Stop the race to legislate for corporate control of our NHS

Many campaign groups are working to Get Centene Out, Stop Corporate Control of Our GPs and Stop the Disintegration of our NHS.

For more info please email info@999callfornhs.org.uk or https://saveliverpoolwomenshospital.com/contact/, or visit the We Own It website.

Under cover of Covid-19, the Johnson government has lost no time in the corrupt advancement of its corporate cronies’ interests and in undermining democracy.

They have awarded £bns of secret contracts for vital Personal Protective Equipment and Covid-19 testing to companies with a hotline to the Tory party through donations and personal connections.  

The government seems to be in thrall to Boris Johnson’s health adviser William Warr, formerly a lobbyist with right-wing campaign strategist, Lynton Crosby; and to a secretive Downing Street task force with a remit to “radically shake up the NHS”, that reports to Munira Mirza, a long-standing and highly ideological Johnson ally, with no background in healthcare.

New NHS Bill to fix stealth corporate takeover of NHS into law

The government’s recent publication of the “integration and Innovation” White Paper has fired the starting gun for the race to fix the stealth corporate takeover of the NHS into law. The White Paper’s proposed changes to NHS commissioning and contracting seem designed to embed Covid-19 crony contracting practices into the routine provision of the whole range of NHS services.

Even before the White Paper was published, the USA’s Centene Corporation had shot out of the starting gate as a front runner in this race. In the winter, one of its UK subsidiaries, Operose Health, asked 13 London Clinical Commissioning Groups to make a rapid decision to approve their acquisition of 40+ London GP practices and out of hours services that care for 375K Londoners. 

The  NHS commissioners allowed the sell-out to be rushed through for the company’s “commercial reasons”. They used an urgent decision process intended to let GPs get approval for quick changes to deal with the pandemic!  Was this haste and secrecy even lawful?

Their decisions have avoided normal processes of accountability and transparency to the extent that there is NO public record of when these decisions were made.

The public, Councillors, MPs, patients and GP practice staff (apart from the Executive GPs who sold their contract-holding company and four other companies to Operose Health) have all been left in the dark.

Arguably, the Centene/Operose Health GPs’ takeover foreshadows the dire procurement and contracting provisions of the White Paper. Clinical Commisioning Groups are to be abolished and their procurement and contracting functions carried out by statutory Integrated Care NHS bodies following a Provider Selection Regime. This underhanded exercise in deregulation risks normalising the secretive transfer of NHS services to “independent sector” providers.  

The NHS belongs to the people, says the NHS constitution

All of a sudden, more and more bits of it turn out to belong to unaccountable corporations. What is happening to democracy?

Centene Corporation, which is driving this Americanisation of our NHS, is a Fortune 50 company that makes massive profits from managing “Obamacare” public health insurance programmes in more than 20 states in the USA,  while selling private healthcare insurance alongside them.

For example, in 2015 Centene Corporation made £355m profit on income of £22.8bn. Other US health insurance companies have lost money on Obama’s Affordable Care Act measures – due to the requirement to insure older and sicker patients – but Centene Corporation has profited and expanded. It has done this by focussing on low-income individuals who have lost their Medicaid eligibility and need to find a private health insurance plan. Centene offers its “marketplace plans” in the same geographic areas and with the same networks as its Medicaid business.

In 2016 Centene Corporation began a drive to expand into more international markets, and  announced its intention to buy up UK primary care and mental health providers. It quickly built on links its new Spanish subsidiary RIbera Salud had previously established with key players in the UK establishment, winning plaudits from the Sec of State for Health for its Spanish subsidiary as an example of best practice in Accountable Care. In 2016 Ribera Salud’s Vice President Cynthia Brinkley set up Centene UK, with herself as a Director.

Somehow Jeremy Hunt overlooked the Valencia police investigation of the Ribera Salud group for overcharging 2.6 million euros in emergency assistance and other areas as well as corruption in the award of subcontracts; and the Valencia government’s outlawing of the company’s discredited Alzira model of  public/private partnership. This model involves a health management company running an area’s entire health service and hospital buildings, paid for with a mix of private and public money.

In 2017 the new Valencia regional coalition government of the Green, Podemos and Socialist parties gave notice to Ribera Salud that its contracts would not be renewed as it legislated to restore the health service to public ownership, management and provision.

Operose Health Ltd/NHS England ‘new care models’ revolving door

More recently, Centene UK was turned into Operose Health. The former NHS England Director for New Models of Care, Samantha Jones, was appointed as director – as well as director of several other key Centene Corporation UK subsidiaries higher up the complicated corporate chain.

The ‘new care models’ Samantha Jones was funding and promoting while at NHS England are exactly the accountable care models promoted by the Health Sec in his push to dismantle the NHS into 42 Integrated Care Systems. Operose Health has positioned itself strategically to profit from these Systems’ establishment as statutory bodies that will both commission and provide almost the whole range of NHS services in their “footprint”.

A connection between Centene and Samantha Jones dates back to her time at NHS England. The Vanguard scheme in Rushcliffe – one of many that Samantha Jones was responsible for funding and overseeing as NHS England Director of new care models – “was invited to collaborate with international experts Ribera Salud…and Centene Corporation to ‘develop an Accountable Care System‘.”

In other words, Samantha Jones  funded the Principia Multispeciality Community Provider Vanguard to hire Ribera Salud/Centene to tell them what an Multispeciality Community Provider care integrator would do, and to set up the model for them.

This was after Capita had subcontracted to Centene the job of Nottingham and Notts Sustainability and Transformation Partnership System Integrator/Transformation Partner.

So I think that could be pretty big clue about what Centene/OH are really after.

Samantha Jones was not the only former NHS England boss to migrate to Operose Health. Louise Watson, Operose Health’s Chief Integration Officer, was formerly Managing Director for the Buckinghamshire Integrated Care System. Before that in 2015 she was the national lead for the development of the multi-speciality community provider (MCP) care model as part of the national NHS new care models ‘vanguard’ programme. In June 2017, after Samantha Jones quit and went to Centene UK, Louise Watson succeeded her as Director of the new care models programme, where she led on the implementation of the new care models outlined in the NHS Five Year Forward View.

As well as holding scores of NHS contracts for GP practices and out-of-hours services, and for community ophthamology services that operate “in partnership” with NHS acute hospitals, Operose Health is also an accredited supplier of commissioning support services, listed on the Health Systems Support Framework under its previous trading name of Centene UK.

The move to health management companies running an area’s entire health service and hospital buildings, paid for with a mix of private and public money, is already emerging in areas like Greenwich, where  Centene takeovers and share purchases are concentrating corporate control over Greenwich NHS and its patients.

Update 3/4/21 Samantha Jones resigns all Centene UK subsidiary directorship after appointment as Johnson’s Health Adviser

Companies House shows that on 30th March 2021 Samantha Jones resigned from 18 of her Centene Corporation UK subsidiaries directorships, retaining only the directorship of Operose Health Corporate Management Ltd. By 3.4.21 she had resigned that too, before taking up her civil service job as NHS Transformation and social care health adviser to the prime minister, in the 10 Downing Street policy unit. It’s unclear when she starts.

Elizabeth Perry, the Operose Health Chief People Officer, has replaced Samantha Jones as Director of 16 of the Centene Corporation UK subsidiaries. Elizabeth Perry has no NHS experience. She previously worked at IBM, Arthur Andersen Business Consulting and RSM and her industry background includes technology, retail and pharma.

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