In July 2018, The Independent and several other publications reported on campaign donations made by a prominent member of a right-wing think tank to the Health Secretary Matt Hancock. Four months later and The Guardian was reporting on complaints about Hancock’s enthusiastic promotion of a private GP app.

With much of the 2019 General Election focussing on the Conservative Party’s manifesto promise to “Get Brexit Done” and speculation that a US/ UK trade deal will involve US access to the NHS – any discussion of privatisation is met with furious denials that the Conservative Party is selling off the NHS.

Whether you believe the NHS really is up for sale largely depends on your politics. But less scrutiny has been given to how the Conservative Party has opened the door for would-be profiteers to influence public policymaking.

So, I set out to examine the players behind the two major controversies involving Mr Hancock.

Firstly, Hancock received campaign donations over nine years totalling £32,000 from Neil Record, the now Chairman of the Institute of Economic Affairs (IEA). Secondly, he publicly endorsed the private GP-app startup Babylon, founded by ex-Goldman Sachs banker Ali Parsa. Parsa had previously founded controversial hospital provider Circle Health.

The Minister(s)
Former 2019 Tory leadership candidate Matt Hancock, has had a meteoric rise to the top of the Conservative Party.

After a period of working as an economist, he became an economic adviser to the then Shadow Chancellor of the Exchequer, George Osborne. Later he became Osborne’s chief of staff. In 2010, Hancock was elected as MP for West Suffolk and rose rapidly through the ranks to become the Minister for Skills and Enterprise in BIS under Vince Cable in 2013. This was followed by stints at DCMS and most recently as Secretary of State for Health in July 2018.

Hancock’s financial connections to Neil Record begin with £18,000 in donations declared between 2010 and 2014. By 2018, this had risen to nearly £32,000 – money from a board member of a think tank that wants the NHS ‘abolished.

The “think-tank”
The Institute of Economic Affairs (IEA), is a registered UK educational charity, that operates as a free-market right wing think-tank and publisher of catchy titles such as “Why we need to abolish the NHS”, “How to abolish the NHS” and “Sharper Axes, Lower Taxes”.

Its current chairman is Conservative Party donor (and Matt Hancock fan) Neil Record, who has been a member of the Board since 2008 and Chairman since 2015. The IEA’s high profile Director-General is Mark Littlewood, while another Director, former Republican Party campaigner Kate Andrews is a darling of the BBC political chat shows.

Record made his fortune in financial services and is also a donor and board member of another think-tank the “Global Warming Policy Foundation”, a right-wing climate change denial organisation founded by Lord Nigel Lawson. Record is also a member of the pro-Brexit “Business for Britain” campaign along with well-known business leaders including Crispin Odey, Brexit Party GE candidate Rupert Lowe and Venture Capitalist Julie Meyer amongst others.

At the time of The Guardian article, the IEA issued a rebuttal of Records contributions, “His donation is personal. It is already in the public domain that he is a personal supporter of, and donor to, the Conservative Party. This in no way alters the IEA’s position of independence from alignment with any political party.”

But personal campaign donations aren’t the issue for the IEA. It’s proximity to government and a lack of transparency. Questions have been asked for years about who funds think tanks like the IEA and just how much access right-wing think tanks have had to government policymakers.

Andy Mayer, the IEA’s chief operating officer, said, “In any year around 5-10% of our income comes from the US (most of the rest from the UK).” However, Littlewood himself has admitted that the IEA “are a bit vague, to be honest, about what constitutes a donor”. What is known is that IEA’s readership is  roughly 40%  US-based, with annual income around £2.5m and that it has raised donations from American backers for two decades. These US donors include the controversial John Templeton Foundation which gave $497,000 to the Institute of Economic Affairs (IEA), between 2014 and 2017.

The Templeton Foundation money was donated specifically for “research into alternatives to the NHS for an ageing population and to fund work on inspiring young people to become supporters of free markets, according to the foundation.”

When the Tories came to power in 2010 Oliver Letwin, the new Minister of State for Government Policy invited Littlewood and other Westminster-based think tanks to discuss the Coalition’s “policy development”. Over the coming months, Littlewood gained significant access to Downing Street and government policy, including Cameron’s technology advisor Rohan Silva. Littlewood used this opportunity to make introductions to his network, including controversial American Venture Capitalist Julie Meyer.

In 2018 official investigations were launched into the IEA, after Littlewood was filmed offering potential US donors access to UK government ministers.

“Why Not Turn the NHS into a Trillion Pound Industry”
In June 2011, Mark Littlewood of the IEA and Ali Parsa, the then CEO of Circle Health were guests at a conference, hosted by Julie Meyer. Parsa spoke on “Healthcare; a £100bn Opportunity- Mixing the Need for Big Transformation with Big Society” and Littlewood on the “The Future of the State and Capitalism”. They would attend multiple events together hosted by Ms. Meyer.

