The government, IDS and Katie Hopkins are all lying about food banks – the evidence that welfare “reforms” are causing poverty and hunger

Katie Hopkins is hardly renowned as a great intellect. In fact she’s famous for her stupidity, for example criticising people who named their children after countries on live TV when she called one of her own children India.

However there is more to her than just a brainless celeb. She’s also a brainless celeb who was handed everything on a plate from the age of 3 in an incredibly pampered upbringing as part of a smug establishment, but loves to condemn people so poor they rely on food banks to eat .

She has become a spokesperson for the rich and powerful, targeting the poor and the powerless on their behalf. That’s not exactly a hard position to get if you were born into the right family. There are thousands of the smug braying nobodies spilling nonsense at us from every newspaper from the tabloids to The Telegraph. They have these positions not because of any talent, but because they are part of the smug establishment, “one of us” , grew up with them, went to public school with them.

No wonder The Sun gave her a column and she goes out shooting with its editors. And The Sun pretends it’s the newspaper of ordinary people!

They share their prejudices and blind ideology, which is why Hopkins is so often stating her agreement with something tory government ministers like Michael Gove have said. In her ludicrous Huffington Post piece on food banks she quotes him on those who rely on food banks supposedly only having to do so because they mismanage their finances.

What a co-incidence that Iain Duncan Smith, the Work and Pensions Secretary, condemns food banks too. And they both, like Hopkins, are tories who went to public school (1).

Hopkins claimed recently on twitter that only people who deliberately give up working could become poor.

She also tweeted that “Food banks are bridging the gap between income and the number of Sky, mobile, car finance contracts clueless individuals prioritised.”

And she keeps on posting links to her own 2013 comment article as supposed proof that food banks are “a complete con”. (2) – (3)

Hopkins’ idiotic witterings would be irrelevant on their own. But they’re part of a propaganda campaign against the poorest by the government, political parties and the establishment. So the lies have to be challenged.

Now let’s take a look at the facts – or more accurately the lack of them – in her piece on food banks.

Hopkins writes that

‘One food bank user commented: "We were given a food parcel. Me and my partner sat down and ate for four hours solid until it was all gone".

To get hold of this free food, users have to wangle a voucher from an agency worker at a job centre or drop in clinic, supposedly to a maximum of three. This limit is not enforced.

Oscar-winning performances of desperation are plenty. A recent BBC documentary showed one man lying that it was his son's birthday in order to procure a voucher.

Individuals like this have become vouchers tourists travelling between agencies, collecting vouchers quicker than genital warts on a student.’ (4)

No source for the “comment” from the food bank user. Googling the quote provides no sources for it. So basically her entire article is based on one BBC documentary.

Given the date of her article it has to be ‘Britain’s Hidden Hungry’ from November  2012. Either she didn’t watch it or else she just picked out the bits she liked, because even the summary on the BBC website page says:

‘Care-leaver Charlotte eats just one meal a day. It's all she can afford, so she starves herself till evening. Sandra, middle class mother of five, is embarrassed that all she can give her son for his school packed lunch is bread and butter. Middle manager Kelly, mother of two, hasn't eaten for two days. Meet Britain's hidden hungry.

As of 2012, more than 170,000 people are believed to be dependent on a chain of 300 foodbanks run by a Christian charity, the Trussell Trust. Bafta award winning film-maker David Modell has spent six months at the Coventry foodbank following the stories of Charlotte, Sandra and Kelly to find out how, in 2012, so many Britons are suffering genuine and prolonged bouts of real hunger.’

Another BBC documentary on hunger and food banks this year ‘Hungry Britain’ came to similar conclusions. You can watch that documentary online here.

A report by Oxfam and Church Action Against Poverty in 2013 found that:

‘We estimate that over 500,000 people are now reliant on food aid – the use of food banks and receipt of food parcels ….Some of the increase…is caused by unemployment, increasing levels of underemployment, low and falling income, and rising food and fuel prices. The National Minimum Wage and benefits levels need to rise in line with inflation…

…up to half of all people turning to food banks are doing so as a direct result of having benefit payments delayed, reduced, or withdrawn altogether. Figures gathered by the Trussell Trust …show that changes to the benefit system are the most common reasons for people using food banks…

There is a real risk that the benefit cuts and the introduction of Universal Credit (which will require internet access and make payments less frequently) will lead to even larger numbers being forced to turn to food banks. Food banks may not have the capacity to cope with the increased level of demand.’ (5)

A recent report of an inquiry into food banks and hunger by MPs of all parties had similar findings – that the main causes of food bank use were rising costs of food, energy bills, low wages, unemployment and welfare “reforms” (6)

So Hopkins, like IDS and Gove, is picking out a handful of examples of people exploiting food banks and ignoring the mountain of evidence that the majority of people going to food banks are in genuine poverty and would go hungry without them.

