Against The Warfare State

Andrea Egan writes:

Speaking to members of my union, this country’s biggest, you can’t not come away in awe: of the dedication to public service, the commitment to caring for our communities and the determination to keep going in incredibly tough circumstances. But there’s a flip side. You also always get a vivid sense of our country’s torn social fabric, the terrible state of the services that people rely on.

‘I’m not living, I’m surviving. Every month I have more outgoings than income when it comes to my salary’, said one of our 400,000 members in the NHS. Another told us they are taking strong doses of anti-depressants and cannot sleep because of work-induced stress and fatigue. Here’s a nurse: ‘I have high levels of anxiety and constantly fear making mistakes due to workload and staffing issues. My immune system is poor. . . . but I fear taking any time off due to financial issues.’ Our surveys and conversations with members show that these are typical experiences, not outliers.

It’s not much different in any part of UNISON’s massive public service membership. School support staff love their work but tell us their pay doesn’t cover the rent and that they’ve taken on second jobs in mid-life just to stay afloat. We know from our research that most are only paid in term time and almost half take home less than £1,400 a month. And then there’s my old profession, social work, where you see the full range of miseries inflicted by austerity and economic decline. Unaffordable housing, fragmented communities, and a surreal, cruel welfare system all combine to make life harder both for social workers and for those we’re trying to help.

That’s what life is like for ordinary working-class folk today. That’s the state of our society, and I think it should count as an emergency: a massive threat to the future of our country, which must be the first priority of any government to fix. It should be dominating the headlines. Yet it rarely does.

Meanwhile, demands for more spending on foreign wars and the weapons to fight them are given exactly this kind of treatment. When was the last time we had a nurse or hospital porter handed a primetime slot on the BBC to tell the government that the country faces ruin if they don’t find tens and tens of billions in new investment? In Britain today, that privilege is reserved for top military officials and the politicians who support them.

We already have the sixth highest military spend in the world, with the Ministry of Defence given the biggest capital budget of any department. But you wouldn’t know it from the media. Top military brass — past and present — have been especially relentless in the weeks running up to Andy Burnham taking office. They are trying to pressure the new prime minister into taking on their agenda wholesale, which means cutting everything else to give more to the MoD.

On their broadcast rounds, the military bosses aren’t exactly subtle. We’ve had the former head of the Royal Navy implying free breakfasts for school kids should be scrapped, remarking that ‘things like welfare. . . . are unimportant when you lose a war’. The current UK chief of defence declared earlier this year that ‘Rearmament is not warmongering’. Maybe not inherently. But constantly inflating the threat of war on British soil, and suggesting we must arm to the teeth in anticipation, is absolutely that. It makes war more likely in the name of preventing it.

The ‘defence’ establishment clearly cannot take yes for an answer. Keir Starmer bowed to their demands — which really just tail the demands of Donald Trump — and took their word as gospel. MoD officials never have to shake the tin, no matter how much cash they waste or how many projects they mothball. In February 2025, Labour committed to increasing defence spending to 2.5 percent of GDP by 2027. By April 2026, Starmer had signed on to the NATO target of 3.5 percent by 2035. But it still wasn’t enough: Defence Secretary John Healey resigned in protest, parroting the demands of the military and the Americans. The outgoing PM used his final weeks in office to lock in almost £7bn worth of cuts to crucial government departments to fund his so-called Defence Investment Plan.

In government, Labour has decided to impose a zero-sum fiscal framework on itself. Anyone who suggests breaking with this is effectively blackmailed by the bondholders. That means all the extra billions the Generals take are billions that will not go to our hospitals, schools, local councils, transport, housing: you name it. Rather than getting patients out of corridors and into beds, reopening community centres, funding a dignified social care system or putting money in the pockets of struggling workers, the military will be handed more blank cheques to buy more weapons made in America.

It would be one thing if this debate were actually about defending the country and making its people more secure. But it isn’t. It’s all about serving the destructive foreign policy objectives of the United States. It’s about maintaining a global British military presence — in far-flung places like the middle of the Indian Ocean — that does less than nothing to offer us protection.

Anyone who doubts this should take a moment to reflect on what the military actually spends its money on, from the disasters in Afghanistan, Iraq and Libya to the recent use of UK bases to attack Iran. Not to mention the bombing of Yemen and the assistance given to Israel in its genocide in Gaza. The only outcome has been to subject tens of millions of people around the world to extreme violence and destruction. At the same time, life has gotten harder and harder for our communities here at home.

