to the Americanisation process known as Sustainability and Transformation Plans (STPs) and Accountable Care Organisations (ACOs). The STPs and ACOs were imposed by NHS England in order to prepare the NHS – already, little more than a logo and a funding stream – for health insurance and privatisation; they impose fixed, localised budgets within which a restricted range of services is to be provided, similar to the US health maintenance organisations on which they are modelled.
At the Health Campaigns Together conference on November 4, shadow health secretary Jon Ashworth said that Labour would 'halt STPs and American-style ACOs.' But as yet there is no sign that Ashworth and his team are encouraging Labour council leaders to join Hammersmith & Fulham and Ealing councils in actively withdrawing all collaboration from these destructive plans. Nor has Labour supported its members by producing any campaign leaflets reflecting the new renationalisation policy.
The composite motion at conference also called for an NHS Reinstatement Bill like the one taken to second reading in the previous Parliament by Margaret Greenwood MP. Such a bill would send out a powerful message about Labour's commitment to renationalisation. We await any indication that tabling of such a bill is to take place. Meanwhile, 72 Labour, SNP and Green MPs have signed a pledge supporting the bill's principles.
Two positive developments are the proposed judicial reviews (JRs) crowd-funded by the 999 Call for the NHS group and by a consortium including NHS Reinstatement Bill author Professor Allyson Pollock and former Deputy Chief Medical Officer Dr Graham Winyard. The first JR challenges the right of the government to replace comprehensive NHS care with an ACO based on a rigidly fixed budget and a restricted range of health services designed to fall short of people's needs. The second challenges Jeremy Hunt's right to impose the ACO contract with neither Parliamentary scrutiny nor public consultation. A third JR is being developed, to challenge the downgrading of hospital services in Banbury, Oxfordshire.
The Skwawkbox blog recently revealed that on 1 November, line management of the political advisers (PADs) to Labour's shadow cabinet moved from Simon Jackson (Director of Policy and Research, based in Labour HQ) to Andrew Fisher (Executive Director of Policy based in the Leader’s Office, in the parliamentary estate). This means that PADs will be taking their political and policy line from close colleagues of Jeremy Corbyn, under the oversight of Andrew Fisher, who was chiefly responsible for the party’s hugely successful General Election manifesto – and not from the still largely right-dominated Southside HQ.
Given that Jon Ashworth's Parliamentary Private Secretary Alex Norris MP, helped develop the Nottingham STP and maintains links with the private health sector, this change of responsibility for PADs has to be viewed positively. The Nottingham STP was the first to explicitly include a private sector partner, the US health insurance giant Centene - whose Spanish partner Ribera Salud has been fined 150,000 Euros for exposing workers in Valencia to carcinogens. The Nottingham ACO is modelled on Ribera Salud's Valencia operation.
These toxic private sector linkages relate directly back to Simon Stevens, chief executive of NHS England and former health adviser to Tony Blair. Prior to his current appointment, Stevens spent 10 years working for predatory US health corporation UnitedHealth. During this period he and colleagues from transnational corporations at the World Economic Forum, worked together to devise strategies for undermining and privatising global public health services. The various elements of NHS England's Five Year Forward View (such as the undermining of NHS hospitals, leading to their replacement by community based, deskilled packages of care, ripe for health insurance funding and privatisation) precisely reflect the strategy developed at Davos.
One reason the Labour Party has failed to oppose the FYFV in the past has been the way in which NHS England has actively sought links with significant Labour politicians and sympathetic journalists. At present, Stevens is actively distancing himself from Hunt and May by his assertive public demands for increased funding. Like his former boss Blair he is seeking to re-establish a reputation in Labour circles. But while a proportion of any funding increase will be spent on austerity-starved clinical services, much would be wasted on the heavy management costs of the STPs and ACOs and the haemorrhage of tax revenues to Centene, McKinsey and Hunt and Stevens' corporate friends.
We must hope that the many constituency parties currently passing motions urging local and national Labour politicians to fully implement Labour Party policy achieve the impact we all fervently desire. As we enter the year of the NHS's 70th birthday, we cannot wait for the next election – we must act now to save and to reinstate what the 2017 manifesto rightly called our proudest achievement.
Alex Scott-Samuel is Chair of the Socialist Health Association