The harrowing case of a murdered executive is shining a light on the pain caused when health is a commodity.

Call To Action

“It is not the model of the NHS that is broken, but the political will to fund it properly.”

I first learned about United Healthcare and its reputation a long time ago, but it wasn’t because of anything happening in the US; it was because of Simon Stevens, the man who was Chief Executive of NHS England between 2014-2021. Stevens took on the job just as I was starting to become interested in healthcare campaigning. I’d been working in an NHS trust where the “austerity cuts” were rife; where we were losing brilliant, experienced members of staff and the services were being cut back, all of which was having a noticeable impact on the care my patients were receiving. I’d never considered myself very political, and then suddenly… I was.

The language used at the time by David Cameron, Jeremy Hunt and others sounded very reassuring; there was a lot of talk about increasing efficiency, cutting back waste, making the service more streamlined and productive. But it didn’t feel like that; not to a junior doctor working in psychiatry in London anyway. My patients were vulnerable and needed decent care, and this help was being cut away before my eyes. One week the art therapist was there, and then she wasn’t. One moment we had an excellent clinical psychologist attending the ward weekly, and then suddenly they were gone too. It felt like the service was being cut back to the bare bones.

And the man in charge, the one with the top job who was being vaunted and praised by media outlets and pundits, was Simon Stevens. As The Guardian wrote, somewhat gushingly, at the time:

“Simon Stevens’s arrival as NHS England’s new boss on 1 April was greeted with great warmth and relief across the service. In some quarters he was regarded almost as a messiah – the man who had come back into the fold, after 10 years in US private healthcare, to rescue the NHS from its crisis of unsustainability. “

Who was Simon Stevens? And what, I wondered, had he been doing in US private healthcare? It turns out that he’d been working for (you guessed it), United Healthcare, as “president of the global health division of UnitedHealth Group, a giant US private healthcare company.”

Stevens held a senior job; a powerful position within a huge healthcare insurance company, and also a job which seemed to sit uncomfortably with his new role. How would he manage to reconcile the priorities of his previous employer (profit creation), with that of the NHS (care)?

They didn’t seem to fit together, they still don’t, and Stevens led the NHS through many years of managed decline, orchestrated by Conservative Party politicians who sought to diminish the service. They cut things back, they treated NHS staff appallingly, they enabled private companies to profit from the service, the waiting lists sky-rocketed, and public satisfaction in the service plummeted as their care deteriorated. Still, Simon Stevens has emerged from all of that unscathed, and is now known as Lord Stevens, because he was awarded a seat in the House of Lords for his efforts.

But while Stevens has exited stage left, his former employer United Healthcare looms large in the minds of many NHS campaigners in the UK. The company, and others like it, represent a model of healthcare provision which we must do everything we can to avoid. Put bluntly, US healthcare is an absolute nightmare for millions of patients. It is difficult to navigate, patchy, is uncertain for many people, and creates delays and denials of care which cost many thousands of patients their well-being, or even their lives.