And now on the lie that most people in poverty are unemployed and unemployed because they don’t want to work.

First, large numbers of people going into work remain in poverty (under 60% of median income or £119 per week for an adult or £288 for a couple with two children) or in deep poverty (a third or less lower income than that). Since 2012 there have been more people in work and in poverty than out of work and in poverty in the UK (7) – (8).

Newly created jobs have increasingly becoming part-time and/or low paid over the past two decades. This accelerated after the banking crisis with the number of people in the UK who want full-time work but can only get part-time having increased by 1 million between 2008 and 2012 alone (9).

Second the number of unemployed people continues to exceed the number of job vacancies even on the government’s figures of 1.96 million and 637,000 respectively, which fiddle the former down and the latter up (10) – (11).

So much for Katie Hopkins’, IDS and every other propagandist and useful idiot who claims food banks are “a con” and that anyone in hunger or poverty is there purely due to their own failings.

Sources

(1) = Independent 22 Dec 2013 ‘Iain Duncan Smith accuses food bank charity the Trussell Trust of scaremongering’, http://www.independent.co.uk/news/uk/politics/iain-duncan-smith-accuses-food-bank-charity-the-trussell-trust-of-scaremongering-9021150.html

(2) = Huffington Post 18 Oct 2013 ‘The Real Reason Food Banks Have Trebled’,
http://www.huffingtonpost.co.uk/katie-hopkins/food-bank-real-reason-use-has-trebled_b_4121733.html

(3) = Huffington Post 10 Jan 2014 ‘Katie Hopkins Calls Food Banks 'A Complete Con' And Defends Benefits Street (VIDEO)’, http://www.huffingtonpost.co.uk/2014/01/10/katie-hopkins-food-banks_n_4574311.html

(4) = See (2) above

(5) = Oxfam & Church Action Against Poverty 30 May 2013 ‘Walking the Breadline: The scandal of food poverty in 21st-century Britain’, http://policy-practice.oxfam.org.uk/publications/walking-the-breadline-the-scandal-of-food-poverty-in-21st-century-britain-292978

(6) = BBC News 08 Dec 2014 ‘'Pay benefits faster' to reduce hunger, MPs urge’, http://www.bbc.co.uk/news/education-30346060

(7) = Joseph Rowntree Foundation 06 Dec 2010 ‘Monitoring poverty and social exclusion 2010’,
http://www.jrf.org.uk/publications/monitoring-poverty-2010

(8) = Joseph Rowntree Foundation 26 November 2012 ‘In-work poverty outstrips poverty in workless households’, http://www.jrf.org.uk/blog/2012/11/work-poverty-outstrips-poverty-workless-households

(9) = ONS 28 Nov 2012 ‘People in Work Wanting More Hours Increases by 1 million Since 2008’, http://www.ons.gov.uk/ons/rel/lmac/underemployed-workers-in-the-uk/2012/rpt-underemployed-workers.html

(10) = ONS Statistical bulletin: UK Labour Market, November 2014 ‘Vacancies Aug – Oct 2014’,
http://www.ons.gov.uk/ons/rel/lms/labour-market-statistics/november-2014/statistical-bulletin.html#tab-14--Vacancies

(11) = ONS Statistical bulletin: UK Labour Market, November 2014, ‘Key Points for July to September 2014’,
http://ons.gov.uk/ons/rel/lms/labour-market-statistics/november-2014/statistical-bulletin.html

Hundreds of MPs and Lords with financial interests in private healthcare firms revealed showing conflict of interest on NHS ' reforms'

The excellent Social Investigations blog  has found hundreds of conflicts of interest and financial interests of MPs and Lords who have voted for the Coalition government’s NHS reforms , relating to private healthcare firms (plus there are some among the right of the Labour party who are supporters of PFIs or PPPs ).

This post on Conservative members of the House of Lords’ links to private healthcare firms is particularly eye-opening.

