Correspondence with John Penrose MP

John Penrose is a Conservative, but made health services a major part of his platform.

It is vital that he gets many letters from his constitutents urging him to resist handing the "franchise" to private companies. His position at present is that so long as the service is free, it doesn't matter who delivers the service. He is dodging questions about his many colleagues (including Cabinet Ministers) who have investments in health industries, and also questions about evidence whether private health delivery is more efficient than NHS delivery. The evidence is very much that the NHS model is more efficient.

Please write. Many people say "It's useless. MPs do not listen". This is exactly what MPs want to happen. They give one bland answering letter, the correspondent gives up, problem solved. You are bound to get a fob-off as a first response. Keep at it, send another letter. If your question has not been answered, put it to him again. And after a few letter, go see him at his surgery on Fridays, in Alexandra Parade.

There is a first letter here that you can use as a model. But do not just copy and paste, re-write it, and add your own point and question. We will build the correspondence up here as it develops.



Here is the latest letter :

Friday, December 06, 2013
John Penrose MP
House of Commons

Dear John
Thank you for your letter of 17th October. I apologise for the delay in replying.

You argue that private corporations can be more efficient financially in providing health care than the NHS, despite the fact that firms have to pay dividends and bonuses, because a number of other factors come in to play. You list operating efficiencies, customer focus, levels of customer choice, competitive pressures, and financing costs. The first four items sound like corporate management-speak. I only recognise financing costs as an effective operational advantage. Corporations can plan their finances as far ahead as they wish, whereas NHS providers are given a set annual budget. If they go over the budget, they are in deficit, and if they under-spend, that sum is clawed back and even lost in future years. This is clearly an inefficient way of running the NHS, and I would like to ask whether you are prepared to ask the Treasury to develop a more efficient funding method for public services?

As things stand, therefore, corporations do have an advantage regarding financing costs, but that advantage is maintained artificially by decision of Government.

Evidence for the efficiency of the NHS is manifest by comparing health expenditure per capita between the USA and UK. The US health system (which is the destination that successive governments are driving the NHS towards) is nearly twice as expensive per capita than the NHS, and it does not even offer care to the poorest in society, who have the highest health needs.

The closest model we have for the Weston situation is Hillingdon Hospital. I attach my letter to the TDA (Appendix A) as evidence that this is by no means proof that Weston should go to a private corporation. It is true that Hillingdon has produced some improvements, but at a cost, and they have had to borrow some £3million extra in their first year. The Hillingdon improvements could be copied in to Weston without privatisation.

The experience of rail privatisation gives the lie to the argument that privatisation is always more efficient. I attach a letter to the TDA to back up this point. (Appendix B)

You point to South Staffordshire as an example of failure in a public service. It is true that failure takes place in the NHS, for a multiplicity of reasons, not least rising demand and falling morale due to the unrelenting attack on the NHS from certain sectors of the popular press over the last few years. I have made a collection of scores of egregious failures on the part of private corporations. I will not bore you with them unless you wish to assert that “Private is good, public bad”.

I hope that you will agree therefore that there is no good the evidence that giving the franchise of services at Weston Hospital to a private health corporation, especially not those who are under criminal investigation, would be to the advantage of your constituents. Will you confirm this please?

Next, you seem to be trying to use the sub-contractor status of GP practices in the NHS as a model for privatisation. You say that GPs are just like corporations, making profit. I can tell you that when I started in general practice in 1979 the deal was, “Here is your 4,000 patients, here is your remuneration”, get on with it. And I did. Successive top down interventions by successive governments have made GPs much more profit conscious, so that some practices are issuing scripts monthly rather than bi-monthly, so that they got twice as much remuneration from their scripts, and the patients have to pay twice as
much in  prescription charges. There is also twice as much risk that patients will run out, which could, for instance, cause hypertensives on beta blockers to suffer a stroke. So yes, GPs are now more profit conscious, but this is far from being an improvement.  In Venn diagrams terms, there is a small overlap between the sub-contracting GP model and the private health corporation model, but is just that, a small overlap.

