Question Time audience member who spun question about NHS privatisation linked to private health interests

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A Question Time audience member who asked a loaded question about NHS privatisation works for a Foundation Trust looking to expand its private-sector role. He also enjoys links to management consultants profiting from NHS and private health contracts.

During Question Time from Canterbury on 11 December 2014 – featuring Russell Brand and Nigel Farage – audience member Alexander Quinn asked: “What role should the private sector play in the future of the NHS?”

Quinn was asking a loaded question, concerning how far – not whether – the private sector should involve itself in Britain’s National Health Service, framing the discussion in terms helpful to private health interests.

Smartly dressed, in a sharp suit, smoothed-back hair and stylish glasses, Quinn cut an unusually professional figure. Viewers were not informed that since July 2014 he has worked as East Kent Foundation Trust’s “Strategic Development Assistant Manager”.

Most Foundation Trusts receive income from the private sector, charging private patients either directly or through subsidiary companies.

As investigative site NHS Privatisation notes,

“All foundation trusts give private patients access to NHS facilities and expertise, and many trusts advertise this as their main attraction to private patients.”

In its Forward Plan Strategy Document for 2012-13, East Kent state that a “key priority” will be to “adapt to the changes to the commissioning and competitive landscape”. “Key milestones include”: “Provide marketing support for increase private patient provision [sic]” and “Identify and follow up on business opportunities”.

Links to management consultants

Quinn is also linked to Practicus, a management consultancy that has secured a string of NHS contracts.

Quinn used to maintain a profile on professional networking site LinkedIn, but deleted it soon after this investigation began. It listed Quinn as a member of private group “Change Management UK”. This group lists as its website “practicus.co.uk” – an international management consultancy. Change Management UK’s owner is non-executive chair at Practicus, and all four managers work for Practicus.

In December 2014, Professor David Oliver, the Department of Health’s former national clinical director for older people’s services, wrote in the British Medical Journal that management consultants were “making a killing” from the privatisation of the NHS. As he put it:

“In times of war, arms dealers, rebuilders, and racketeers profit from the chaos. “Disruptive innovation” has led to similar spoils for management consultants, with taxpayers’ money diverted from already struggling health and care services.”

Spending on consultants, which the Tories pledged to “slash”, has doubled since 2010.

The Department of Health commissioned Practicus to help enact its NHS reforms. Practicus also has links to Virgin, which, through Virgin Care, is now seeking to profit from NHS commissioning.

Its site states that “The mantra of “better for less” is driving transformational change across government”, and that “[n]ew approaches need to be embraced to implement” this change, “potentially involving private sector partners.”

It claims that Practicus “currently works with a great number of NHS organisations” and “have considerable experience with change and transformation within the NHS, particularly around commissioning”.

Practicus claim that their “clients cover most of the industries across the world and range from multinational blue chip businesses to innovative public sector organisations”, adding:

“From FTSE-listed financial institutions to leading public sector bodies, we understand what change our clients want to achieve, and why. And we roll our sleeves up to help them deliver it.”

This “starts with us aligning our goals with our clients’ own and ends with us delivering results”. “We view life from our Client’s perspective,” they add, “striving to ensure that every solution is designed in your best interests.”

Practicus have “worked with numerous Private Hospital Groups” to help expand their businesses, including helping with “bid development”. They also service suppliers of “healthcare products and services”:

“As businesses increasingly see the value in fusing healthcare products with the wrap around services they support, Practicus is helping a number of small and medium size enterprises build their propositions.”

The consultancy claim to have “carved out a niche for helping Pharma businesses” to “commercialise new operating models” as they “transition from product centric” to “service orientated” businesses. They also claim to have “carved out a niche” within the IT sector – a major source of public-sector contracts. “Our clients,” they state, “choose to partner with Practicus to take advantage of our deep networks” in this area.

Exactly how and why Quinn is connected to Practicus is unclear.

Reporting on the “big four” accountancy firms’ role in tax avoidance in 2013, The Commons Public Accounts Committee observed that

“we have seen what look like cases of poacher, turned gamekeeper, turned poacher again, whereby individuals who advise government go back to their firms and advise their clients on how they can use those laws”.

As the NHS is privatised, private management consultants give every appearance of doing the same thing.

Vested interests on the BBC

This is not the first concern to be raised about the audience of the Nigel Farage-Russell Brand edition of Question Time.

After the comedian criticised the UKIP leader, he was harangued by audience member Robert Carver – later exposed as brother of James Carver, UKIP MEP for the West Midlands. A biography appended to a blog Robert Carver wrote claims UKIP asked him “to stand as the party candidate in the Tory safe seat of Beckenham” in 2015.

Quinn’s role raises further troubling questions about how the BBC address conflicts of interest in its Question Time audiences.

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