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A majority of the members of the NHS Future Forum, the body which recommended scaling back NHS health reform, are NHS-affiliates.  They are either directly or indirectly employed by it, or have another financial interest in it.  Not a single Forum member represents the private for profit sector.  The Government says it will largely follow the Forum’s recommendations.  Deciding NHS policy is apparently an inside job. 

Out of the Forum’s 43 members, 23 have strong NHS links.   Another 12 are directly or indirectly employed by the state (including councils and universities).  Of the voluntary organisations, several have NHS links.  There is not a single private for profit provider represented on the Forum.


The Future Forum organised a large listening exercise about the Government’s NHS reform proposals. Who did they listen to?  Mainly their friends, I suspect:

‘…patient groups, professional bodies and unions, third sector groups, as well as local government, regulators and (lastly) the independent sector.’  

I wonder how many from the independent sector were actually consulted out of the total.

The ‘public and stakeholders’ were also invited to send emails: 25,000 did so, but it went pear shaped, as the Report points out:

"a large proportion of these emails were generated by campaign groups and that as a result, many of them contained similar wording.  Nonetheless, our approach is that if an individual sees fit to take part in such campaigns, their emails are fully considered". 

Public consultations are the purvey of the self-selected few at the best of times.  Consultations rarely reflect the views of those in employment and with kids.  The silent majority doesn’t have the time for surveys and public meetings.  Therefore public consultations are dominated by a specific stratum of society.  And…by those with a vested interest.  It would be interesting to find out how many of the "public" consulted by the Forum are in the NHS’s employ.

Are we surprised the Forum’s recommendation is to scale back the proposed competition?  Instead of generalised competition, the scope is to be determined by the Commissioning Board.  Is it wildly off the mark to expect this Board to be dominated by NHS affiliates, too?  Will the "scope" they decide upon leave any room for private sector competition?    Until they allow widespread private sector competition, private health quality will remain the preserve of the happy few.

Policy by public consultation is flawed to the core.  What is wrong with listening to the whole electorate?  Why do we have an elected parliamentary democracy if we shove it aside for self-selecting special interest groups?

28 comments for: JP Floru: An inside job – NHS special interests decide UK health policy

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