I’d already posted reports from the Guardian on some of the private healthcare firms whose executives donated money to the Conservative party – and on one adviser to the current government moving to the healthcare division of a major accountancy firm, but from Social Investigations’ work, this seems to have been only the tip of the ice-berg.

Things are almost as bad as in America where many of both main parties’ members of congress are in the pockets of private healthcare firms, though some Democrats remain above board in this respect and so do many Labour MPs.

There's no public or professional support for the NHS privatisation reforms - and the LSE Study's indicators can't measure quality of patient care

David Cameron’s planned NHS reforms are opposed by more than twice as many people as support them. A YouGov poll this month found 48% oppose them and only 14% support them (1). That’s up from 41% opposing them and 20% supporting them in a June 2011 YouGov poll, showing that as people hear more about the ‘reforms’ they like them less and less (2).   The rest are don’t knows, probably because they don’t understand the reforms, which is no surprise because even Professors of Healthcare funding say they don’t understand how they’re meant to work in practice.

The British Medical Journal reports that ‘Despite 25 years of experience researching health systems, including writing over 30 books and 500 academic papers, Professor Martin McKee from the London School of Hygiene and Tropical Medicine says he still can’t understand the government’s plan for the NHS.

In a Personal View published on bmj.com today, he writes: “I have tried very hard, as have some of my cleverer colleagues, but no matter how hard we try, we always end up concluding that the bill means something quite different from what the secretary of state says it does.”’ (3)

Mark Britnell, a former adviser to David Cameron, is now head of the Healthcare division of accountancy firm KPMG told a conference of private healthcare companies that the NHS would be shown “no mercy” in the reforms leading to “big opportunities” for private healthcare firms (4). No wonder Andrew Lansley and David Cameron don’t want people to be clear about what their ‘reforms’ would involve.

Cameron later claimed to have no idea who Britnell was and to have never met him, despite Britnell being the head of the NHS body covering Cameron’s constituency and NHS Oxford documents showing Britnell and Cameron had definitely had at least one meeting. The Financial Times reported that Britnell certainly was in meetings with Paul Bate, Cameron’s special adviser on healthcare, so either way clearly has some input into and understanding of the government’s healthcare plans (5). (The fact that Britnell was a senior NHS official under Labour might ring alarm bells about the right wing of the Labour party too).

The “quite different thing” which the bill will actually involve if it’s passed is likely step by step privatisation, as with the Royal Mail, with the planned end game being to set the NHS impossible tasks to compete with private firms who are cherry picking the profitable business and leaving the expensive work to the public sector, which is then judge to have failed and so to require privatisation (and when I say ‘work’ I mean ‘patient care’ as we ‘dinosaurs’ who don’t see ensuring everyone can afford healthcare as just an impediment to profits for private firms)

he June 2011 poll also showed 71% opposed privatisation of the NHS with only 7% supporting it (6).  So if more understood the reforms include private companies running NHS hospitals, even more would oppose them.

Private healthcare firms like Care UK are reported to have donated money to Health Secretary Andrew Lansley’s office and Paul Ruddock, who, according the the Conservative Home website, donated over £480,000 to the Conservative Party , is one of the major shareholders of Circle Healthcare, the first private company to be given a contract to run an NHS hospital.

The reforms are also opposed entirely by 75% of GPs and 65% of all NHS employees polled ; and many more want them changed. If passed they would result in much of already overworked doctors and nurses’ time being spent on management rather than patient care (7) – (8).

Many studies show increased competition leads to increased death rates among heart attack patients, an internationally accepted measure of patient care (9) – (11).

Some others claim evidence that competition improves patient care – but the indicators they use as supposed measures of ‘efficiency’ , ‘productivity’ and ‘quality of care’ can’t show anything of the kind. For instance the recent London School of Economics study, which supposedly found competition improved care, used how long patients stayed in hospital before and after hip operations as it’s only indicators. Yet shorter stays may mean less preparation for the operation and less post-operative care – i.e poorer care. You might as well try and measure temperature by using the average height of lamp posts as try to measure quality of patient care by how long they were in hospital before and after hip operations (12) – (13).

Professor Steve Field, the GP heading the government’s listening exercise says the plans would destroy key NHS services and that what is needed is not more competition but more co-operation between different hospitals and practices (14).