So I hope the new Prime Minister has the strength to resist the siren calls to defund the British people in order to bankroll more overseas bases and more American wars. We need investment in our people, our services, our socially useful industries. We need to improve lives here, not destroy them abroad. We need to rebuild our country, not collapse other ones. That’s the trade union movement’s agenda, and it’s one we expect Labour to follow.

And Simon Fletcher writes:

We are today in one of the most dangerous periods since the end of the second world war. Extreme warmongering is normalised, and the drive for higher military spending across Europe and the NATO member states is unrelenting.

Behind it all lies pressure from the United States. Indeed, the US Ambassador in London warned Andy Burnham shortly before he became Prime Minister that Britain must move beyond ‘rhetoric’ and make ‘sustained investment’ in defence rather than focusing on ‘other spending priorities.’ The government must not be ‘held up’ by ‘backloading’ additional investment in defence for a later date, he said.

There is no ambiguity here. Some might rationalise support for rearmament on the basis that Donald Trump is an unreliable ally, meaning Europe must now do more to protect itself directly. But the main force driving NATO member states to spend more on arms is the United States itself. The Americans wish, as they have for almost a century, to deepen our dependence by further binding us to their own military-industrial behemoth.

Today, this longstanding American objective is hitched to an aggressive posture, wherein the rearmament of subordinate states like Britain serves not US withdrawal from the world but a strengthened NATO under the thumb of the dominant power. This strategy is centrally geared towards enhancing American military might in the face of China – the principal long-term economic and geopolitical priority in Washington.

A Military Colossus

The Left in Britain cannot hope to avoid this question or simply focus on bread and butter issues alone when the scale of what the NATO countries have signed up to is so enormous. It alters the whole political picture. At the 2025 NATO summit, member states agreed to increase the proportion of their economies spent on defence and national security to 5% of GDP by 2035. This consists of two elements: ensuring at least 3.5% of GDP is devoted to spending on core defence requirements; and spending a further 1.5% of GDP on defence and security-related investments.

The real balance of military power on the planet is already absolutely overwhelmingly on the side of the US and its allies. America alone accounts for one third of all global defence spending. China is way behind at approximately twelve per cent. Russia’s spending is lower than that, at just over six per cent of the global spend. NATO’s expenditure, in other words, is vast compared to the states it talks up most as threats. Just Germany and the UK combined spend more in total than Russia. Depending on which analysis is used, Britain is already either the fifth or six largest military spending state. Rearmament, then, is a monumental effort to reassert Western military power over the rest of the world. 

Wages or Weapons?

With defence spending already so high, and given choosing to spend more on the military means spending elsewhere is sacrificed, we should not be giving an inch to attempts to give rearmament a progressive lick of paint. 

Some in the labour movement have pushed for higher spending on defence, criticising Keir Starmer’s government for not going far enough. But this has a cost. To give an indication of what Britain pushing its military budget up still further entails; the UK’s GDP was £3,037 billion in 2025. One percent of that is just over £30 billion, so 3.5% of GDP is just over £100 billion for the military. According to the government’s own figures, its spending on schools in England in 2026/27 will be £65.9 billion. 

At present, the government’s pay offer for teachers is not fully-funded, meaning that schools will be forced to make cuts – at the same time as the government is debating how fast it can go to meet its military commitments. Choices like this will become the norm of politics. Welfare and wages not warfare, books not bombs, nurses not nukes – these are not just campaign slogans but actual choices in the British economy, as they are elsewhere in Europe. In Germany, climbing military expenditure has now overtaken Britain’s, whilst Chancellor Friedrich Merz is imposing a package of economic retrenchment including tough rules for sick leave and raising the retirement age.

The Labour government wants to show that its commitments on defence spending will bring military-Keynesian benefits, including by stressing a ‘buy British’ element to the contracts. But military spending is one of the least effective forms of investment for jobs and benefits to the wider economy. Economic analysis by Greenpeace focused on Germany, Italy and Spain showed that investing in health, education and environmental technology creates more jobs and growth than defence. Modelling of government spending in the US and Europe laid out in CND’s Alternative Defence Review, meanwhile, demonstrates that public spending on solar, wind, environmental protection and education likewise creates more jobs than military contracts.

