Manifesto: Tories open to legislation to curb internal market

From Health Service Journal - 18th May 2017


The Conservative manifesto says the party is open to introducing health legislation if the NHS’s leaders ask for it to help deliver the Five Year Forward View, for example to create new integrated care models.

It also commits to “review the operation of the internal market and, in time for the start of the 2018 financial year, we will make non-legislative changes to remove barriers to the integration of care”.

Health secretary Jeremy Hunt told HSJ that the “internal market is too bureaucratic”, and indicated that changes could include a shift to capitation funding, under which providers receive budgets for the care of their entire population, eliminating some commissioner functions.

The manifesto states: “We will hold NHS England’s leaders to account for delivering their plan to improve patient care.

“If the current legislative landscape is either slowing implementation or preventing clear national or local accountability, we will consult and make the necessary legislative changes.

“This includes the NHS’s own internal market, which can fail to act in the interests of patients and creates costly bureaucracy.”

Over the past year senior NHS figures, including NHS England chief executive Simon Stevens, have indicated that parts of current NHS legislation, including the Health Act 2012, can make it more difficult to develop integrated care and new contracting and organisational models.

Potential options for legal change range from changing competition and/or procurement law; merging NHS England and NHS Improvement, and potentially other quangos; to creating new NHS structures locally or regionally – potentially eliminating or dramatically reforming the commissioner/provider split.

The NHS has begun work on developing accountable care structures, but is at a relatively early stage. Many of those involved see it as very difficult within current legislation and rules.

NHS England is currently working to prepare to announce next steps for the NHS’s first “accountable care systems” shortly after the general election, with up to nine areas of the country

Comment:   Abolishing the market and purchaser/provider split once new Accountable Care Organisations are in place will cement the regional nature of ACOs and will facilitate capitated funding.  The final step in the regionalization and privatization of the NHS will have been completed.

World Economic Forum and McKinsey & Co decide UK health and social care policy

If any further proof were needed that the UK is not in charge of its own health and social care policy, please read the following article dated 25th May by Stewart Player on Socialist Health Association's website:

It is about two reports apparently prepared in 2012 and 2013 by McKinsey & Co for the World Economic Forum (of Davos fame) entitled "The Financial Sustainability of Health Systems: a Case for Change" ( and "Sustainable Health Systems: Visions, Strategies, Critical Uncertainties and Scenarios" (

It is not clear when these reports were uploaded to the WEF website. If it was recently then the delay is suspicious.

These are explosive documents: they give the lie to assertions by NHS managers and the Government that STPs are "local" plans.

Please read carefully the list of participants at the end of the two enquiries and resulting reports. It is a roll-call of the powerful players in the "global healthcare market", as they see it. The "Project Steward" of the "Steering Board" was Simon Stevens, then President of Global Health at UnitedHealth Group, now CEO of the NHS. West Yorkshire STP lead Rob Webster was a workshop participant there. Amanda Doyle, STP lead for Cumbria was another.

Simon Stevens was recruited by the Coalition, directly from UnitedHealth in 2013 to dismantle the English health service. UnitedHealth has been acquiring contracts under the NHS logo using its English subsidiary Optum. Already one area has Optum as both Commissioning Support Unit and 'provider of services'. What conflicts of interest are there? The councils do not have a veto, whether they subscribe to the STP plans or not. This was revealed in the House of Commons in response to a question by Justin Madders MP. The public have not been consulted, nor have they voted for any of this.


While I was giving out "Save Charing Cross Hospital" posters in Hammersmith, wearing "Save Our Hospitals" badge and T-shirt, I talked for a long time with an Australian senior hospital manager in a shop. He recognised instantly the phrase "Sustainability and Transformation Plan" - this is now common currency in the global health management business.

Updated 6th June 2017 to incorporate details about STP leads Rob Webster and Amanda Doyle and the career of Simon Stevens.

CrowdJustice - update to legal challenge to the STPs by 999 Call For NHS

In late May 2017 "999Call for the NHS" closed the present round of the crowd-funding appeal having raised £12,500 from the public.

Leigh Day and the campaigners are proceeding with the opening skirmishes of the legal battle and making a continued appeal for publicity and outrage against STPs:

"The CCG has (belatedly) replied to the initial letter from our lawyers. Neither we or our lawyers are impressed and we're working together now on a reply that lays out clearly why their reply is totally unsatisfactory. We'll keep you posted.

If you have any questions contact us at: This email address is being protected from spambots. You need JavaScript enabled to view it.


While we press the pause button on DONATIONS, we are turning up the volume on a message to all Parliamentary Candidates that new NHS and social care organisations called Accountable Care Systems must not go ahead!  They will end the NHS as a comprehensive service that provides the full range of care to all who need it, free at the point of need.

Please help us with this. Here is a first step.

Find who your Parliamentary Candidates are and tell them all that you will not stand for the destruction of the NHS. And that you refuse to accept American health insurance - style funding arrangements for the NHS and social care.

These are being introduced through new local NHS and Social Care organisations, called Accountable Care Organisations/Systems.

Their fixed budgets are supposed to cover an area's population but they will be insufficient to meet the public need. These finance restrictions will force our NHS to behave like an insurance company.

This will decisively end the NHS as a comprehensive service for everyone who needs health care.

Please tell them ALL to say “NO” to  Accountable Care Systems/Organisations in the NHS

Find your candidates here:"