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Editor's blog Tuesday 17 May 2011: Reaching the Apax of curiosity as the Britnell brouhaha continues

KPMG's Global Head Of Health Dr Mark Britnell has rather become the story since his Health Service Journal opinion piece on debating NHS funding.


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I wrote a response piece here, including with his permission some comments from Mark in reply to my piece.

Since then, the blogosphere (I'm afraid I don't know who spotted this first) has drawn wider attention to this report of an APAX Partners healthcare conference in October 2010, which quotes Mark as saying, “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.”

The monolithic arm of state control will be relaxed which will provide a huge opportunity for efficient private sector suppliers". (We should note that the typography of the document is ambiguous whether this last line is a direct quote or a paraphrase.)

These quotes subsequently appeared in The Observer, leading to a rejoinder from Lib Dem peer Baroness Shirley Williams that Mr Cameron should sack Mr Britnell as a kitchen cabinet adviser.

Now Mark has written a piece for Health Service Journal which states that "The article in The Observer attributes quotes to me that do not reflect the discussion that took place at a conference last October".

Very curious stuff.

So I have contacted Apax Partners to ask whether they stand by the quotes printed in their document. And will report what they say, once I hear from them.

There is an interesting irony in the fact that the conference at which Mark spoke and the report of what he apparently said were the work of private equity firm Apax Partners. Many of you will know that, in a joint venture with Guardian Media Group (who own and publish The Observer), Apax Partners bought out and still own EMAP, owners and publishers of Health Service Journal.

A curious addendum
At yesterday's Guardian listening event, Professor Steve Field found himself in the curious and invidious position of being asked to defend Britnell's actual and alleged comments (you can hear the audio here, sliding the player bar along to 71:37).

Field told the event, "I’m not a member of the Conservative Party. I don’t work for them. I know Mark Britnell … As reported, Mark Britnell was wrong. I haven’t heard any intention from government that this is what they want. What comes across in public as well as in private is David Cameron’s real care … I’ve heard no intention of that from government but I can only tell you what I’ve heard.

"I’m not aware of any kitchen cabinet. Mark Britnell I know but I’ve only read what you’ve read. I wasn’t in NY when he said that. He has a legitimate view as a citizen of England as you do. My job is to hear views - from 'let’s have a free market' to 'let’s have a system that is so tied down locally that there is no choice for the patient'.

"If Mark Britnell's saying this system is to be insurance-led, I've not heard any indication of that in Government.

"I have heard no intention from any politician to go down the route Mark Britnell describes".

I must admit to being totally confused why anyone thought Steve Field was going to be able to or indeed should answer for Mark Britnell's written and reported views. It was, quite frankly, a bloody stupid question to ask Steve Field.

The debate about the role of the private sector and competition in the NHS risks being unhelpfully polemic (although it is intrinsically somewhat polarised).

Surely even the most ardent believers that the NHS should be wholly, 100% publicly-owned (who must of course want to nationalise general practice and pharmacy) would rather have those who think the opposite making their case in public, so they can be spotted and debated?

That is what reasoned politics is about, isn't it?

I get the impression of a demonising tendency at work here, which reduces debate to simplicity when often, the issues are complex.

Mark Britnell is no demon: he's a clever and thoughtful man. His pieces in Health Service Journal, linked above, correspond to the intellectually curious person I know. He emphasises his strong personal support for the NHS, based on life-saving treatment he received.

Moreover, looking beyond the rhetoric, his reported statement on "insurance provider" can be read as an attempt to explain changes in UK healthcare provision to a US and global conference audience, to whom such terms would be more immediately familiar.

It is also quite accurate to state that the current NHS reforms are about getting the Government out of the provision business: a trend that started with the foundation trust movement.

The monolithic arm of state control is rhetoric: FTs aren't state-controlled, and nor are most GP practices.