On the matter of conflict of interest, I think you will find it to your political advantage to call for Kathy Headdon to resign, as she is very likely to do so as her position is most clearly untenable. Another Conservative MP in Bristol have called for her to resign. It seems odd that you, as local MP, are holding back.

Regarding the Cabinet Ministers who have, or recently have had, financial interests in health care companies, I attach Appendix C (see below)  which details them. I would be grateful if you would check, as a Whip, that the Cabinet Ministers have either totally relinquished these interests (that is, have not just passed them to their family), or will absent themselves from Cabinet when decisions regarding Weston Hospital and NHS franchises generally are being discussed.

Finally, lest you begin to feel impatient with this correspondence, I would remind you that as an elected Member of Parliament, your primary duty is to serve the best interests of your constituents, and not to serve the current dominant ideology of the political party of which you are a member. I can see that you believe in the ideology, and I still believe that in your heart you do care about your constituency, but the evidence clearly points to the conclusion that the best outcome for your constituents would be for WGH to be partnered with an NHS Foundation.

Thank you


Appendix C


Interest of Cabinet Ministers, and those with access to Cabinet, in private heath corporations

Prepared for John Penrose MP by Dr Richard Lawson
Friday, 06 December 2013

1 David Cameron  (DC) Prime Minister has received £22,000 from Huntsworth, which has health interests. £10,000 went to his leadership campaign.

DC received £25,000 shortly after the health reforms were started from Lord Popat's TLC Group, which funds private nursing homes. Popat was made a Lord shortly after Cameron got into No 10.

DC has an adviser called Mark Britnell. He is/was head of KPMGs Global Health group. KPMG is heavily involved with the NHS  reforms and CCGs. Britnell said the 
NHS should be shown no mercy.

In 2005 Cameron 
received £1,500 from care home property company Chiltern Care Holdings according to the electoral commission.  

2 George Osborne (Chancellor of the Exchequer) invited Lord Nash, chairman of Care UK and founder of Sovereign Capital, which runs a string of private Health Care firms, to join his HM Treasury Independent Challenge Group, whose remit is to “question the unquestionable” in the Treasury's austerity drive. 

3 Philip Hammond, Defence Secretary
 was chairman of Castlemead Ltd for 2 years in the 90s. Castlemead has interests in design and procurement in the NHS. He still has a financial interest in Castlemead's performance.

4 Maria Miller (Secretary of State for Culture Media and Sport) is a former director of Grey's Advertising Ltd, who work extensively with clients in the healthcare sector.
Former director of the Rowland Group, which became Publicis Consultants, who are also a marketing company working extensively with private healthcare.

5 Andrew Lansley, the architect of the controversial Health and Social Care Bill that lies at the root of the current issue for WGH, was replaced as Secretary of State for Health by Jeremy Hunt after his bill was forced through Parliament.

Lansley received 
£21,000 for his personal office from John Nash, former chair of Care UK, one of the corporations who are interested in Weston Hospital.

One of his aides, Christina Lineen, went to work for 
Circle, again a corporation interested in Weston General.

Lansley was director of Profero, a marketing agency that acted for Diageo, an alcohol company that was accused in 2008 of flouting voluntary agreements, but whom Lansley nevertheless later allowed to "educate" midwives in alcohol advice.

6 Francis Maude has access to Cabinet. He was a director of Huntsworth until 2005, which has health and pharmaceutical interests. He is also non executive director of two other companies with interests in health care and software supplies to the NHS.

7Oliver Letwin: has access to the Cabinet. He was a non-executive director of N.M. Rothschild Corporate Finance Ltd until 2009. Rothschild Group are one of the world's largest investment companies and invest heavily in healthcare.

8 David Willetts has access to the Cabinet. He had financial support paid to his research account by HgCapital private equity manager, Ian Armitage in 2008. HgCapital 
funds healthcare companies.

9 Dominic Grieve has access to the Cabinet. Has shares in Reckitt Benckiser, GlaxoSmithKline, Diageo , Astrazeneca, Standard Chartered (Health insurance).

10 William Hague, Foreign Secretary, was in 2008 a director of AMT Sybex, a supplier of IT (computer technology) to the NHS.

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