The British Medical Association: Who are they working for?

The British Medical Association: Who are they working for?

Despite copious rhetoric about “modernisation” and “transformation”, the changes in the National Health Service (NHS) since the 1980s have never been about improving it for patients. These words, commonly heard since the infiltration of NHS decision-making by the global business lobby, are euphemisms for privatisation.

“Modernisation” is just a pretty cover story to distract the public during the stealthy asset-strip of the NHS.

The reorganisations made “for modernising the NHS” have formed part of a pre-set sequence of changes to transplant the structures and methods of the US insurance industry into the NHS. The details can be found in chapters 4-6 of The Adam Smith Institute’s Health of Nations, 1988, which sets out all the changes to the NHS that we have seen as a way to converting the NHS to an insurance-based arrangement and then ultimately passing its control to the global insurance industry.

The British Medical Association (BMA) has not only gone along with the NHS privatisation plan, but on close scrutiny it appears they may have become a key enabler for it.

For instance, in 2000 the BMA signed up to the privatisation as co-creators and signatories to the “NHS Plan”, a ten-year plan for “modernisation” which expanded the Private Finance Initiative (PFI) programme for hospitals and extended it to GP surgeries. Private debt obligations were incurred, enriching bankers and financiers from the NHS budget, transferring ownership of hospitals out of the public sector and setting up future financial collapse to justify privatisation.

The NHS Plan also found an excuse to divert money to private sector provider facilities for clinical services for the first time, and it pledged to involve the private sector in local service planning.

On the back of the NHS Plan and the huge structural upheaval already underway, a £230 million “re-engineering” programme ensued which included bringing in two American insurers with a track record of incurring fines for malpractice, UnitedHealth Group and Kaiser Permanente.

These insurers “assisted” in redesigning the NHS system to an insurance-compatible basis as part of a Transformational Change Programme to implement the changes set out by the Adam Smith Institute in 1988.

By the time the Prime Minister Blair’s Health Policy Advisor Simon Stevens left the Department of Health to work for UnitedHealth in 2004, overseeing their efforts to reshape and exploit the NHS, he was already declaring that “the Age of English exceptionalism is over” and praising the similarity of the new NHS structure to those of the American insurers.

The BMA is our national trade union for doctors, which officially is funded by doctors to promote doctors’ interests. So why has this key organisation joined the insurance industry’s attack on the NHS?

Beginning in 2000 the BMA began a lucrative commercial relationship with UnitedHealth Group.

UnitedHealth arranged with the BMA to distribute a new BMJ journal named “Clinical Evidence”, and they formed a joint venture which lasted until 2004 to create a new website for this publication, with UnitedHealth bearing the full cost of the venture. The joint venture was incorporated as “Unified Ltd” (Companies House Number 04078652); see Group Accounts 2000:

The BMA negotiated a new General Practice (GP) contract during the same period they were engaged in a joint venture with this most aggressive of the firms seeking NHS contracts. The GP contract negotiations led to the opening up of primary care to private companies which UnitedHealth subsequently took advantage of, leading to, among other things, sudden loss of GP services for 4,700 North London patients. (see also page 34 in the 2010 book “Plot Against the NHS” by Colin Leys & Stuart Player)

The BMA pursued and expanded its relationship with UnitedHealth, despite the clear opposition of the medical profession, the public towards and its own official policy positions, to NHS privatisation and in spite of UnitedHealth’s notoriety repeatedly charged with fraud in the US, including frauds against its policy holders, medical staff, and the government funded scheme Medicare, for which it is being currently sued by the Federal Government for $1bn.

By 2005- 2006, under Labour Health Secretary Patricia Hewitt, the intention to privatise the NHS became blatant and had triggered bitter and vigorous opposition from the public and health professionals. In her inaugural speech in 2005 Hewitt announced an intention to double in five years the number of operations performed by the private sector. Under the public narrative of moving NHS care into the community she revealed plans to privatise community services and outsource Primary Care Trust commissioning functions to companies like UnitedHealth.

In response to the backlash of the medical profession which included a judicial review of the plans by the Royal College of Nursing, Patricia Hewitt arranged for the BMA other relevant trade unions to sign a pledge with Government and NHS Employers to work together in a “Social Partnership Forum” in a relationship of mutual trust, and to engage in confidential discussions on the implications of the NHS policy on the workforce. The BMA and other health unions also took on “agreed external positions” as part of this arrangement.

See “History of the SPF” here:

This “Partnership Agreement” with Government continued smoothly through the 2010 change in government. The Health Unions re-signed the document in 2012 prior to the passing of the Health & Social Care Act and again in 2016 with NHS England. Today it is endorsing and embedding structures and policies to give expression to the desires of UnitedHealth and other privatisation beneficiaries as they covertly finish off the reshaping of the NHS system to their preferred form.

UnitedHealth’s subsidiary Optum is now gaining access to our personal medical records and control of the funds spent on NHS care through their new “commissioning support” role to the Clinical Commissioning Groups (CCGs are GP groupings structured as insurance funding pools, and they outsource their technical work to “commissioning support providers” such as Optum: access to hospital treatment is solely through them now, as they must authorise release of the funds to pay for it).

Through the Social Partnership Forum, the BMA is embedding NHS England’s privatisation agenda while its profitable subsidiary company the British Medical Journal (BMJ) provides a willing platform for the major corporate beneficiaries of the privatisation to market themselves. For instance, last year Optum was the “Gold Sponsor” of the 2017 BMJ “Leaders in Healthcare” Conference in Liverpool.

The current phase of the privatisation requires NHS staff to be made ready for transfer to profit- maximising new private employers. For junior doctors, this was achieved by the BMA scuppering their own industrial action, allowing stealth imposition of a dangerous new contract which had been overwhelmingly rejected by members in two separate ballots.

This will make NHS doctors more precarious and ultimately more obedient through legal protection and provision for adequate rest.

Next in line for betrayal by the BMA are the consultants, whose contract is being currently negotiated.

The money generated by the BMA from publishing and advertising today greatly exceeds what it takes in from membership subscriptions, according to BMA accounts.

The question can be legitimately asked by doctors: who is the BMA working for?

About the author: tgnhsh

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