‘You Had Better Learn to Speak Russian’

In order to persuade the European working class and its allies to forego jobs, services and improved living standards and to accept a programme of rearmament, a dangerous escalation of rhetoric is underway. In France, Macron has proclaimed a l’économie de guerre (‘we have launched a war economy,’ he declared last week). Here in Britain, Chief of the Defence Staff Admiral Sir Tony Radakin said his message to Andy Burnham was that he must be ‘almost like a wartime prime minister.’ Repeatedly in the media we hear former senior military figures counterpose spending on the military and spending on welfare very sharply. 

‘There’s no point worrying about our welfare if the cities are in ashes,’ General Sir Richard Barrons who led the government’s Strategic Defence Review argued on Sky in May. Former First Sea Lord, Lord Alan West, argued in June that it’s ‘all very well having nice funding for breakfast for children at school, which is important stuff, and other things. But if that means you have to fight a war and lose it, and you have Russians stomping down your streets shooting the children who would have been having breakfast, and that sort of thing, it’s. . . . not a very good swap, is it?’ He told BBC Radio 4 that welfare is ‘unimportant when you lose a war and you have Russian Chechen stormtroopers coming down the street raping women and killing people.’ 

NATO iterates the same hysteria, applying pressure over domestic British political choices with deliberately alarming cold warrior language: Secretary General Mark Rutte warned last summer that ‘if you do not do this, if you would not go to the 5%, including the 3.5% core defence spending, you could still have the National Health Service, or in other countries their health systems, the pension system, etcetera, but you had better learn to speak Russian.’ In a way, Rutte is quite right that there is a choice between arms and socially useful spending, but wrong about the conclusions.

The military lobby’s absurd rhetoric reveals the weakness of its case. Russia has been fighting a war with Ukraine for four years. It is not about to set up military checkpoints outside your local Greggs. Yet the bloodcurdling rhetoric builds the drumbeat of militarism and the spiral logic sets in. Once the military has the weapons; the greater the urge to use them.

Counting the Costs of Rearmament

We are now at a new stage. Efforts to make cuts in some departments’ capital budgets to fund the Defence Investment Plan burst out into open conflict in Keir Starmer’s government. John Healey resigned as the defence secretary over the pace of rearmament — not fast enough, supposedly — hastening the departure of Starmer and Rachel Reeves, whom Healey had fought. In his resignation comment, Healey argued that the Defence Investment Plan meant ‘Britain will still be spending just 2.7% of GDP in 2030, the date when NATO has warned we could face a Russian attack.’ 

Now Healey is the Chancellor of the Exchequer. Andy Burnham has committed his government to increasing defence spending from 2.6% of GDP up to 3.5% by 2035, which The Guardian noted implied a real-terms increase of more than £25bn in less than a decade. The new defence secretary, Wes Streeting, has said that spending more on defence would come at ‘an opportunity cost across government.’ But it is not yet clear how the government intends to meet its targets, or exactly by when.

Andy Burnham’s administration has set out an ambition to reconnect with voters and deliver a ‘circuit breaker for Britain’ after a failed forty-year consensus. Measures such as bus fare cuts or help for pubs and live music venues are rightly welcomed. But at the same time the room to raise productive public investment and better services is massively reduced by the a priori commitment to rearmament. 

Left Ruptures

In the British labour movement, whilst the Unite and GMB unions have lobbied for higher defence spending, the leader of the country’s largest union, UNISON’s Andrea Egan, has strongly opposed it. The TUC shifted position last year through a motion on ‘wages not weapons’ initiated by the University and College Union. A large international conference organised by the Stop The War Coalition earlier this summer was addressed by MPs and trade union leaders.

Rearmament and the question of funding for war has caused ruptures and shifts in the labour movement before. In 1914 it split the entire Second International, effectively killing it. In the 1950s opposition to rearmament gave birth to the Bevanite revolt. In that decade into the 1960s and again in the 1980s huge anti-missiles movement surged through the labour movement, reshaping the politics of the left.

Opposition to the Vietnam War was formative in the creation of a new left. Mass opposition to the Iraq War worked its way through politics and shaped left opinion at the beginning of this century. We do not yet know the longer-term political impact of the genocide against the Palestinians but the sustained movement in opposition to Israel’s war and Britain’s complicity has already profoundly affected the political landscape, including within Labour’s electoral base. We are now only in the foothills of the political impact of rearmament; historic political arguments over it are now inevitable. 