At the time, Ms. Meyer, was a special advisor to both the IEA and Taxpayers Alliance (founded by the man behind Brexit, Matthew Elliott). Meyer was also an advisor to Vince Cable the Business Secretary between 2011 and 2015 – a time when Matt Hancock was a junior minister in BIS in charge of Enterprise and Skills.

She was also a digital advisor to one of Hancock’s predecessors as Secretary of State for Health, Andrew Lansley. Lansley being the man credited with enabling the mass privatisation of NHS services through the passing of the Health and Social Care Act 2012.

Meyer herself is a big fan of privitisation. In February 2012, Meyer appeared on BBC Newsnight arguing “why not turn the NHS into a trillion pound industry”. Later in 2012 she was awarded an MBE for services to entrepreneurship and continued to be associated with prominent figures including Prince Andrew and Conservative MPs including Liam Fox and Bernard Jenkins.

That was until 2017, when Meyer’s firm went into administration owing hundreds of thousands of pounds to taxpayers.

The serial Health Entrepreneur
Nearly a decade earlier in 2004, former banker Ali Parsa had founded Circle Health. Under Labour they secured contracts to operate a number of NHS treatment centres. But it was only in 2012 that the business rose to public prominence. On 10 November 2011, Circle signed a contract to become the first independent provider to privately operate an NHS hospital when it signed a £1bn, 10-year deal to run Hinchingbrooke hospital.

At the time Circle Health had three major investors, Lansdowne Partners (co-founded by Tory Party donor Paul Ruddock), Toscafund (whose boss Neil “The Rottweiler” Hughes was a vocal supporter of Britain leaving the EU), and Invesco Ltd. (an American investment management company that acquired WL Ross & Co. the company founded by Wilbur Ross, Donald Trump’s Cabinet Secretary for Commerce). Wilbur Ross famously said that Brexit was a “God-given opportunity” to steal business from the U.K and has been a vocal supporter of removing barriers to US access to British markets including agriculture and healthcare.

But Hinchingbrooke was a disaster. The Care Quality Commission (CQC) watchdog gave Circle’s management of the former NHS hospital their worst ever rating for “caring” and their lowest possible rating “inadequate” for both safety and leadership.

In Feb 2015, Circle said it would end the Hinchingbrooke deal seven years early and then promptly asked for a government bailout of nearly £10m, just six weeks before it was handed back to the public sector.

Despite this initial failure, in 2019 it was reported in NHS figures obtained by the Guardian that the number of patients receiving an operation in a private hospital had risen from 214,967 in 2009-10, to 613,833 in 2018. That represented a 185% rise in nine years under the Conservatives – Circle Health had treated 41,435. And in November 2019, Britain’s largest private hospital chain BMI Healthcare was in talks to be sold to Circle.

Parsa, who was paid a reported £1.1m a year, left Circle in 2012 and founded healthtech Babylon in 2013.

Babylon itself has become one of the UK’s tech successes – widely lauded for its GP video calling app. But it’s also been highly controversial and accused of diverting funds from GP practices, lacking fairness and cherry-picking which patients that can use the app. Its controversial GP practice is now one of the largest in the country but is estimated to have diverted £10m in funding from Hammersmith & Fulham CCG in 2018.

According to the Health Service Journal (HSJ), in 2016 Babylon also threatened to sue the Care Quality Commission to prevent the publication of a report questioning the safety and effectiveness of the Babylon app.

But the controversy doesn’t stop there. Boris Johnson’s Chief of Staff, Dominic Cummings has previously been an advisor to Babylon on its communications and senior recruitment strategy. And in 2019, Babylon announced investment from Centene, the largest Medicaid managed care provider in the US, who recently faced a grilling by the US Senate health committee.

In November 2018, Health Secretary Matt Hancock was accused of breaking the ministerial code by promoting Babylon in a sponsored newspaper supplement. The paid advertorial in the Evening Standard included a section entitled “Matt’s Apps” and a quote from Hancock where he promoted Babylon, saying that “this technology allows more resources for the people visiting GPs directly.”

Where does this leave Hancock and the Tories?
The NHS has long been a political football – a sacred cow or trade bargaining chip depending which way you lean.

However, for most rational individuals it is entirely possible to be both a supporter of a public NHS free to all at the point of use, and accept that private technology has a role to play in delivering smart new services.

But with a record £9.2bn of the NHS’s budget going to private firms, greater scrutiny is needed of just how these organisations gain access to NHS funding. With fears that Amazon may soon get free access to patient data, there is once again concern that access is not being granted for the good of patients but rather the enrichment of capitalists. And that access almost always starts with political favour.

The first layer of due diligence and complete transparency should thus not just be focussed on the quality of the technology but on who stands to benefit and how conflict of interest should be prevented at all costs.

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