Image: Parliament.gov.uk

As the Health and Social Care bill was being debated in 2012, Social Investigations produced a list of parliamentarians with healthcare interests to highlight both the volume of vested interests and the flaw in the rules that allowed them to vote on the bill despite these interests. Now, two years on, a new list has been drawn up that paints the same picture.

MPs and Lords are able to vote on legislation, even when they have a relevant financial interest. This gaping hole in the democratic system meant that over 200 parliamentarians with recent or present interests in healthcare-related companies were able to vote the Health and Social Care bill into law.

The new Act holds a legislative gun to the temple of the NHS, forcing it into the world of competition and subsequently into an external market. Scooping up the resultant contracts are some of the same companies that donate to parties and individual parliamentarians or even who directly employ Lords and MPs.

Jeremy Hunt’s aunt, former Conservative Health Minister Baroness Bottomley, sits on the board of headhunter company Odgers and Berndston, and holds shares in its parent company. Freedom of Information requests revealed how they were paid £200,000 for recruiting twelve key positions within the NHS and competition regulator, Monitor in the wake of the huge NHS reorganisation that followed the Bill. They also went on to gain a further £200,000 from the CCGs. The Baronness was a keen supporter of the Bill, saying at its Second reading that "I give this Bill an unequivocal and extraordinarily warm welcome.”

Baroness Cumberlege moved her own company into an alliance led by PricewaterhouseCoopers (PwC) that was formed to help develop the new CCGs. Baroness Cumberlege is the former Parliamentary Under-Secretary of State for Health, who also runs a business that runs training programmes across the NHS spectrum for consultants, GPs, NHS managers, Directors and Chief Executives. Part of their training programme covers ‘Politics, Power and Persuasion’, a tailored two-day programme, which includes topics such as: ‘Managing the markets, the challenges of commissioning’, ‘who’s who’, and ‘brokering deals with other independent sector providers’.

This programme formed part of a series of courses run by Cumberlege Eden & Partners for Health Education England (HEE), which was established following the Health and Social Care Act. These were run for a cost of £80,000 and further FOI requests also reveal that NHS South Eastern Hampshire and NHS Fareham and Gosport CCGs’ were given a bursary of £12,896 for a one-day course on ‘Understanding Politics Masterclass’, one of several CCGs to receive courses from his company. Baroness Cumberlege was another peer happy with the new Health bill, rising in the Lords to say, “I applaud the flexibility of the Bill”.

PwC have Conservative peer, Lord Freeman and Labour peer, Lord McConnell of Glenscorrodale on their Advisory board.  The accountancy giants were instrumental in the development of the CCGs and went on to gain contracts to the tune of £3.4 million to help with their assessment and authorisation.

Baroness Barker was a Spokesperson on Health for the Liberal Democrats and a a member of the Health and Social Care Team of which she remains. She debated, made multiple key amendments and voted on the health bill, helping it become an Act. One month after the Act gained Royal Ascent, she incorporated a consultancy company, which she co-owns that works with the third sector to assist in their quest for NHS contracts.

The company, Barker & Woodward offer consultancy to third sector organisations that according to her partner’s LinkedIn account include ‘Making a business case for selling to CCGs (Clinical Commissioning Groups)’. Another area they cover, which is explained on their website is a project called “the right prescription”, which provides services on how ‘third sector organisations can constructively work for the NHS’ and advice about ‘competitors and development of strategic partnerships.’ Her consultancy's latest offering is a £50 per head briefing on the Care Act (as it will be by then).

Baroness Barker drafted several amendments, which included in the area of conflicts of interests, one of which read "CCGs must make arrangements for managing conflicts and potential conflicts of interest in such a way as to ensure that they do not, and do not appear to, affect the integrity of the group's decision-making processes". She concluded “It is extremely important that these groups not only set out to uphold the highest standards but that they are seen to uphold them.”

When Social Investigations drew up their original list of healthcare vested interests in parliament, they sent it to the Lords for them all to see. Baroness Barker was one of the few to respond and demanded that we should  “supply your evidence that any of the people named below who have taken part in the Health and Social Care Bill have failed to declare their interests as they are required to do.”

Baroness Barker has registered her company in her interests, and there is no suggestion that others have not done so correctly.

But this misses the point. It should not be enough for Peers to simply register your interests. Local councillors must abide by a stricter regime, which is imposed on them by parliament. If they have a financial or non-financial interest, then they must neither ‘participate in any discussion of the matter at the meeting’ nor ‘participate in any vote, or further vote.’ It is time that parliament followed suit.

The Code of conduct that all Members sign up to states that ‘Holders of public office should take decisions solely in terms of the public interest. They should not do so in order to gain financial or other material benefits for themselves, their family, or their friends.’ 

Why should the public be placed in a position whereby they have to take the politicians word that despite their financial links, their vote was in the best interest of the public? It may well be that when the above examples voted on the Health bill they did so because they genuinely believed this legislation would benefit the public. However, there is room for doubt - and this doubt must be removed.

In an interview for the recent BBC Inside Out South East documentary in these issues, Gordon Cowen the Labour councillor for Dover district council said, “This is absolutely and totally wrong…and if you went out into the public today, and asked them the question, I am sure it would be  (this is) 100% it is wrong.”

Or Gareth Tomlinson of the Patients Participation Group said “When you’re passing legislation on an entity that is supposed to care for the welfare of the population of the country and you have a financial interest in the decision at the end of that process, then you should not be involved in that process.”

 Currently the government has no intention to reform the rules that govern their own working life. In response to a petition placed on the No10 website that demanded “No member of Parliament may speak or vote in a debate on legislation which could financially benefit any commercial operation in which they have a financial interest”, they replied that it would “not be practical” to introduce any curbs to such behaviour because a “significant number of legislative provisions in any year may have beneficial financial implications for all or most commercial operations.”

Exactly!

See the full list of parliamentary financial interests to healthcare here.