By Lori Inglis-Hall @LoriInglisHall
In March, Real Media reported on the U.S lawsuit against private health giant United Health, in which the company is accused of defrauding federal Health Insurance provider Medicare and the US taxpayer out of billions of dollars. The Chief Executive of United Health’s Medicare arm during the time under investigation was one Simon Stevens, who now works a bit closer to home, as Head of NHS England.
But Stevens isn’t the only link between the NHS and United Health – enter Nick Seddon, Executive Vice President of Optum, a section of United Health which provides services to – yes, the NHS. You might have heard of Seddon. In 2013, there was a whimper of uproar when David Cameron brought him into No.10 as his Special Advisor for Health, but not because of Seddon’s overt support for handing over large chunks of the NHS to private companies (more of which later), but because of his background as a Lobbyist. In 2010 Cameron had called for an end to the ‘cosy club’ of Lobbyists and Politicians (‘It arouses people’s worst fears and suspicions about how our political system works’), but just three years later had apparently forgotten all about this, and Seddon was in.
As Deputy Director of pro-market thinktank Reform, a mouthpiece for private healthcare and insurance companies, Seddon had made an impression on Cameron during the passage of the Health and Social Care bill, with his fierce lobbying in defence of competition in NHS commissioning. The NHS needed innovation, he argued and for Seddon, innovation could only be delivered by opening up the Health Service to outside forces. He declared an urgent need for radical thinking because;
‘The crisis facing healthcare in the UK is not a sudden storm, but climate change. If we want the NHS to survive we will need to transform the relationship between the individual citizen and the state.’
In several articles published during his time at Reform, Seddon repeatedly highlighted the case of Valencia in Spain, in which private companies had taken on the running of a fifth of hospitals and primary care services. He argued for a loosening of the hard-won regulations which protect NHS workers, including an end to collective bargaining and national pay scales, because pay accounts for 60% of an average Trust’s costs and ‘this is about saving money’. He called for a complete overhaul of the business model, in which patients are given individual budgets and the ability to ‘buy the care they need’, because to people like Seddon individual choice, as well as competitive services, top a clinical responsibility to deliver necessary care.
In a Telegraph article, Seddon highlighted the delays many patients experience in trying to secure a GP appointment, but instead of examining the cause – chronic underfunding of services by the Government – he highlighted American health service plans which allow patients to ‘choose services’. All the talk we’ve heard in the last few years about paying for GP appointments? That was Seddon.
Seddon is clever with his language. Profit is never mentioned, only savings, and patient care is paramount. It is all for them, of course, and the staff, who are unmotivated because they work in a system which is broken rather than a system which is being systematically broken by his future paymasters. At Reform, Seddon was a mouthpiece for the private healthcare and insurance companies which fund the thinktank, yet media organisations such as the Telegraph and the Guardian allowed him to present his arguments with little mention of his professional agenda nor his history. Before Reform, Seddon held a senior position at Circle, the first private healthcare company to take over the running of an NHS hospital.
Seddon left Government in July 2016, shortly after David Cameron’s resignation. The damage wrought on the NHS during Seddon’s tenure was severe. Budgets were slashed, the quality of care fell, doctor’s protested, and in 2015 alone privatisation of NHS services increased by 500%. So, in terms of our beleaguered health service, you might be forgiven for thinking Seddon’s departure was a positive move…
…Except, just four months after leaving Downing Street Seddon was appointed Executive Vice President of Optum, part of U.S private healthcare behemoth United Health, which as previously mentioned, is currently under investigation by the U.S Department of Justice. Optum has had its own troubles, and Seddon’s move comes at a critical time for the company. In July 2016, Optum paid an $18 million fine in the US following allegations they put non-terminal patients into palliative care hospices, as a way of squeezing more cash out of, yes you guessed it, Medicare.
Optum already provides services to 156 NHS organisations, including contract negotiations and medication management. Surely that’s a conflict of interest, I hear you cry! And you’d be right, except in 2014 David Cameron changed the rules, meaning Seddon’s move from the public to the private sector no longer had to be vetted for such conflicts. The Cabinet Office approved Seddon’s new role on the condition that he did not lobby the UK Government for two years or draw on privileged information he may have gathered during his time at the heart of Cameron’s team, which seems like something akin to a pinky swear to be good.
NHS campaigners claim Seddon’s move illustrates the ‘wafer-thin partition’ between government and the private healthcare industry. Another example would be Simon Stevens, moving from his role as adviser to Tony Blair, to United Health, and back again, as Chief Executive of NHS England. The Huffington Post calls this constant movement of lobbyists and officials between the public and private sector ‘influence laundering’.
What is clear is that Seddon remains as much of a threat to the NHS as he was when he was driving Government policy. Much has been written of the possible future relationship between U.S private healthcare companies and the NHS in post-Brexit Britain, but the reality is that the infiltration has already begun. The U.S companies are here, and the Government is waving them in.