US Health Insurance Provider in prime position to take over new NHS Integrated Care Systems

The USA’s Centene Corporation is now England’s biggest private hospital healthcare provider. Earlier this month it took full ownership of Circle Health Group,  with the acquisition of Toscafund’s remaining shares for a reported £900m.

Through its UK subsidiary Operose Health, Centene Corporation is also the largest GP provider in the country.

There is nothing in the new Health and Care Bill to prevent private companies from membership of the Integrated Care System Boards that are to take over responsibility for commissioning health care services.

Centene Corporation’s UK subsidiaries are well placed to become members of Integrated Care System Boards,  as England’s biggest provider of both GP practices and private hospitals – which are to be heavily involved in clearing the huge NHS waiting lists caused by the pandemic, with £10bn public funding allocated to the private sector for this purpose. 

Operose Health is also an NHS England-accredited provider of Health Systems Support Services, selling a variety of commissioning and support services to Clinical Commissioning Groups and the Integrated Care Systems that are intended to replace them by April 2022 – if the new Health and Care Bill makes it through Parliament by then.

The “support services” the accredited suppliers sell to NHS commissioners/Integrated Care Systems include the skills and software required to analyse patients’ confidential GP records and identify those deemed to be at risk of costing the NHS a lot of money.

This is central to the work of setting up and using a commercial insurance-based model within the NHS shell of Integrated Care Systems.

All in all,  Centene Corporation’s UK subsidiaries are in a position to cover all bases within huge Integrated Care contracts: as commissioner/insurer and primary and secondary care provider. A fully integrated set-up,  that brings to fruition the 1997 statement by Chris Ham, (now Co-Chair of the NHS Assembly, Chair of the Coventry and Warwickshire Health and Care Partnership, non-executive director of the Royal Free London Hospitals NHS Foundation Trust and an expert adviser to Carnall Farrar):

“Integrated Care is alternative terminology for market-focussed imports from the USA”

(May 1997, Journal of Managed Care)

Centene Corporation’s takeover of the NHS can only be strengthened by the appointment of the former Chief Executive of Centene’s UK subsidiaries, Samantha Jones, as the Prime Minister’s NHS Transformation and Social Care Adviser.

Samantha Jones: photo credit unknown

Before joining Centene UK, Samantha Jones was the NHS England adviser on the insurance-based ‘New Care Models’  which are central to the new Integrated Care Systems. She played a central role in giving the USA Centene Corporation access to NHS contracts.

In Downing Street, Ms Jones is to work with Boris Johnson’s special political adviser on health, Will Warr – a former lobbyist at the firm of Lynton Crosby, who masterminded numerous Conservative Party election campaigns and Johnson’s successful 2008 London mayoral bid. Warr described the NHS as ‘outdated’ in a Telegraph article  shortly before he and Johnson entered Downing Street last year.

Appointed at the end of March, it’s not clear if Samantha Jones has yet started work in Downing Street. But it seems she will also work with another key Johnson adviser, Adrian Masters.  While employed by the management consultancy McKinsey,  Adrian Masters played a key role in shaping the last major piece of NHS legislation, the 2012 Health and Social Care Act. McKinsey was reported to have drafted large parts of that bill.

According to Open Democracy, Adrian Masters re-joined Number 10 in 2020 as civil service policy lead on a secretive “No.10 Health and Social Care Taskforce”, where he advised on elective care recovery.  The Taskforce reported to a Steering Group chaired by Munira Mirza, the influential head of Boris Johnson’s policy unit, that met weekly for several months last year.  Open Democracy proposed that

“Mirza’s leading role and the lack of leaders from the Department of Health suggest that [the taskforce’s] work is politically focused…Both the Department of Health and the NHS now appear to be taking a back seat in policymaking.”  

The Health Service Journal has reported that the new Health Secretary, Sajid Javid, and the Prime Minister are now at odds over the new Health and Care Bill, and that the Health Secretary does not support it, with little commitment to it among backbench Tory MPs.

Update 3.2.2022

Munira Mirza has resigned over Boris Johnson’s ‘scurrilous’ attempt in the House of Commons to associate Keir Starmer MP with the failure to prosecute paedophile Jimmy Savile.