Cameron and Lansley’s plan would not save the NHS – it would destroy it. It has no support, either among the majority of the electorate or among the majority of healthcare professionals – and there is no evidence that competition improves healthcare provision – only dodgy studies drawing conclusions that can’t follow from the indicators they use.

(1) = YouGov / Sunday Times Survey Results 9th - 10th February 2012 , http://cdn.yougov.com/cumulus_uploads/document/ly9ei68uye/YG-Archives-Pol-ST-results-10-120212.pdf  and http://ukpollingreport.co.uk/blog/archives/4807

(2) = YouGov/ Politics Home 07 Jun 2011 ‘The Politics of NHS Reform Special Report’  page 3, http://www.politicshome.com/documents/articles/NHSReportJune2011.pdf

(3) = British Medical Journal 17 Jan 2012 ‘Does anyone understand the government’s NHS reforms, asks senior professor’, http://www.bmj.com/press-releases/2012/01/17/does-anyone-understand-government%E2%80%99s-nhs-reforms-asks-senior-professor

(4) Observer / guardian.co.uk 14 May 2011 ‘David Cameron's adviser says health reform is a chance to make big profits’,http://www.guardian.co.uk/politics/2011/may/14/david-cameron-adviser-health-reform

(5) = Financial Times 03 May 2011 ‘Meeting prompts talk of sidelining Lansley’, http://www.ft.com/cms/s/0/b7e17268-75bb-11e0-80d5-00144feabdc0.html#axzz1mx8CBt7q

(6) = YouGov/ Politics Home 07 Jun 2011 ‘The Politics of NHS Reform Special Report’  page 9, http://www.politicshome.com/documents/articles/NHSReportJune2011.pdf

(7) = Channel 4 News 28 Jan 2012 ‘’Don’t derail NHS reforms’ senior GPs warn’, http://www.channel4.com/news/dont-derail-nhs-reforms-senior-gps-warn , ‘ And a Yougov poll in the Sunday Times also shows that 65 per cent of NHS workers want the bill withdrawn, 66 per cent believe it will make the NHS worse, and 84 per cent are concerned about the role of the private sector, Clare Gerada, chair of the Royal College of General Practitioners, pointed out, however, that last time they had surveyed their members, 2,600 had responded and 90 per cent had had serious concerns about the NHS reforms. Dr Gerada said that 56 heads of clinical commissioning groups was small in light of the increasing opposition.’

(8) = guardian.co.uk 12 Jan 2012 ‘Three-quarters of GPs want health and social care bill withdrawn, poll reveals’, http://www.guardian.co.uk/society/2012/jan/12/gps-health-bill-withdrawn-poll

(9) = Karl Propper, Simon Burgess & Katherine Green (2002)‘Does competition between hospitals improve the Quality of Care : Hospital Death Rates and the NHS Internal Market’, ; ‘We find the impact of competition is to reduce quality. Hospitals located in more competitive areas have higher death rates, controlling for hospital characteristics, actual and potential patient characteristics. The estimated effect of competition is small, but is

robust to different measures of competition and hospital volume. We also find evidence that AMI death rates in small local areas that are served by many hospitals are higher (again conditioning on population characteristics) for all but the wards that are located in the most competitive areas. Whilst the estimated impact of competition on quality is small, what it is not is positive.’ http://www.efm.bris.ac.uk/ecsb/papers/deaths.pdf and http://www.sciencedirect.com/science/article/pii/S0047272702002165

(10) = Karl Propper, Simon Burgess & Denise Gossage (2003) ‘Competition and Quality: Evidence from the NHS Internal Market 1991-1999 , ‘Payer-driven competition has been widely advocated as a means of increasing efficiency in health care markets. The 1990s reforms to the UK health service followed this path. We examine whether competition led to better outcomes for patients, as measured by death rates after treatment following heart attacks. We exploit differences in competition over time and space to identify the impact of competition. Using data on mortality as a measure of hospital quality and exploiting the policy change during the 1990s, we find that the relationship between competition and quality of care appears to be negative.’ , http://www.rwj.harvard.edu/papers/propper.pdf