The left, inside and outside parliament, in Labour and not, must recognise that the choices and conflicts caused by rearmament are an unavoidable reality of the current phase of politics; and must organise its actions, priorities and programme accordingly – including its economic programme – so that concerted opposition to rising military spending and warmongering is a central priority.

The Betrayal At The Heart

Paul Knaggs writes:

The Oldest Story in the Labour Movement Has a New Chapter, and It Stinks 

In 1874, a bookbinder named Emma Paterson founded the Women’s Trade Union League because the unions of her day would not organise women. This is not a new story. It is, if anything, the oldest story in modern history, and not only in the labour movement. Men shut the door. Women build their own room. 

Those rooms worked. Mary Macarthur built the National Federation of Women Workers for the women the established unions would not take, and in 1910 the women chainmakers of Cradley Heath struck to force employers to honour a minimum wage the law had already granted them. They won. The movement absorbed their victory into its mythology and has been proud of it ever since. That is the pattern, and it repeats: women organise separately because the general movement has neglected them, they win something nobody else was fighting for, and afterwards the movement discovers it had always believed in equal pay. Women are welcomed as symbols, celebrated on anniversary posters and praised from conference platforms. The warmth disappears when they organise as women, identify their own interests and refuse to surrender control of the room. 

It is disappearing again now, in the run-up to Liverpool. 

UNISON, ASLEF, USDAW and the Musicians’ Union are boycotting Labour’s Women’s Conference because its formal proceedings are reserved for women. The seats they leave empty do not belong to four general secretaries, a policy committee or a press officer at union headquarters. They belong to the female members whose subscriptions paid for them. 

That is the betrayal at the heart of this dispute. Union leaders have taken political representation purchased by women workers and thrown it away to make an ideological gesture against women organising as a sex. 

Labour’s Women’s Conference will take place in Liverpool in September. Transgender members may attend fringe meetings, receptions and exhibition areas, but only women will participate in the main conference proceedings, debate policy, vote on motions and elect representatives to the National Women’s Committee. Labour says the arrangement reflects the Supreme Court judgment on the meaning of sex in the Equality Act and the party’s legal obligations. The four unions have responded by refusing to send delegations, while confirming that their attendance at Labour’s main annual conference will continue as normal. 

Of every room available to them, they chose to empty the women’s room; it is an attack on women and women’s voices. 

Steelmanning

Recently, I have made a habit of steelmanning the arguments this column takes on: giving the other side its best case, stated fairly, before answering it. On this occasion, the word earns its own pun, because the case being steelmanned is, at bottom, the case of men. Here it is at its strongest. Trans women previously took part in Labour’s women’s structures, some transgender union members will experience the change as exclusion, and trade unions carry a duty to protect those members from harassment and discrimination. That duty remains. Trans people continue to possess legal protection under the protected characteristic of gender reassignment.

None of that abolishes sex, nor does it give trade union executives the right to confiscate women’s political representation. Strip away the language of inclusion and what remains is a choice: these unions have placed the concerns of men who identify as women above the material realities of women. That is the priority they have set, and they should be made to own it in those words.

The Supreme Court settled the legal meaning in April 2025. References to “woman”, “man” and “sex” in the Equality Act concern biological sex, while protections against discrimination for transgender people remain intact. The Government laid the revised EHRC code before Parliament on 21 May, its scrutiny period ended on 9 July without challenge, and the commencement order has been made: the code comes into force as statutory guidance on 5 August, days after these unions announced their boycott. They are not confronting an unlawful Labour exclusion. They are protesting because Labour has finally accepted that a women’s political structure must be capable of identifying the class of people it was established to represent.

The word ‘women’ cannot perform any political work if it is forbidden from describing women.

A women’s conference exists because women experience material conditions arising from their sex. Pregnancy discrimination is not allocated according to identity. Maternity penalties do not descend upon men who feel insufficiently represented. Women remain disproportionately responsible for unpaid care, more likely to work in low-paid public services and more vulnerable to particular forms of sexual violence and workplace harassment.

These are not abstractions assembled for a diversity seminar. They shape the wage packet, the pension, the night shift, the maternity meeting and the changing room. Women require the political freedom to discuss those conditions together and organise demands around them. That freedom is an exercise in collective assembly, the very principle on which trade unionism stands. 

