FOI? No, FU – no right to know even staff nos as health is privatised

The potential consequences of this are disastrous, both in terms of the health and lives of millions of people in England and for the right of any of us to know what is being done with our money, in our name. Please read to the end and take action – and share widely.


Almost 2 years ago, the then health minister Paul Burstow made a remarkable statement to the House during written answers to health questions:

The Department has supported the right to request (R2R), which has enabled 45 staff-led social enterprises to be established as shown in the following table. This policy has supported approximately 25,000 staff to move out of the national health service into social enterprises with contracts worth roughly £900 million a list of these are also in the table.

The Department cannot provide details of individual social enterprise staff and turnover figures as they are commercial in confidence and belong to the social enterprises as they are now independent bodies. Contracts were negotiated between the new social enterprises and commissioners (ie primary care trusts). The Department’s policy was the contracts should be for between three and five years, depending on services and the introduction of any qualified provider for their services.

Why is this statement so important?

Earlier this year I was able to reveal that around 20,000 NHS nursing posts were simply being left unfilled in order to cut costs – a figure that was not then available anywhere else in the public domain, and which has obvious and massive consequences for the safety of patients, and huge relevance to the current debates on overstretched accident and emergency departments and lengthening NHS waiting times.

I was able to reveal that vital information because of a series of FOI requests – one to each and every one of the 140 or so acute hospital Trusts in England. Not all responded, and some of those who did refused to divulge the information. But half did – more than enough to gauge the scale of the huge, previously-hidden gulf in nursing numbers.

In fact, the figure of 20,000 might be too low, since one can reasonably assume that hospitals with more to hide are more likely to withhold their answer. The government’s claims to be increasing spending on the NHS were already obviously untrue – the FOI requests revealed their claims to be increasing ‘clinical’ numbers (not ‘nurses’, since 7,000 or so nursing positions have been openly cut) to be cut from the same deceptive cloth.

But Mr Burstow’s written statement to the Commons reveals how much the ongoing, piecemeal-but-inexorable privatisation of the NHS threatens our wellbeing and safety – and even our right to know that how big the risk is.

Even back in 2011, Burstow reported that 25,000 staff had been ‘supported’ to move from the NHS into the ‘social enterprise’ sector. But he admitted that it was impossible to know how many of them were still working – because the information was considered ‘commercial in confidence’, and non-public companies cannot be forced to reveal such details.

The current FOI Act contains an exemption for ‘commercial in confidence‘ information applicable to public bodies, but it’s very difficult for them to hide behind it because their public funding carries an expectation of openness and their non-profit status makes calling anything ‘commercial’ difficult. It happens, but not often – and even when it does happen it can be overturned by the Information Commissioner’s Office (ICO) if a member of the public appeals.

But there is no such right of appeal for any facility that has moved into the private sector – nor even the right to make the FOI request in the first place. As Mr Burstow admitted, any kind of private company negotiates its contracts with the decision-making body – and then has carte blanche to decide how to fulfil that contract.

This means that private providers can bid low in order to win NHS contracts, then cut staff to maintain profit margins – and you, or I, have no legal right whatsoever to know about it. When it comes to healthcare, patient safety, and our right to be informed, are considered to be of less importance than the maintenance of company profitability.

Hinchinbrooke hospital has already been taken over by a private company, Circle, which has expressed a desire to take over more hospitals. GP surgeries and other NHS facilities have been taken over by companies like Virgin and Serco, and more services including hospitals are set to be absorbed under the government’s ‘section 75’ measures to force all NHS services to be offered to private providers.

And once they’re in place, they can cut staff numbers at will – and you won’t even have the right to ask about it.

Late last year, the excellent MP Grahame Morris tabled an Early Day Motion, EDM 773, for the FOI Act to be extended – in accordance with a (broken) campaign promise by David Cameron – to apply to private providers as well. 110 MPs signed the EDM, but the parliamentary session ended before it went anywhere.

The new motion (267), tabled after the Queen’s speech, currently has only 45 signatures. This is what it says:

That this House notes that the most significant development that has followed from the Government’s healthcare reforms has been the £7 billion worth of new contracts being made available to the private health sector; further notes that at least five former advisers to the Prime Minister and the Chancellor of the Exchequer are now working for lobbying firms with private healthcare clients; recalls the Prime Minister’s own reported remarks prior to the general election when he described lobbying as ‘the next big scandal waiting to happen’; recognises the growing scandal of the procurement model that favours the private health sector over the NHS, by allowing private companies to hide behind commercial confidentiality and which compromises the best practice aspirations of the public sector; condemns the practice of revolving doors, whereby Government health advisers move to lucrative contracts in the private healthcare sector, especially at a time when the privatisation of the NHS is proceeding by stealth; is deeply concerned at the unfair advantages being handed to private healthcare companies; and demands that in future all private healthcare companies be subject to freedom of information requests under the terms of the Freedom of Information Act 2000 in the same way as existing NHS public sector organisations.

