The BBC ignores Donorgate's latest twist

Chance chat over dinner led Blair to order u-turn on private beds

David Hencke, Westminster correspondent, The Guardian
Friday July 28, 2000
The Guardian

When Tony Blair took Cherie for dinner at the fashionable River Cafe restaurant in west London earlier this year, it was coincidence that a Daily Express associate editor, Stephen Pollard, was eating with his girlfriend at a table nearby.
 

On the way out, the prime minister called the other couple over for coffee, and they began talking animatedly about the NHS bed crisis.

During the conversation Mr Blair mentioned a chap, whose name he could not remember, who had challenged him on Newsnight in February over people left on trolleys in NHS hospitals.

Mr Blair was seeking confirmation from an old colleague (Mr Pollard had been a Labour researcher when the PM had been an opposition MP) that he had not been fed a line by the private sector. The unknown man turned out to be Tim Evans, external affairs director of the Independent Healthcare Association - effectively the most powerful lobby for the 460,000 beds and 211 hospitals and nursing homes in the private sector.

Mr Evans had in essence caught out the prime minister by getting him to agree to use spare capacity in private hospitals to help out the NHS.

After the TV programme, Mr Blair went over to Mr Evans and questioned him. Mr Evans, a fast-talking postgraduate who previously worked at the free market Adam Smith Institute, gave an instant run-down of the country's private facilities, pointing out 800 high dependency beds and operating theatre facilities that were underused. He also mentioned he knew Mr Pollard, and that the NHS executive had sent out a circular making it all but impossible for the NHS to use private beds.

Mr Blair went away and did some checks. The story stood up, and it helped persuade the prime minister that he should take personal charge of the whole NHS initiative.

He then discovered that his former health secretary, Frank Dobson, had shifted the NHS's position from neutrality toward using the private sector when necessary, to one of being positively hostile.

The NHS executive annual letter sanctioned by Mr Dobson and sent to all chief executives and GPs on September 9, 1997 read: "Health authorities, GPs and NHS trusts should explore the scope to make maximum cost-effective use of local NHS capacity before contemplating recourse to private sector hospital provision. Where care is nonetheless commissioned from private hospitals, the reasons must be reported to the regional office."

The circular had made hospital trusts nervous at using beds in nearby private hospitals in the winter beds crisis. It also led to a heated but fruitless exchange between the private sector and Robert Hill, the Downing Street policy adviser, weeks before Mr Blair's appearance on Newsnight.

Within days of the River Cafe conversation, Mr Blair is understood to have ordered Alan Milburn, the health secretary, to repeal the offending letter. But that was not all. Letters were sent out to a range of leading doctors, health care companies and drug firms to come for talks at No 10 - ostensibly with the Downing Street policy unit, though most visitors were ushered straight into the PM's office.

What emerged was an instruction from Downing Street for a concordat with the private sector to be negotiated by senior civil servants at the Department of Health, who months before had dismissed the idea. The fruits of the deal were published yesterday.