That history makes UNISON’s position particularly indefensible. The union describes itself as containing one million women, around 80 per cent of its membership, and has promoted the claim that without women there would be no UNISON. It also maintains a women members’ group whose stated purpose is to campaign against workplace inequality and advance women’s rights. Yet when Labour provides a conference at which women can debate precisely those matters, UNISON refuses to represent them. 

No publicly available statement from the union shows that its million women members were balloted on surrendering their delegation. UNISON’s explanation is a single sentence: restricting the conference floor to women conflicts with its policy on trans equality. ASLEF, USDAW and the Musicians’ Union have offered no publicly demonstrated mandate from their female membership either. A policy written elsewhere has simply been placed above the right of women members to participate. 

That is not representation. It is substitution, the executive’s politics placed where the members’ voices should have been. 

Labour Women’s Declaration

The Labour Women’s Declaration is a seven-point political statement launched in November 2019 by members of the UK Labour Party. Its stated aim is to protect women’s sex-based rights, single-sex spaces, and the use of biological definitions of sex within policy and internal party structures.

The Labour rulebook has allowed an affiliated organisation one delegate for every 10,000 members, up to a maximum of 25. Trade union delegates also elect representatives to Labour’s National Women’s Committee. Boycotting therefore means more than missing speeches and sandwiches in Liverpool. It removes votes, influence, committee representation and the ability to shape the policies later carried into Labour’s wider conference machinery. 

Power does not disappear when a union walks out. It passes to those who remain, and if the unions won’t use it, then women must organise themselves. 

The female cleaner, care worker, teaching assistant, shop worker, train driver or musician does not gain anything from this performance. Her union does not become more principled by silencing her. She simply loses a representative in the room while continuing to pay the subscription that funded the empty chair. 

UNISON’s conduct in the Darlington nurses’ case shows that this boycott is not an isolated error. It belongs to an established political choice. 

Eight nurses at Darlington Memorial Hospital brought employment tribunal claims after they were effectively required to share their female changing room with a biologically male colleague who identified as a woman. The tribunal found that the trust had prioritised the perceived rights of its transgender employee over those of the nurses, leaving the women with no genuine alternative changing provision. It concluded that the policy violated their dignity and created a hostile, humiliating and degrading environment. 

Seven of the nurses later received a combined £187,000 in damages, together with an apology from the trust and a commitment to provide separate changing facilities for male and female staff. 

UNISON was not the organisation standing beside them. The women had to secure outside legal support and establish the Darlington Nursing Union. Before the tribunal ruling, UNISON president Steve North accused the then health secretary of pandering to anti-trans bigotry, merely for meeting the nurses. After the judgment, UNISON issued a statement saying it needed time to consider the lengthy decision and reaffirming its existing policy on trans, non-binary and gender-diverse members. Its published statement did not offer solidarity to the women whose dignity the tribunal found had been violated. 

That record matters. It tells female members what may happen when their rights collide with an ideology already adopted by the union hierarchy. Their union may decline to represent their position, condemn the politicians who listen to them and then issue a carefully sterilised statement after a court vindicates them. 

Now the same hierarchy is applying that choice on a national scale. 

The boycott also carries financial weight. UNISON gave Labour close to one and a half million pounds before the 2024 general election, USDAW more than half a million, ASLEF a hundred thousand. None of the four unions has publicly threatened to withdraw Labour’s funding over the conference. They do not need to spell out every implication. When several affiliated donors coordinate a public walkout, the party leadership knows which ledger is being placed on the table. 

That makes the dispute a test of whether Labour will defend women’s lawful political organisation when organisations holding money and institutional influence demand otherwise. It is also a test for the trade union movement. A union exists to represent its members against concentrated power, not to use concentrated power against its own members. 

The women paying subscriptions to these unions are entitled to ask who authorised the boycott, which governing body approved it, whether women members were consulted and what democratic process allows their conference representation to be surrendered. Those questions should be tabled in branches, recorded in minutes and directed to every executive member responsible. Where leaders refuse to answer, women should organise to replace them.

Emma Paterson did not wait for established organisations to discover their consciences. Mary Macarthur did not tell women chainmakers to accept that somebody else’s policy took precedence over their wages. The Darlington nurses did not remain quiet when their own union failed to defend them. Each generation of women has been forced to organise because institutions claiming to speak for everyone decided that women’s interests could be postponed, diluted or exchanged.

