NHS Plan 2000
Last Updated: March, 2019

With all NHS reforms before and since, you have to read past the headlines of this plan, which taken at face value don't sound particularly harmful. In July 2000 after 2 years of restrictions to public spending, the then Chancellor - Gordon Brown - agreed to increase spending on the NHS to a level close to the EU average. However, in return there were to be reforms in every sector of the health service, including the breakdown of professional barriers and the introduction of flexible labour markets. Modernisation Action Teams were established and NHS Plan 2000 was born.

The essence of the Plan was a more radical marketisation of the NHS, going further than the  National Health Service and Community Care Act , opening the NHS up to private providers of health care, and making even the public owned institutions of the NHS increasingly like commercial companies.

In October 1999 Frank Dobson was replaced as Health Secretary by  Alan Milburn . In October 2000 a 'concordat' signed by Alan Milburn between the government and the Independent Healthcare Association made a commitment to planning the use of private providers, not only at times of pressure, but on a long term basis spelled out in Long Term Service Agreements. The NHS would pay up to 40 percent above the NHS costs for treatment of waiting list patients in private wards. This paved the way for the private provision of elective care and diagnostic tests (X-ray, MRI, ultra-sound etc.) paid for by the NHS. Consequently this opened the doors to private companies becoming permanent providers of treatment to NHS patients, and the first public-private partnerships took the form of  Independent Sector Treatment Centres .

Tim Evans who negotiated the 'concordat' on behalf of the Independent Healthcare Association said that he looked forward to a time when the NHS would simply be a kitemark attached to the institutions and activities of a system of purely private providers.

Health Secretary Frank Dobson had tried with limited success to restrain the advance of privatisation. In February 2000, Tim Evans was in a TV audience for a question-and-answer session with then Prime Minister Tony Blair. Evans asked Blair if he had any ideological objection to cooperation between the NHS and the private health care sector. When Blair said no, Evans told Blair about Frank Dobson's 1997 letter instructing hospitals to only use private providers in exceptional circumstances. Shortly afterwards Blair cancelled Dodson's instructions.

The plan was co-authored by Penny Dash. She was Head of Strategy at the Department of Health before joining  McKinsey . She also co-founded the Cambridge Health Network, which aims to bring NHS and private health care leaders together.

The prices demanded by the UK private sector had proved much higher than the cost of equivalent services provided by the NHS. In 2003 the government backed down and said that it would still pursue the privatisation of clinical services, but by opening up the competition to international providers. The race to bottom begins!