Yet another blog about hapless hospital botherer and haunted dishcloth Matt Hancock
This week the Government announced an inquiry into the relationship between Greensill Capital, David Cameron and Boris Johnson’s Government. Most of the questions the press are asking are about the relationship between Cameron, Rishi Sunak and Greensill over Covid loans.
But there is another dimension to this scandal, which raises very serious questions about how Government operates. Greensill were provided with access to Matt Hancock and senior people across the NHS and Department of Health to sell them financial services.
David Cameron personally lobbied Matt Hancock on behalf of Greensill with regards to a staff payment scheme to help NHS staff access their wages early in case of hardship. This became the app Earnd.
Earnd’s advisory board, includes Louise Casey, former government adviser, and David Blunkett, former Labour education secretary. Lord Blunkett at least had the decency to resign from the board when the story broke.
Cameron took Hancock for a drink October 2019 to introduce him to Lex Greensill. Bill Crothers, the then boss of Government Commercial services also attended: Cameron and Crothers both have shares in Greensill. Earnd were awarded a contract to provide payday services to NHS staff alongside another provider Wagestream.
The NHS’s corporate services provider, NHS Shared Business Services , arranged the contract with Greensill and Earnd, launching it last year. NHS Shared Business Services is itself a joint venture between the Department of Health and the French IT services company Steria.
Shared Business Services also awarded a place on a framework contract to a company called Topwood, the majority of shares in which are owned by Matt Hancock and his sister. From that framework contract Topwood won £300,000 of business from NHS Wales. None of this was declared until last month when Hancock revealed his share holding, but not his sisters.
Greensill provide Earnd to the NHS free of charge. What Greensill got in return was access to the personal and financial information of NHS employees, which they could then commercialise to sell low paid NHS staff financial services through Greensill Bank.
Incredibly NHS England are still promoting Greensill and it’s products on it’s website despite its collapse:
Greensill also run PEPS – the Pharmacy Early Payments Scheme, which allows community pharmacists to draw down income from the NHS early. PEPS was, of course, set up by while David Cameron was PM.
This isn’t the only strange data deal that the NHS has done recently. During the pandemic DH secretly let a contract to Palantir – the US data giant spun off from the CIA which brings together Government data in order to prioritise interventions. In the UK it has been used by Sunderland Council to target families and individuals in contact with multiple agencies, in the US it is used to target suspected illegal immigrants for deportation.
The deal with Palantir always looked odd. They originally agreed to work on Covid data for £1, which looks like a loss leader allowing them to either sell future products or get access to commercialisable data. This then became £28m, and then £20m a year for 5 years. The actual costs and terms of the contract are still opaque.
Letting a contract to Palantir is not illegal or immoral – as long as the contact and the use of data is transparent and has appropriate safeguards. DH let this contract in secret and without safeguards, and only revealed the extent of the involvement of Palantir after they were taken to court. Matt Hancock owning shares in a company that contracts with the NHS is not illegal or immoral either – as long as this is transparent and appropriate safeguards are in place.
Over the last 11 years lots of good Civil Servants have left. That doesn’t mean that all the ones who stayed are duffers, but some parts of the Civil Services have suffered as staff with valuable talents have moved from being gamekeepers to poachers. Government procurement and commercial staff, and HMRC tax experts are among those in highest demand. People who will rubber stamp deals that Ministers favour have flourished, people who would insist on safeguards and transparency have been pushed out. This is a culture that has been nurtured over the last decade from Cameron onwards.
There has been a lot of noise on line that this represents creeping privatisation of the NHS. Strictly speaking this isn’t true. Privatisation is where NHS services are outsourced to a for profit private company. In this case this wasn’t an existing NHS service, nor did Greensill make money off it – in fact they weren’t making money off anything – that’s why they went bankrupt and the whole mess became public.
The left have long campaigned ineffectively against NHS privatisation – for years they have claimed that the NHS was about to be sold off to US private healthcare firms. These campaigns failed to convince anyone but the people who were doing the campaigning for one obvious reason – they weren’t true. There never was a secret plan to sell the NHS to American hospital chains. The free market neo-liberal fears of the left were a fantasy, and they would have been better off focussing their campaigns on Unite the Union, Liverpool Council and their property deals.
What is going on here is something very different, and in my view more dangerous.
This is a new kind of commercial arrangement where the private sector doesn’t provide services but acts as a financial intermediary making profit by commercialising data from public bodies.
I honestly don’t mind the private sector providing services to the NHS as long as they risk their capital to achieve their profit. There are lots of capital intensive areas like diagnostics and I am happy for the private sector to invest their capital to create faster access for patients in return for profit. There are some really good private companies who provide services to government who compete and win those contracts fairly and squarely.
What is happening here isn’t free market capitalism. Greensill, while calling itself a bank, wasn’t investing in patient services, it wasn’t funding the building of hospitals, it wasn’t hiring Doctors or Nurses. It was acting as a financial intermediary, managing transactions for the state in return for access to valuable data, which intended to exploit.
It was able to do so not because it was competed and won customers through price or service but through patronage and access.
This is the mix of data, authoritarianism, and political patronage that the Chinese Government have pioneered. A ruling party with a desire to be in Government forever building a nexus of data, economic and political power.
While the left complained about neo-liberalism they missed the rise of neo-authoritarianism. While our attention is on Covid and Brexit we are becoming an oligarchy like Russian under Putin.
Having worked with Government commercial services I am staggered that no-one spotted the commercial and ethical problems with these deals. Clearly the ethical framework of the Department of Health was very different than in my day.
It is fashionable to say that the Blair and Brown Governments were no different to the Tories, but there is no way deals like this would have been allowed in the pre-Cameron era. The last time we saw behaviour like this in Government it was Mark Thatcher taking a cut. Even then Minister resigned time to time. Not now.
The NHS, sadly, has low paid staff who would use a pay advance system. The NHS could easily have done this themselves- HMG has it’s own huge payment services departments who could do the job. Instead they chose to commercialise their employees financial and personal information to benefit their mates.
The ethical problems with this are eye watering, but the contempt they show to hard working low paid NHS staff is nauseating.
And if they have such contempt for the staff what do they think about the patients…?