“Hypocrisy” or “privatisation to a ludicrous extreme” - Norwich politicians in war over words over NHS

PUBLISHED: 17:23 21 November 2014 | UPDATED: 17:23 21 November 2014

Jess Asato, Labour Prospective Parliamentary Candidate for Norwich North.

Jess Asato, Labour Prospective Parliamentary Candidate for Norwich North.

©2012Geoff Wilson

A war of words over the NHS has broken out between two politicians fighting to represent Norwich North next year.

2009 letter to Andy Burnham

Rt Hon Andy Burnham MP

Secretary of State for Health

Richmond House

79 Whitehall



20th November 2009

Dear Andy,

This Government has made major strides in improving the healthcare of our nation through record investment and a relentless focus on increasing standards of care. Recent moves which will formalise targets as entitlements are to be welcomed and will ensure that Britain never again takes on the mantle of the sick man of Europe. Your work on an NHS Constitution will similarly entrench the notion that citizens deserve to know what they can expect from their National Health Service and will form a bulwark against future forces which may work to downgrade levels of care.

One of the reasons why we believe that the NHS has improved to the extent it has is partly down to the Government’s non-dogmatic approach to the use of external expertise in the provision of its services. The presumption that the private and voluntary sectors should be considered on equal terms with state provided services has increased the capacity of the NHS to provide high quality services. Indeed, the commitment to using third sector providers was made in the 2005 Labour Manifesto: ‘In a range of services the voluntary and community sector has shown itself to be innovative, efficient and effective. Its potential for service delivery should be considered on equal terms.’

We are worried, therefore, about your announcement that henceforth the NHS is the “preferred provider” of NHS services. We understand the need to ensure that frontline staff are not taken for granted and feel valued for the tremendous work that they do, but there are more effective ways of reflecting this through pay, training and career progression opportunities. By restricting the use of the private and voluntary sectors solely to the provision of new services will limit your ability to use their huge innovatory potential in a constrained fiscal environment. Both sectors are ideally placed to help find more cost-effective and user-orientated solutions to provision as budget holders increasingly strive for efficiency savings.

As well as a missed opportunity, we are particularly concerned that this move will have a detrimental impact on the future stability of the voluntary sector. As you will know, the third sector is unique in having doubled its turnover and swelled its overall workforce by more than a third over the last 12 years. Much of this growth has been due to the sector bidding for and winning public sector contracts. Indeed £4.7bn worth of NHS services are delivered by the third sector. Many third sector organisations have factored continued public sector provision in their business plans for the future, but are now confused as to whether these opportunities will continue to exist under a future Labour Government.

One of New Labour’s strengths has been to recognise that excellence and talent is not confined to one sector or one institution, and that it is the duty of politicians to continually ask whether service provision could be improved in the interests of the user. NHS staff often hold the key to unlocking improvements at the frontline, but so do the thousands of workers in the voluntary sector who equally believe in the ethos of public service.

We would like to ask you to rethink your approach to the NHS as the preferred provider of services as we build up to the next election. Now is not the time to alienate important sectors that hold much good will and are potentially the key to the citizen-centred, high quality health services of the future.

Yours sincerely,

Jessica Asato, Acting Director, Progress

Peter Kyle, Deputy Chief Executive, ACEVO

Simon Blake, Chief Executive, Brook

Jeremy Swain, Chief Executive, Thames Reach

Professor Julian Le Grand, London School of Economics

Professor Paul Corrigan

Stephen Burke, Chief Executive, Counsel and Care

Allison Ogden-Newton, Chief Executive of Social Enterprise London

As Labour proposals to “take a scalpel to cut the heart out” of the Government’s “hated” NHS reforms cleared their first Commons hurdle, sitting MP Chloe Smith has accused her opponent Jessica Asato of “hypocrisy”, and has replied to constituents asking her to support the Labour bill, with an attack on the candidate.

Ms Smith has quoted a letter from Ms Asato to shadow health secretary Andy Burnham in 2009 raising concerns about his plans to make the NHS a “preferred provider” of NHS services.

Ms Asato, who was the acting director of Blairite think tank Progress at the time, told Mr Burnham in 2009: “By restricting the use of the private and voluntary sectors solely to the provision of new services will limit your ability to use their huge innovatory potential in a constrained fiscal environment. Both sectors are ideally placed to help find more cost-effective and user-orientated solutions to provision as budget holders increasingly strive for efficiency savings.”

This week Ms Asato called on Ms Smith to back Clive Efford’s National Health Service (Amended Duties and Powers Bill) - a move Ms Smith claimed was “saying the opposite”, to her previous views.

But Ms Asato said she believed there was a place for a degree of private and voluntary sector involvement in NHS provision, but the Tories had taken it to a “ludicrous extreme” and put competition at the very heart of all NHS provision.

She said: “This has led to fragmentation and a dangerous distortion of priorities as well as escalating costs. NHS managers are now spending £65m a year bidding against each other for the same contracts, still more millions on competition lawyers and even have to spend money to bid for services they already run,” she said.

The Commons vote was passed by 241 votes to 18, with a majority of 223, at second reading, with very few coalition MPs turning up to the House of Commons session.

It is unlikely the reforms will become law in their current form as a Private Member’s Bill without the coalition’s backing, as it only has limited time to progress through the Commons and will be opposed by the Government at future stages.

Shadow health secretary Andy Burnham said the proposals would form the basis of Labour’s Repeal Bill if it forms the next government.

Introducing his Bill, Mr Efford said it will remove the obligation to put NHS services out to tender and create a system for contracting that puts patients ahead of competition. An additional section will prevent competition and procurement regulations arising from the massive EU-US free trade deal known as TTIP applying to the NHS, with critics warning the trade deal could lead to US companies suing future governments for reversing privatisation.

He said: “This Bill is not the solution to all of the mistakes that this Government has made in its top-down restructuring of the NHS but it is an important block to enforced privatisation.

“The argument can be simplified into two distinct sides. If you believe that the National Health Service should be a pure market, open to competition regulations, where the interests of competition are put before National Health Service patients, then you belong on the side of the Government.

“If you believe that the NHS is a public service that should be free of competition rules and put the interests of NHS patients first, then you should vote for this Bill today.

“We know that No 10 did not understand what was going on in 2012, the Chancellor was asleep at the wheel, the Liberal Democrats suffering from some form of terminal Stockholm Syndrome were led by the nose to turn the NHS from a public service into a free market. The Bill takes a scalpel to cut the heart out of the hated 2012 Act and put right the worst of their mistakes. It will remove the sections that require tendering of NHS services for competition with the private sector, the result of which has been millions of pounds being diverted from patient care into pockets of lawyers and accountants through the tendering process.”

Health Minister Dan Poulter, who is a practising NHS doctor as well as an MP, defended the Government’s reforms and insisted they must be allowed to bed in.

Dr Poulter also dismissed concerns over the TTIP EU-US trade deal, saying it would have no effect on the NHS.

The Tory minister said: “I reaffirm this Government’s commitment to the founding principles of the NHS - a health service free at the point of delivery and recognising that, since its very creation in 1948 by Nye Bevan, our NHS has always been a public-private partnership.

“The aim should be to change fundamentally the way the NHS was run, to break up the monolith, to introduce a new relationship with the private sector, to import concepts for choice and competition - those are not my words, but those of Labour prime minister Tony Blair in the reforms he introduced.

“It is important the NHS is not used as a political football and services are always designed and delivered in the right way for patients. There is often too much scaremongering in these debates.”

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