(11) = Stephen M. Shortell, Ph.D., and Edward F.X. Hughes, M.D., M.P.H. (1988) ‘The Effects of Regulation, Competition, and Ownership on Mortality Rates among Hospital Inpatients’ in New England Journal of Medicine 1988; vol 318: pages1100-1107April 28, 1988 ; ‘ We found significant associations between higher mortality rates among inpatients and the stringency of state programs to review hospital rates (P≤0.05), the stringency of certificate-of-need legislation (P≤0.01), and the intensity of competition in the marketplace, as measured by enrollment in health maintenance organizations’ http://www.nejm.org/doi/full/10.1056/NEJM198804283181705

(12) = guardian.co.uk 20 Feb 2012 ‘NHS reform: competition improves hospitals, report finds’, http://www.guardian.co.uk/society/2012/feb/20/nhs-reform-competition-improves-hospitals ; ‘Prof Zack Cooper, who led the study team, said …"We found two core findings. Clearly competition between NHS hospitals improves productivity, quality and efficiency. But when they opened up competition to private sector in 2008 it didn't improve results," said Cooper.

 (13) = Zack Cooper, Stephen Gibbons, Simon Jones and Alistair McGuire (2012) ‘Does Competition Improve Public Hospitals’ Efficiency? Evidence from a Quasi-Experiment in the English National Health Service’, Center for Economic Performance, London School of Economics , CEP Discussion Paper No 1125, February 2012 http://cep.lse.ac.uk/pubs/download/dp1125.pdf  ‘The underlying logic for this measure is that if hospitals can maintain quality and deliver care within a shorter period of time, this is evidence of improvements in efficiency. However, rather than improving their efficiency, hospitals could shorten their overall LOS by skimping on quality and discharging patients ‘sicker and quicker’. Likewise, because overall LOS is heavily dependent on patient 3 characteristics (which directly influence recovery time), hospitals could also appear to shorten their LOS by avoiding high risk patients and focusing their care on patients who are likely less costly to treat or alternatively discharging patients before it is clinically appropriate ……….To address these issues and differentiate between genuine productive efficiency gains and quality skimping, we disaggregate LOS into its two key component parts: 1) the time from the patient’s admission until surgery; and 2) the time from the patient’s surgery until discharge.’ (How can this ‘disaggregation” possibly “addresses these issues’?)

(14) = guardian.co.uk 13 May ‘Andrew Lansley's NHS reforms are unworkable, says review chief’, http://www.guardian.co.uk/society/2011/may/13/andrew-lansley-nhs-reforms-unworkable ; ‘In an interview with the Guardian, Field says Lansley's plan to make the NHS regulator Monitor's primary duty to enforce competition between healthcare providers should be scrapped. Instead it should be obliged to do the opposite, by promoting co-operation and collaboration and the integration of health services…."If you had a free market, that would destroy essential services in very big hospitals but also might destroy the services that need to be provided in small hospitals," says Field.’

Cameron’s ‘public service reforms’ would mean a privatised but publicly subsidised NHS – without any electoral mandate

Prime Minister David Cameron’s ‘Big Society’ ‘public service reforms’ would be PFI on steroids – the end of free healthcare paid for by taxes and it’s replacement with private healthcare only for those who can afford it, but subsidised by all tax payers and effectively paid for twice by those who can get it – once in taxes and once in charges.

Cameron in his recent speech on ‘public service reform’ and ‘The Big Society’, claimed that ‘Sometimes, a charity or social enterprise trying to come into public services will find strong forces trying to keep them out…vested interests, people who want to stick to the status quo…We need a level playing field so that anyone with a good idea can get involved.’ (1)

Here Cameron pretends that the main bidders for health service contracts will be charities or not-for-profit groups. In fact most bidders will be private healthcare firms such as ‘Assura’ a firm he also referred to in his speech as one which could provide ‘NHS walk in clinic’ services, or privatised GP consortia profit sharing with these firms.’

The Bureau for Investigative Journalism found that ‘At least half the board members of some GP consortia, the new bodies that will take over commissioning, have links with… Assura Medical, majority controlled by Sir Richard Branson’s Virgin Group… Most were GP members of Assura, meaning their practice had formed a joint company with it…. with profits split 50:50 between Assura Medical and member practices.’ (2)

One of Cameron’s principal advisers on healthcare ‘reform’ is Mark Britnell, who is employed in the Healthcare division of accountancy firm KPMG. He has told private healthcare firms that “GPs will have to aggregate purchasing power and there will be a big opportunity for those companies that can facilitate this process” and that “The NHS will be shown no mercy”. (3) – (4)

Britnell also wrote in the Health Service Journal that the NHS’ ‘funding mechanism is no longer resilient’ and that in future patients will be charged for treatment. (5)

The GP who headed the government’s review of it’s ‘healthcare reform’ policy- Professor Steve Field – has said that introducing internal competition into the NHS would be ‘destroy key services’. He’s also said that allowing private sector patients to be treated in NHS hospitals would open up the NHS to EU competition law, potentially allowing private firms the legal right to be allowed to bid for contracts for all NHS activity. (6) – (7)

Cameron also claimed in the speech that “A study published by the London School of Economics found hospitals in areas with more choice had lower death rates.”

