Britnell’s Got Talent
At Prime Minister’s Questions on May 15th, David Cameron claimed had not heard of one of his health advisers, Mark Britnell, until he’d Googled him on Sunday. His interest was provoked by The Observer’s report of a speech that Britnell, Global Head of Healthcare at KPMG, gave to a group of private health companies in New York last October. According to a brochure summarising the conference, Britnell said: “GPs will have to aggregate purchasing power and there will be a big opportunity for those companies that can facilitate this process … In future, the NHS will be a state insurance provider, not a state deliverer…The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years.” Britnell responded by saying that the quotes ‘did not reflect the discussion that took place.’ But in the same month, he launched a KPMG sponsored GP Commissioning Academy at the National Association of Primary Care conference attended by health secretary Andrew Lansley and health secretary in waiting Stephen Dorrell.
Cameron’s desire to distance himself from a member of his kitchen cabinet of NHS experts, assembled by his health adviser Paul Bate, is understandable. But to claim he’s never heard of Britnell stretches credulity. Britnell worked for the NHS for twenty years before he jumped ship to KPMG. He is ambitious and forceful, and has advised politicians from all major parties on NHS reform. So, as head of South Central Strategic Health Authority – which oversaw the new Tory leader’s constituency – it seems likely he would have collared Cameron when they both attended an Oxfordshire PCT meeting on February 19, 2007.
More worrying, given Cameron’s desire to protect and love the NHS, is his professed ignorance of a key architect of both Blair’s and his own health reforms. In Wales and Scotland, there was – and remains – no appetite for an NHS market. They just concentrate on providing the best service they can through cooperation. But Britnell was – and remains – a huge fan of commissioning. In 2007, he became Director General of Commissioning at the Department of Health and was voted third most powerful person in the NHS, ahead of health secretary Alan Johnson (Eye… December 2007). Britnell coined the phrase ‘world class commissioning’ and cemented the concept in NHS policy to the extent that the Tories are forming a National Commissioning Board and ‘liberating’ hundreds of GP consortia to ‘do commissioning’, rather than treat patients.
Britnell also came up with FESC (Eye Dec 2007), ‘a Framework for procuring External Support for Commissioners, which is part of the ‘buy’ option, providing PCTs with easy access to a bank of specialist expertise in areas such as data analysis, contract management and public engagement’. As the Eye observed, ‘FESC is just an excuse for clueless PCTs to buy the ‘expertise’ of huge for profit health insurance corporations. In America, these organisations keep costs down by offering doctors perverse incentives to deny patients the care they need (600,000 doctors have been sued for this) and there are widespread legal claims for misapplying fee schedules, errors in claims processing and delayed payments.’
In October 2009, Britnell jumped ship to KPMG, one of the companies that took PCT money under FESC and – presumably unknown to Cameron – secured a contract to do so for NHS London in January 2011. A revamp of the costly FESC is pretty much what Britnell is suggesting now, hardly surprising to Cameron’s health adviser Bate, a former Blair adviser who Britnell met on appointment, or his head of Policy Development Paul Kirby, formerly a close associate of Britnell at KPMG. Cameron may limply claim to have never heard of Britnell, but Britnell’s – and KPMG’s – agenda is alive and kicking in the Health and Social Care Bill.
PS In 2006 Britnell was a director of the health research company Dr Foster when the Department of Health struck what the public accounts committee called a ‘backroom deal’ with it, costing the taxpayer £4million too much. In 2008, shortly before leaving the health department for KPMG, he awarded a contract to advise healthcare trusts on commissioning to a joint venture between…. Dr Foster and KPMG!