Was Lansley sacked for lie & u-turn on SW NHS pay cartel?

On 7 August, I wrote about the Department of Health’s response to my FOI request about its communications with the South-West Pay, Terms & Conditions Cartel Consortium, and how the emails it provided in response demonstrated that Andrew Lansley had lied when he claimed to have ruled out pay cuts as a means of achieving the DH’s ‘efficiency challenge‘ to the NHS.

The 3 emails provided in response to my request were telling, but I wrote back to the DH to request a review, because I couldn’t believe that 3 emails was the entire correspondence for a whole year between the DH and a group of 19 (now 20) NHS Trusts.

I received a response today (right on the deadline specified by the FOI Act), indicating that there was in fact a further email that hadn’t been sent to me originally. That email appears below, and the picture it paints, when combined with the Parliamentary debate it refers to, shows that not only were Health Ministers fully aware of and happy with the Cartel’s plans a week before they said they weren’t, but their sudden u-turn to claim to be against pay cuts surprised a director of the cartel so much that he was emailing the DH within minutes of the parliamentary debate in which the initial ‘no pay cuts’ statements were made. Lansley’s spineless inability to stay ‘on message’ may very well be the reason why he was sacked yesterday and replaced with a more ruthless man.

Reading carefully and cross-referencing the emails with the debate in Parliament paints a very clear picture of just what the cartel’s plans were that health ministers approved of – that those plans definitely included pay-cuts for NHS staff – and that Lansley and his minister then went off-script to betray the cartel that they had reassured only days before. To follow the threads and weave them back into a picture will require a little patience, but bear with me to the end and I’ll do my best to make sure it’s clear and worthwhile.

First, the new email:

David Amos, as well as being a consultant, is also a director of the pay cartel, for which he reported receives a 6-figure salary. In the original response from the DH, his name and the name of Chris Bown (who works for the Poole Hospital NHS Trust, which is a cartel member), were redacted from the mention of the meeting with Nic Greenfield, a DH director responsible for NHS pay & pensions, but included in the updated response.

For the sake of brevity in this post, I won’t repost all the emails included in the first DH response to my FOI request, but if you want to check the details of those, please refer to the original article. But here I’m going to lay out the chronology of the events & emails, the relevance of the information they reveal and also include a few extracts from the parliamentary debate Amos refers to in his above email, so that you’ll hopefully finish with a clear picture of what the DH and the cartel have been up to:

Tuesday 10 July: Meeting between Health Ministers and the cartel – and Ministerial approval

Both the email from Jon Fisher (Communications Manager of the Poole Trust) to a redacted DH official at 12.40 on 13 July, and Greenfield’s reply less than an hour later (13.32) make clear that Greenfield met with David Amos of the cartel and Chris Bown on Tuesday 10 July. Details of the discussion have not yet been disclosed by the DH, so I’ve put in a separate FOI request for full information.

However, the reply from the un-named DH official to Fisher makes it clear that pay was discussed during this meeting, since he advises Fisher that he needs to speak to the Pay Team.

In light of this, Greenfield’s email already referred to nails then-Health Secretary Lansley and Minister of State for Health Simon Burns in a lie when they said that the DH did not agree with the need for pay cuts (just pay flexibility to achieve a reduction in pay cost, though how that differs from a pay cut is anyone’s guess!).

Greenfield’s email includes this statement: ‘When Nic met David and Chris on Tuesday it was made clear that the NHS Chief Executive, David Nicholson, and ministers had been briefed on the south west consortium position and were content and grateful for the briefing.

Lansley and his minister lied to Parliament by claiming that they did not approve of or see the need for pay-cuts (Lansley even goes so far as to say he had always insisted that they were not necessary) – when in fact they had not only been fully briefed but also approved and were grateful for the update! More detail on that shortly.

Friday 13 July: ‘a just-received media issue…’

Fisher’s initial email refers to ‘a just-received media issue…’ – but the version of the email provided by the DH does not give any further information on what the issue is. From the DH’s reply stating that Fisher needs to speak to the Pay Team, it’s obvious that the email contained more information, but it has been deleted (without indicating the deletion) by the DH in its response to me, which is a definite no-no.

However, we can still identify what the issue was from Andy Burnham’s contribution to the parliamentary debate the following Monday. I’ll look at some fuller extracts in a moment, but at one point in his address he states: ‘But we heard yesterday that a breakaway group of 19 NHS trusts in the south-west has joined together to drive through regional pay‘.

Looking at the emails sent by Fisher and the un-named DH official, it’s very obvious that the cartel had been informed that their pay plans were going to be revealed in the weekend’s press, and was looking to the DH for guidance on how to manage the story.

Monday 16 July: Parliamentary debate, Ministerial lies and betrayal, cartel panic

I hope you’re still with me, and I apologise if it’s hard going. Digging through a mass of information/disinformation to find the kernels of truth can be a slog – I’ve spent all of tonight reading and parsing information, as well as many hours on previous days to start to narrow down the picture.

If you’ve made it this far, thank you – and please bear with me as this last section contains excerpts from a very long Parliamentary debate that contained some critical points that complete the chain of events and prove that Lansley and Burns not only lied to Parliament but also executed a complete, sudden and duplicitous u-turn on their friends in the cartel:

Don’t panic! Don’t panic!