This is true – the study was made by Zack Cooper, an LSE researcher, but it is far from undisputed. Professor Allyson Pollock, an expert on NHS funding, found serious problems with the methodology and the data it used . Pollock concluded that based on Cooper’s study ‘the only safe conclusion is that if you live near an NHS hospital or have many NHS hospitals in your area, you may get care quicker and be less likely to die from an acute heart attack. This is hardly a ringing endorsement for competition, or the Department of Health policy of centralisation and hospital closures under the expensive private finance initiative.’ (8) – (9)

Pollock, on the proposed healthcare ‘reforms’ in general writes that ‘The bill, as designed, will allow commissioners (purchasers of healthcare or insurers) to pick and choose patients and services. It abolishes the duty to secure or provide comprehensive care, and permits GP consortiums to recruit members, and introduce charges and private health insurance, as well as enter into joint ventures with private companies. In a market, insurers and commercial providers must be able to limit their risks by carefully selecting members on the basis of ability to pay and predictable costs.’ (10)

In other words it would mean the end of guaranteed free public healthcare and instead returns to a system where people can only get what healthcare they can pay for. Even worse, the private healthcare firms and privatised or ‘mutualised’ GP consortia would be getting huge taxpayer subsidies without any limit on how much they can charge or any requirement for them to treat people who can’t pay what they demand. (This would repeat the disaster of privatised but publicly subsidised railways).

This would not be greater efficiency or greater choice, but the worst kind of privatisation, including a public subsidy for private firms. It’s not reform, but PFI on steroids.

It will also lead to chaos, with many people lacking vital services in their areas due to the government letting hospitals and schools go under if they fail to compete in internal markets. In fact government ministers have been encouraged by their advisers to allow public sector hospitals to fail in order to hasten “reform” and the entry of the private sector (expect budget cuts to public services like the NHS with claims of lack of the money to fund them, followed by greater levels of public funding appearing for private healthcare firms) (11)

If all this goes ahead we’ll see cases like the one of the American man who had no way to get the healthcare he needed, so in desperation staged a bank robbery of one dollar in order to get sent to jail so he could get treatment (12).

Devolution in Scotland could prevent this happening North of the border, assuming the government don’t try to impose it here by cutting funding or making future funding conditional on such ‘reforms'. That might boost support for independence and Cameron and the Conservatives might want to encourage that to remove a lot of Labour MPs from the British parliament. However while many voters in Scotland would like to avoid involvement in more Iraq and Afghanistan wars by independence, just as many may be nervous of independence after the financial crisis brought down RBS, fearing ending up like Iceland. So with independence no certainty the British government's policies on public services may still affect Scotland's.

Cameron also claimed that New Orleans since Hurricane Katrina provides a model for British public services.

What’s actually happened in New Orleans since Katrina is that people have been forced out of much public housing which was never flooded by armed private mercenary companies like Blackwater and the properties sold off to private developers to build luxury flats to rent. This resulted in mass protests against the enforced evictions and homelessness. To stop this and to stop them trying to return to homes many of them had lived in for decades, many have been sent to trailer parks, surrounded by razor wire fences and guards, effectively imprisoned and not allowed to leave (13) – (16).

That is not a good model to follow. It certainly provides profits for some, but as with Cameron’s plans, at the expense of the majority and especially the poorest. The same goes for government plans for ‘mutualised’ and ‘for profit’ ambulance and fire fighting services (17)

Cameron and the Coalition have no electoral mandate whatsoever for their plan for a privatised, publicly subsidised healthcare system. The plan did not appear in his election campaign or his party’s manifesto – in fact he made election pledges to end the endless and disruptive reorganisation of the NHS (18). A YouGov poll in January showed only 34% support the ‘reforms’ and only 5% ‘strongly’, while 37% oppose them (16% strongly opposing them). The other 30% didn’t know (19)

The more people hear of the details of the ‘reforms’ the more people who supported them are becoming "don't knows" and the more ‘don’t knows’ are becoming opposed. A Comres poll in June found 49% of people thought the NHS reforms should be scrapped, with only 19% supporting them and 32% unsure (20). Only 27% of British voters support allowing private companies to provide NHS services (21). If Cameron goes ahead and attempts privatisation he is virtually certain to be a single term Prime Minister – if he even survives that long.

