Health and Care Bill

Baroness Bakewell Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Bakewell (Lab)]

My Lords, I welcome a Bill that brings together the National Health Service and social care. How could I not? It is a long overdue development. However, I have serious reservations about the Bill’s direction of travel. I fear that the reforms set out here will fragment and disconnect the NHS from the very people—the patients—it was created to serve. The proliferation of protest groups and increasing numbers of petitions, as well as individual cases to challenge existing changes being taken all the way to the High Court, all bear witness to a popular groundswell of opposition to what is happening.

There also comes a warning this week from former Health Secretary Jeremy Hunt about the risk of equity-funded investment in care homes. When the motive is profit, he says, standards of care are squeezed. The NHS motive is exclusively private care—and so we come to the continuing inroads made into the NHS by Centene, America’s leading health insurance company and its subsidiaries in this country under Operose. They have been steadily buying up surgeries around the country and including them on their schedule of profit-making enterprises designed to offer good returns to their global shareholders.

Anyone with any knowledge of American healthcare, whether first-hand or reported, will know how expensive it is. The level of your care depends on the level of your insurance; without insurance, you can be refused care. The New Yorker recently reported that American hospitals are closing at a rate of 30 a year. It reported that, increasingly, hospitals are seen as businesses—that

“a fifth of hospitals are now run for profit, and, globally, private-equity investment in health care has tripled since 2015.”

In 2019, according to this report, some £60 billion was spent on acquisitions globally. That “globally” includes—indeed targets—us and our NHS.

Centene and its British subsidiary Operose now own 70 surgeries around the country, from Leeds to Luton, from Doncaster to Newport Pagnell, from Nottingham to Southend, and in many other areas, Centene/Operose now owns and runs for profit surgeries formerly owned and run by NHS doctors. It is now the biggest provider of GP services in the country. It has further designs on the existing fabric of the NHS, seeking to have its representatives sitting on the boards of CCGs, and making decisions about the deployment of NHS funding. This is a direction of travel that needs to be monitored and checked—and it will be.

Why does all this matter, as long as patients have good and free treatment at the point of delivery, wherever they need it? What is the reputation of the company Centene in America? It is not good. Since the year 2000, there have been 174 recorded penalties against Centene, its subsidiaries and its agents for contract-related offences against its patients. The fines paid by Centene go into millions—billions—of dollars. This is not a fit company to be part of the NHS. I repeat the Government’s campaigning cry: “Take back control”—of our NHS.