In his email to Nic Greening, David Amos expresses the urgent wish for a ‘catch-up’ ”especially after this evening’s House of Commons debate“. What was in the debate that caused Amos such apoplexy? Let’s take a look:

Shadow Health Secretary Andy Burnham says:

“we heard yesterday that a breakaway group of 19 NHS trusts in the south-west has joined together to drive through regional pay, in open defiance of the Deputy Prime Minister. They are looking at changes to force staff to take a pay cut of 5%; to end overtime payments for working nights, weekends and bank holidays; to reduce holiday time; and to introduce longer shifts. We even hear that if staff will not accept this, they are going to be made redundant and re-employed on the new terms. So let us ask the Secretary of State and the Minister to answer this today: do the Government support regional pay in the NHS and the other moves planned by trusts in the south-west? If they do not, will they today send a clear message to NHS staff in the south-west that they are prepared to overrule NHS managers?”

Burns responds:

“the Government’s position is clear: it is for employers, not for the Government, to lead negotiations on the terms and conditions of their staff, and to do so with the agreement of staff…

The negotiations are not about a pay cut, and we would not support one…

Although they [NHS employers] are free [under the Health Act 2006] to opt out of the national pay framework, they cannot do so unilaterally; they must consult and seek agreement with their staff and representatives…

Pay is the largest element of NHS costs, and pay systems must evolve. The trusts in the south-west wish to work and negotiate with the trade unions to agree changes, not to dismiss and re-engage staff”

A little later in the debate, then-Health Secretary Lansley adds his own contribution:

“I have made it clear, as the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford [Burns] has, that we are not proposing any reductions in pay as a consequence. I do not believe they are necessary or desirable in achieving the efficiency challenge.”

Is there any alternative explanation? Is it possible that the cartel’s plan didn’t really include pay-cuts and firing any staff who objected? No.

In the same debate, Alison Seabeck, Labour MP for Plymouth, Moor View, said:

‘On pay for staff in the south-west, the chief executive of the Royal Cornwall Hospitals Trust [one of the cartel members] said to me in a letter:

“In recent years NHS organisations have largely exhausted other avenues of potential cost-saving (including reducing reliance on bank or agency staff and implementing service improvement initiatives)” She goes on to say that the consortium, which consists of 20 organisations in the south-west, “is looking at how pay costs may be reduced”

So, the truth is out. Lansley approved and then, under pressure, lied and u-turned.

Now picture the scene: David Amos is sitting down in his plush pad somewhere, with a cigar in one hand and a whisky or G&T in the other, after a hard day plotting to rob hard-working doctors, nurses and other NHS workers of their pay and benefits.

6 days before, he’s had a meeting with a senior DH official who has assured him that Health ministers and the CEO of the NHS have ‘been briefed on the South West consortium position and were content’.

The fly in the ointment of his calm is only a small one – the story breaking in the previous day’s Sunday papers of the true extent of his plans. But one of his helpers from the Poole Trust had got wind that the story was going to break and had been in touch with the DH to inform them of it and to get guidance from them in how to handle the media. And the ministers were ‘briefed and content’. No real need to worry, then.

So he’s relatively sanguine as he sits down to watch the debate on BBC Parliament. But as soon as the opposition press the question of whether ministers agree with the cartel’s plans – they do a u-turn and say they’ve never been in favour of it!

The cigar flies across the room and the whisky glass shatters as Amos lurches out of his chair and grabs his phone.

Am I exaggerating to suggest panic? I don’t believe so. The notes of the Parliamentary  debate include timestamps. The debate finishes at 7.30pm. As you can see in the image of it above, Amos’ email to Greening – phrased with a strained attempt at nonchalance – was sent just 80 minutes later, at 8.50pm.

Within that short period, Amos had spoken to his partner-in-crime at the meeting with Greening (‘Chris and I wondered‘!), agreed what to do and written & sent his message to Greenfield. At the very least, there was a strong sense of urgency.

Lansley was sacked yesterday as Health Secretary. He was a detestable, lamentable excuse for a Health Minister – and from his behaviour regarding the SW pay cartel he is clearly spineless and quite happy to lie to Parliament to cover himself.

But his replacement, Jeremy Hunt, is a man who not only has a clear history of being prepared to collude with private interests to the detriment of the public but is also on record as despising the very NHS he’s taking responsibility for, describing the NHS as a ’60 year old mistake’ and ‘irrelevant’ to today.

David Cameron promised ‘The NHS is safe in my hands’. But in unguarded moments – and sometimes even in books they’ve co-written! – Tories occasionally admit that they despise the NHS and want to destroy both it and the entire welfare state.

Lansley let the side down. Eroding staff pay and conditions is a key pillar in the government’s strategy for dismantling the NHS and handing it out cheap to private health companies. Lansley showed he can’t be relied on to stay calm under pressure and to stick to the script.

How much do you want to bet that the real reason Lansley was fired was because he didn’t stick to the plan and support the cartel, and preferred to lie to Parliament rather than help a cartel – whereas Hunt was happy to lie in order to help News International form one, and then stayed cool enough to keep his job even when it was obvious that he should resign or be fired? The official brief was that Hunt replaced Lansley because of his superior communication skills – which once you know the context is just a sanitised version…

The NHS is now in the hands of a ruthless man who’ll cut the legs out from under the doctors and nurses we rely on – and smile while he does it. After his appointment, Hunt said ‘It’s a huge task’ – but plainly he meant dismantling the NHS. It’s more important than ever that we unite – and fight to defend Britain’s greatest institution.