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From Thornbury to privatisation: march of the agency staff

Britain is back to its bad old ways, spending billions on health service stand-in staff — a vicious cycle that lines up the private providers to take over entirely as the NHS drains its funds on temps, explains SOLOMON HUGHES

NHS spending on agency staff went up to £3.5 billion in 2023. That’s an increase from £3bn spending the previous year and around £2.4bn spending for the preceding four years. The figures, dug out of NHS accounts by the Health Service Journal show a previously successful drive to reduce the massive NHS agency spending bill has gone into reverse.
 
The figures also show how the Conservatives can privatise the NHS just by running the health service down. If you pay existing nurses so badly they go on strike, and refuse to train new nurses, you create a shortage of public-sector nurses. Public money flows to private corporations who will supply — at greater cost — agency nurses.
 
Let’s take one example. The very English-sounding Thornbury Nursing are one of the main suppliers of agency staff to the NHS. But the company is actually a mechanism for diverting NHS cash into the hands of a Canadian billionaire called Gerry Schwartz.
 
Thornbury Nursing was founded by Moira Sloss, a nurse, and her husband John in Bristol in 1982 — Thornbury is a small town outside Bristol. But they sold off the firm in 2002, leaving the Sloss family with an estimated fortune of about £45 million. Since then the firm has been bought and sold by various private equity firms, who saw nursing agencies as a good way to leach money out of the NHS.
 
Right now, Thornbury Nursing is merely the trading name of a company called Independent Clinical Services (ICS). The latest accounts for ICS, published at the end of September, but covering the year up to December 2022 show, that their turnover increased from £273m to £399m — a 46 per cent surge in business, largely from the NHS.
 
Profits increased by a more modest 12 per cent to £51.3m. That’s an excellent rate of profit.
 
If we want to find out who owns ICS, we have to go through a long chain of companies with increasingly silly names. This is because the firm has been bought and sold by private equity companies, who like these elaborate structures, which help them extract the maximum value while often reducing the amount of tax they pay.
 
So: ICS is owned by ICS Healthcare Services Limited — which is owned by ICSG Limited — which is owned by Indigo Bidco Limited — which is owned by Indigo Cleanco Limited — which is owned by Indigo Intermediate Limited — which is owned by Indigo Parent Limited — which is owned by Impala Bidco 0 Limited — which is owned by Impala Midco II Limited — which is owned by Acacium Group Limited.
 
Schwartz owns up to 50 per cent of Acacium Group, with his co-investors owning the rest. Schwartz’s investment firm, the Toronto-based Onex Corporation, bought ICS, including Thornbury Nursing, from another investment firm in 2020.

Under Schwartz, they have used Thornbury Nursing as a core firm, attaching other health temp agencies to the company. Acacium Group now has an £897m turnover in Britain: they claim they are “Britain’s largest Healthcare Solutions Partner.”

Other Acacium firms making big money from NHS medical temps include Pulse, Bank Partners, Maxxima, Pathology Group, and A and E Agency. The firm profits from shortages of NHS nurses, doctors, therapists, pharmacists and many other health staff. Acacium has also expanded into the US, Australia and other international temp staffing, so their overall revenue is now £2.2bn.
 
Acacium’s latest annual report says: “In Britain, the group is successfully expanding its managed service and master vendor footprint.” What this means is that Acacium doesn’t just sell temp nurses to the short-staffed NHS: they actually become a “Master Vendor” for individual NHS Trusts — where Acacium actually becomes the single management of all temp staff for a hospital or group of hospitals. It really shows how temp staff firms can become the master of, instead of the servant of, the NHS.
 
The growth of Thornbury Nursing, and of Acacium, shows how the NHS can become a pipeline to pump money to international investors. The Conservatives would like to privatise the NHS directly, as made clear by Tory “position papers,” from Thatcher to Truss — but every time they try, the popular reaction is too negative. However, if they simply continually short-change the NHS, so nurses leave and waiting lists extend, they can privatise by default, as hospitals have to turn to private agencies and patients who can afford it feel forced to “go private” for treatment.
 
Steve Reed’s idea of the ‘right kind of migrant’
 
When Sky News asked Labour shadow minister Steve Reed about Tory plans to deny migrant care workers the right to bring their families to Britain, he told them “I like the idea of it.” His only worry about denying migrant care workers a family life was “when you phase it in.”
 
According to the Register of Members Interests, Labour has arranged for Lisbet Rausing to pay a huge £155,000 towards “staffing and related costs” for Reed’s “front-bench role”, paid in eight monthly instalments of £19,400.

Lisbet Rausing was born and raised in Sweden with huge family wealth. She got all this money not through her own hard work, but because her grandfather invented TetraPak drinks containers. She is now a joint Swedish-British citizen resident in Britain. She is arguably an “economic migrant” as her father came to Britain to avoid Sweden’s high taxes.

So it is perhaps not surprising Reed’s position is that hard-working but low-paid migrants looking after our relatives in care homes mustn’t have a family life, but super-rich migrants who might put £150,000 towards his political career can have all the freedom they like.
 
Lisbet Rausing was, like her father, once a Tory donor, giving the Conservatives £50,000 in 2008. She went through a more liberal phase, giving £10,000 to Caroline Lucas in 2018 and £25,000 to the Women’s Equality Party in 2020 — both parties with liberal attitudes on migration. She has now gotten over her brief liberal phase and is back to donating to a party with a mean attitude to low-paid migrants and a permissive one to “high net worth” migrants like herself.

Follow Solomon Hughes on X at @SolHughesWriter.

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