This summary statement of the damage-by-stealth being inflicted on the NHS is exemplary in its clarity and accuracy. Under this government, however, it faces almost certain defeat unless all the Lib Dems who supported the earlier 773 – and more besides – support 267.

Only two have so far done so – Andrew George, who rightly and bravely condemned the Tories’ politicisation of the Keogh report last week, and Mike Hancock.

The LibDems who signed 773 but have not so far signed 267 are as follows:

  • John Hemming, Birmingham Yardley
  • Mark Williams Ceredigion
  • Dan Rogerson North Cornwall
  • David Ward Bradford East
  • Tim Farron Westmorland and Lonsdale
  • Ian Swales Redcar
  • Andrew Stunell, Hazel Grove
  • Annette Brooke, Mid Dorset and North Poole
  • Adrian Sanders, Torbay

If you have a LibDem MP, whether on this list or not, please write to him or her and insist that they sign. The chances of winning this motion and moving it even a step closer to legislation might be slim – but the alternative is to stand by like sheep while our safety is auctioned off and our right to know disappears behind the ‘commercial in confidence’ veil.

Edit: Julie Taylor made an excellent suggestion in the comments as follows:

“if any Skwawkbox followers living in these LibDem constituencies (or any constituencies where the MP has not signed the EDM ) could write letters/articles for local newspapers to help raise awareness among older people who might read newspapers but who aren’t necessarily online.”

If that’s you, please get to it!


  1. As I see this there are further problems in that the NHS had to check the credentials of all employee’s, this system takes that check away, who is to say what qualifications these staff have.

  2. It should come as no surprise that research into hospital mortality statistics is now the responsibility of HQIP – a network of charities that is similarly unaccountable to the public, and equally immune to FoI.

  3. Hi Steve. Retweeted and put on Facebook! I know this is focused on health but I guess any public sector work put out to (private) tender will have the same result! Keep up the fantastic work!

  4. Steve, I am wondering if any Skwawkbox followers living in these LibDem constituencies (or any constituencies where the MP has not signed the EDM ) could write letters/articles for local newspapers to help raise awareness among older people who might read newspapers but who aren’t necessarily online. Great article, thanks for the info. (Glad to see my MP has already signed this EDM !)

  5. This totally exposes Jeremy Hunt’s moralising spin about improving ‘care’ for the ideology and rhetoric that it is. It also exposes hundreds of nurses and HCA’s to the possibility of a more precarious contract of employment since private healthcare is now the second biggest user of zero hours contracts, the majority of which are for nursing and HCA jobs. And you only have to look at the terrible standards in our children’s homes which are now almost exclusively run by the private sector with none of the transparency that FOI demands, to know what’s in store for health services. Its frightening.

  6. Reblogged this on Grannie's Last Mix and commented:
    This post highlights a crucially important issue. Please share this as widely as you can and if your MP is one of the LibDems mentioned please urge him to sign the Early Day Motion referred to. Its OUR NHS and we need to fight to keep it that way.

  7. I worked in the NHS for 22 years before changing careers in 2001. Even then, we could see this privatisation coming, with self-governing trusts, and fund-holders. Well done for giving it all a wider audience. Pete.

  8. Steve, I’m afraid even now we’re only at base camp.


    It’s even more base than lying to the public in order to join a war or in order to destroy public institutions.

    It’s baser even than a select few deciding for political ends to nudge a public denied representation between elections while big money trumps their interests.

    We are riddled with this secret, corrosive self-serving attitude which only open and direct democracy can hope to bypass.

  9. It is all very scary. This government only seem interested in Helping those who have made huge donations, and do not have any morals. Look at AtOS, it doesn’t matter who contracted them in the first place but despite being made aware of the cost to human life there wrong decisions and often false reports and awful manner used in conducting the assessments they have failed to step in. The company that now has the Plasma banks is linked to the company involved in abusing vulnerable people in its care. David Cameron hasnt honored any of his promises and all we hear is blatant lies and made up figures that cannot be backed up by statistics. Instead of addressing issues they have tried to change human rights and take taken away rights of legal aid for disabled people’s appeals. The only way the reforms are succeeding is by the tens of thousands of deaths of sick and disabled people,. families being torn apart. Now with the NHS being sold of to money motivated companies how much health care can the general public expect. The cuts that have already occurred have closed a&e’s across the country along with many wards, also added to the unemployment figures and reduced the number of jobs available whilst making horrendous cuts to benefits for the low paid, unemployed, sick and disabled. whilst the Rich have had tax cuts which have cancelled out the savings of the cuts. All this will just lead to more deaths and with the private health care not having to disclose information there will be cover ups aswell as neglect.

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