Finally, Cameron repeatedly made bizarre comparisons to buying mundane services or goods from private firms – for instance ‘You wouldn’t pay for a gym membership and then get told you’re only allowed to use the running machine or only allowed to come in on a Tuesday’ and ‘Imagine you’re buying a mobile phone. You go to the shop – only one shop – and there they’re selling one model of phone. You can guarantee the service wouldn’t be what you’d expect, the quality wouldn’t be great.’

He also claimed that ‘choice’ and ‘competition’ in healthcare will ‘get real value for money’

Cameron ignores the incompatibility of motives between maximising profit by treating only those patients who can pay and those illnesses that are profitable to treat (the primary and often sole aim of private firms) and providing good healthcare, education or social care based on providing it to everyone equally according to need.

Heart operations or cancer treatment or fire-fighting or ambulances are not mobile phones or gym memberships, nor are they comparable to them. Mobile phones are incredibly cheap compared to healthcare and no-one selling mobile phones needs to have had many years of training and experience to sell a mobile phone to someone without endangering their health or life by recommending the wrong phone. A gym membership can affect your health over the longer term, but you won’t die if you can’t afford the gym membership you want. You will die if you can’t afford health care and have a serious illness. Choosing whether to use a running machine does not require years of training, education and experience to avoid someone dying. Healthcare does. As a result private health care will always be more expensive than public sector healthcare as private firms have to make a profit. It also follows that the more share of the healthcare provision market is given to private healthcare firms, the more costs will rise, especially as public services will end up short of fully qualified and trained doctors and nurses.

(1) = 10 Downing Street Press Office 11 Jul 2011 ‘Speech on Open Public Services’,http://www.number10.gov.uk/news/speech-on-open-public-services/

(2) = Bureau of Investigative Journalism 15 Jun 2011 ‘Conflict of interest fears in NHS shakeup plans’ by Emma Slater and Sophie Clayton-Payne , http://thebureauinvestigates.com/2011/06/15/half-on-some-consortia-have-links-to-virgin-group/  ; ‘At least half the board members of some GP consortia, the new bodies that will take over commissioning, have links with a single private healthcare company, an investigation by Bureau of Investigative Journalism, published in the Independent and Pulse Magazine can reveal.

Assura Medical, majority controlled by Sir Richard Branson’s Virgin Group, has links with 50 per cent or more of the board members at three of the 52 first-wave GP pathfinders… More than 60% of those with private links were associated with Assura Medical. Most were GP members of Assura, meaning their practice had formed a joint company with it…. with profits split 50:50 between Assura Medical and member practices….At the Sutton Consortium in Surrey, 19 out of 25 board members are linked to Assura Medical. In the South Reading Consortium, three out of five board members are GP members of Assura, and two are employees of an Assura member practice. At the Calleva Consortium in Basingstoke, Hampshire, six out of 11 voting members on the consortium board have links with Assura, as does the non-voting board secretary..’

(3) = Health Service Journal 11 Jan 2009 ‘Mark Britnell quits NHS for private sector’,http://www.hsj.co.uk/news/policy/mark-britnell-quits-nhs-for-private-sector/5002713.article

(4) = guardian.co.uk 14 May 2011 ‘David Cameron's adviser says health reform is a chance to make big profits’,http://www.guardian.co.uk/politics/2011/may/14/david-cameron-adviser-health-reform

(5) = Health Service Journal 11 May 2011 ‘Mark Britnell: the NHS funding model is no longer 'resilient'’,http://www.hsj.co.uk/comment/opinion/mark-britnell-the-nhs-funding-model-is-no-longer-resilient/5029675.article

(6) = guardian.co.uk 13 May 2011 ‘Andrew Lansley's NHS reforms are unworkable, says review chief’,http://www.guardian.co.uk/society/2011/may/13/andrew-lansley-nhs-reforms-unworkable ; ‘Prof Steve Field, chairman of the NHS Future Forum – set up last month to undertake the coalition's "listening exercise" – flatly rejects the health secretary's plan to compel hospitals to compete for patients and income, which he says could "destroy key services". The proposal, contained in Andrew Lansley's health and social care bill, has led key medical organisations to warn that it will lead to the breakup of the NHS and betray the service's founding principles.’

