Sustainability and Transformation Plans

End NHS Privatisation, Kurds Call For Democracy: On Friday 4th November 2016 I photographed two unrelated protests. Opposite Parliament a rally supported the second reading of Labour MP Margaret Greenwood’s NHS Bill to end the creeping privatisation of our National Health Service, and from there I joined hundreds of Kurds as they marched through Parliament Square on their way to protest at the Turkish Embassy follow the arrest of leaders and MPs of the pro-Kurdish oppposition in Turkey earlier that morning.

Bill to reverse NHS Privatisation

Old Palace Yard, Westminster

End NHS Privatisation, Kurds Call For Democracy - 2016 — *Larry Sanders, Green Party Health spokesperson and Bernie’s brother speaking*

Labour MP Margaret Greenwood’s NHS Bill which proposes to fully restore the NHS as an accountable public service and to prevent further marketisation at the hands of the Tories stood little chance of actually being debated that day as it was low on the list. Of course had no chance of ever becoming law against a government and opposition majority including many MPs receiving donations or having interests in private healthcare.

The privatisation of NHS services was taking place under New Labour before the Tories came to power in the 2010 coalition but was accelerated by the Health and Social Care Act 2012 which allowed NHS services to be contracted out to ‘any qualified provider‘, including private companies – and increasingly Clinical Commissioning Groups have been under pressure to outsource.

In 2016 Sustainability and Transformation Plans were being developed in private for 44 areas covering the whole of England to be in place by Christmas. The NHS England director of strategy Michael McConnell had said that these STPs offer private sector companies an “enormous opportunity” but critics said that they could mean the end of the NHS as we have known it.

Private healthcare is parasitic on the NHS. Their contracts cherry-pick the more straightforward areas of provision – such as my annual diabetic eye photographs – while leaving the more difficult areas to the public sector. And where complications do happen, the private NHS badged providers are quick to pass on patients to the real NHS as they do not have the trained staff or resources to deal with them.

Only the NHS is there to cope with accidents and emergencies – the private sector offers no A&E services. And it is only the NHS that trains the doctors and other medical staff that keeps the private hospitals and the services that private healthcare contracts from the NHS running.

Of course there is no chance of Parliament reversing this trend while private healthcare makes huge donations to politicians to pursue their interests. ‘Every Doctor ‘ reported in April 2025 that “The Labour Party received four times as much in donations from donors connected to private healthcare than all other political parties combined … in 2023-2025“. Health Minister Wes Streeting alone has received “almost £167,000 from individuals and companies with ties to the private healthcare sector.” The total amount of donations to politicians from people and companies involved in private healthcare in that two year period was more than £2.7 million.

On Byline Times you can read a 2021 investigation “The Conservative Party’s Private Healthcare Patrons” which explores “the financial ties between Conservative MPs and private health companies“. It’s a remarkable list of MPs and Tory Peers with details of their connections and the amounts involved.

Although the Byline Times article is careful to point out that “There is no evidence that any of the companies have benefited due to their relationships with Conservative MPs or donors” it is hard to believe that these and the other donations have had no influence on the increasing takeover of NHS services by private healthcare companies. And although there do seem to be clear possibilities of conflicts of interest so far as I am aware no MP or Peer has ever abstained from a vote because of this.

The MP’s code of conduct is extremely weak on this matter, and simply relies on MPs to do the right thing – “Members must base their conduct on consideration of the public interest. They must avoid conflict between personal and public interest. If there is any conflict between the two, they must resolve it at once in favour of the public interest.”

This is one of the areas which have caused the current high levels of distrust of politics and politicians. We need much tighter controls on lobbying, an end the system which allows large political donations in cash or kind to MPs, and ensure that MPs who have conflicts of interest abstain from voting on these issues. MPs are paid to represent their constituents, not healthcare companies and not their own financial interests.

More about the protest on My London Diary at Bill to reverse NHS Privatisation

Kurds march for Peace & Democracy

I left the protest at Parliament when over 500 Kurds marched into Parliament Square protesting noisily against the arrest early that morning of two leaders of Turkey’s pro-Kurdish Peoples’ Democratic party (HDP), along with at least 11 MPs.

They sat down briefly on the road in front of Parliament on their way to the Turkish Embassy in Belgrave Square.