In an interview with the Guardian, Field says Lansley's plan to make the NHS regulator Monitor's primary duty to enforce competition between healthcare providers should be scrapped. Instead it should be obliged to do the opposite, by promoting co-operation and collaboration and the integration of health services.

(7) = guardian.co.uk 28 Jun 2011 ‘NHS forum GP admits private patient doubts’,http://www.guardian.co.uk/society/2011/jun/28/nhs-private-patients-doubts ; ‘The government is facing renewed pressure over its health bill after the GP who led its "listening exercise"…Steve Field acknowledged that the government would leave hospitals vulnerable to European Union competition law due to the presence of private patients in NHS hospitals.’

(8) = London School of Economics working health paper No.16  Does Hospital Competition Save Lives? Evidence from the English NHS Patient Choice Reforms’,  by Zack Cooper http://www2.lse.ac.uk/LSEHealthAndSocialCare/LSEHealth/pdf/Workingpapers/WP16.pdf

(9) = guardian.co.uk 16 Jun 2011 ‘A return to pre-NHS fear’, by Professor Allyson Pollock,http://www.guardian.co.uk/commentisfree/2011/jun/16/nhs-fear-tory-reforms-competition

(10) = See (9) above

(11) = Guardian 11 Jul 2011 ‘Ministers urged to let schools and hospitals fail to hasten reforms’,http://www.guardian.co.uk/society/2011/jul/11/nhs-health

(12) = guardian.co.uk 21 Jun 2011 ‘US man stages $1 bank robbery to get state healthcare’,http://www.guardian.co.uk/world/2011/jun/21/verone-one-dollar-robbery-healthcare

(13) = Klein, Naomi (2007), 'The Shock Doctrine' , Penguin , London, 2007, Chapter 20

(14) = Greg Palast 29 Aug 2007 ‘“They wanted them poor niggers out of there.” – New Orleans Two years after’, http://www.gregpalast.com/%E2%80%9Cthey-wanted-them-poor-niggers-out-of-there%E2%80%9D/

(15) = Mail & Guardian (South Africa) 21 Dec 2007, 'Housing protests grip New Orleans', http://mg.co.za/article/2007-12-21-housing-protests-grip-new-orleans

(16) = Greg Palast 24 Aug 2010 ‘Five Years and Still Drowning - The New Orleans CNN Would Never Show You’,http://www.gregpalast.com/five-years-and-still-drowning-the-new-orleans-cnn-would-never-show-you/

(17) = guardian.co.uk 09 Nov 2010 ‘Ambulance drivers and firefighters could break away from national service under new plans’,http://www.guardian.co.uk/society/2010/nov/09/ambulance-firefighters-mutualise-plans ; ‘Ambulance drivers, paramedics and firefighters could be given the right to breakaway from the national rescue service to form for-profit groups and run their services themselves, the Cabinet Office minister Francis Maude has said.

The government is to unveil a white paper that will give nearly all public sector workers a right to "mutualise" services, along the lines of a John Lewis model whereby employees own the service they work for, and can profit if it makes money.

Maude said that almost all public services – bar the police and the armed forces – could be mutualised. One ambulance service had already expressed an interest and he would also look at options for the fire service, he said.’

(18) = New Statesman blog 14 Apr 2011 ‘Video: Cameron slams “pointless reorganisation” of the NHS - The Prime Minister – then in opposition – addresses the Royal College of Nursing conference in 2009’, http://www.newstatesman.com/blogs/the-staggers/2011/04/royal-college-opposition

(19) = YouGov 20 Jan 2011 – Politics – The National Health,http://today.yougov.co.uk/politics/national-health

(20) = Comres 13 Jun 2011,http://www.comres.co.uk/systems/file_download.aspx?pg=796&ver=2

(21) = guardian.co.uk 21 Jan 2011 ‘Poll reveals widespread suspicion of NHS reforms’, http://www.guardian.co.uk/politics/2011/jan/29/nhs-private-companies-yougov-poll