At Belgrave Square police tried to stop them and keep them on the opposite side of the road to the Embassy, but they simply walked around the police line and crowded on the pavement and road in front of the Embassy door.

Eventually the police abandoned their attempts to push the protesters back and simply stood several lines deep in front of the doorway while the protest continued.

The rain came down heavily and we were all getting wet but the noisy protest and speeches continued. Eventually the protesters moved away from the embassy and I left them.

Many more pictures on My London Diary at Kurds march for Peace & Democracy.

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Save Our NHS – The NHS was under attack by the Conservatives before it was established in 1948 and has come under repeated attacks since by governments of both major parties particularly since the 1990s.

Providing universal healthcare costs and the current financial year (2023/24) figure of £160.4 billion is around one seventh of total government spending of around £1,200 billion. So it isn’t surprising that governments should wish to see that the money is being spent wisely. But that isn’t was most changes in government health policy have been about.

Even with that large sum, the UK is still getting healthcare on the cheap. According to Statista the spending per person is less than in the US, Switzerland, Germany, Norway, Netherlands, Austria, Belgium, Australia, France, Sweden, Luxembourg, Canada, Denmark, New Zealand, Ireland and Finland and roughly the same as in Iceland and Japan.

It’s perhaps not surprising given this that we often hear reports which compare the results of NHS care critically with those in other countries. But those reports on the BBC and in the papers seldom if ever mention the poorer funding the NHS receives than many of those with better health outcomes.

The US spend per person is considerably higher than all other countries and roughly two and a quarter times that in the UK. But many of the NHS reforms made this century have been based on making our health system more like the American model, which would be a disaster. But it would mean a great opportunity for private healthcare companies, particularly some of those US companies, to make huge profits at our expense.

A surprising number of our MPs have had some financial interest in healthcare either through shareholdings or by sponsorships. The Daily Mirror in 2014 published a list of 70 MPs with links to private healthcare firms which included almost every leading Tory and some from other parties. As well as then Prime Minister David Cameron, they included Former Health Secretary Andrew Lansley, responsible for the disastrous Health and Social Care Act 2012, Health Secretary Jeremy Hunt, former Health Minister Simon Burns, the Work and Pensions Secretary Iain Duncan-Smith, William Hague, Philip Hammond, Sajid Javid, Oliver Letwin, Chancellor George Osborne, Priti Patel, Jacob Rees-Mogg and many other leading Tories, along with Lib-Dems then in the coalition government Vince Cable, Nick Clegg and Simon Hughes.

It’s these people who have introduced policies which have led to large areas of NHS services being provided by private companies, though still retaining the NHS logo and still providing services free to the public. But generally these are the kind of simple, straightforward services and the more complex areas are still left to the NHS.

There is still huge public support for the NHS, despite its problems some of which have been created possibly deliberately by government reforms to erode that support, though more clearly in a drive to make more of its services available to be taken over by private companies.

On Saturday March 4th 2017, thousands came to Tavistock Square, outside the BMA headquarters to march to Parliament Square in protest against the cuts and privatisation of the NHS which they said was at breaking point.

In particular they were protesting the Sustainability and Transformation Plans for hospital closures and cuts in services which had already caused many premature deaths. Doctors and other healthcare workers clearly saw these as a part of a rapid stealthy privatisation with medical services increasingly being run for private profit rather than public benefit.

In 2017 the STPs mutated into Sustainability and Transformation Partnerships and in 2018 these were told to transform themselves into Integrated Care Systems which have now replaced Clinical Commisioning Groups. These plan, buy, and provide health and care services in there areas and are subject to inspection under 70 performance metrics and can be put into ‘special measures’.

According to the Wikipedia article “A report from the Nuffield Trust in December 2021 found that there was very little evidence that integration policies across the UK – including pooling budgets and creating new integrated boards and committees – had dramatically improved patient experience, quality of services or supported the delivery of more care outside of hospitals.” But clearly they had diverted a considerable amount of expertise, time, energy and money away from the real business of the health service – and funding towards private companies.

Estimates for the number on the march varied even more wildly than usual, but it was clearly a large march. My guess was perhaps 30,000 but it could well have been twice that if not the 250,000 the organisers claimed. All the pictures in this post come from the march and the rally before the start, and I was too tired by the time it reached Westminster to photography the rally in Parliament Square.

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Tag: Sustainability and Transformation Plans

Save Our NHS – 4th March 2017