The executives of UNISON, ASLEF, USDAW and the Musicians’ Union have made that same decision. They have placed ideological conformity above female representation and called the resulting silence inclusion.

Women’s rights were never a man’s to grant. They are not a union’s to boycott or betray.

Stop Lowering Our Sights

Bernard Lovell founded Jodrell Bank under a Labour Government, indeed under the Labour Government, of which it was very much in the spirit. With that caveat, Ameer Kotecha writes:

Why is the UK shutting its iconic space telescope? The news that Jodrell Bank, which hosts the largest telescope in Britain, is to be closed, after the government scrapped funding for the facility, has been greeted with widespread outrage. The Royal Astronomical Society said it was ‘shocked and dismayed’. I’m angry and depressed.

Jodrell Bank is a serious bit of kit. The Lovell Telescope – 76 metres in diameter – is the world’s third-largest, fully steerable dish radio telescope. In the Cold War, it tracked Sputnik. Just last year, GCHQ revealed the secret role Jodrell Bank played in the space race, working with the intelligence agency to intercept signals from satellites, orbital weapons and space probes. The dish continues to conduct world-leading radio astronomy. It has researched black holes and the afterglow of the Big Bang. Just last week, experts demonstrated that the telescope could track space debris.

The mooted closure is reportedly the result of cuts to the government’s physics and astronomy research budget. The UK Research and Innovation (UKRI) has decided that, when the current funding agreement ends in March 2028, it will stop supporting the entire e-Merlin network – a group of seven UK radio telescopes, including the Lovell at Jodrell Bank. Together, they make up one of the world’s most important networks for astronomical observation. Manchester University, which helps run the observatory, said it would be ‘difficult to sustain’ the telescope without replacement funding.

At present, Jodrell Bank receives just £2.8million a year. That is peanuts. Never mind that the facility represents just 0.03 per cent of UKRI’s annual budget. As a country, we recently spent £100 million on a bat tunnel for HS2. We spend £300 million a day on debt interest. By the time you’ve read this article, Britain will have spent more servicing its national debt than it would cost to keep Jodrell Bank operating for an entire year. We spend £9 million a day on asylum accommodation. But then, who needs to search for alien life when we have illegal aliens arriving on the south coast who need housing?

The decision to close such an iconic facility, which costs such a measly amount to run and which clearly punches so significantly above its weight, provokes genuine bafflement. Perhaps, as one weary soul on X suggested, it had been given the chop because the telescope is white.

But seriously, how can the UK credibly claim to be the best place in the world to do science, let alone want to lead the technologies of the future, while choosing to close internationally respected research infrastructure that costs what amounts to a rounding error? The UK has managed to become a significant global player in radio astronomy thanks to just a handful of globally significant sites, including Jodrell Bank and the Mullard Radio Astronomy Observatory near Cambridge. That leadership is now seriously imperilled. And how is it that UKRI, an organisation whose budget will reach £10 billion by 2030, cannot find a couple of million for one of its most iconic and important facilities?

When I was growing up, getting my hands on a telescope came second only to a metal detector (so I could go up and down the garden looking for buried treasure). Big telescopes are the sort of thing that capture children’s imagination. If Andy Burnham really wants to encourage kids from working-class communities to dream big and reach for the stars, being able to see them would be a good start.

Of course, the message this sends internationally is pitiful. As China expands its scientific capability and the US continues to invest heavily in frontier science, we are scrapping what assets we have to fund ever more handouts and international aid, including to countries like Pakistan – which has its own space programme.

Like death by a thousand cuts, national decline comes through many small choices that quietly signal a scaling back of ambition. Closing Jodrell Bank is that sort of choice. One waits to see whether Burnham will step in, in response to the backlash – the facility is, after all, just outside Manchester and near his constituency.

We need to decide whether we still want to be the sort of country that dreams big and plays its part in discovering the great questions of life – or just be a welfare state with a country attached. We should stop lowering our sights and instead look to the stars.

During Scrutiny

Even The Times editorialises:

The prime minister said on Wednesday that before there was a wider debate on the principle of assisted dying, “there’s something that needs to happen first and that’s the fixing of the funding of palliative care and social care”. Fixing palliative care and social care is a long-term project. Lauren Edwards, a Labour backbencher, has pledged, in the next parliamentary session, to reintroduce the deeply flawed Terminally Ill Adults (End of Life) Bill that was mercifully timed out in the Lords in April. The message to her from her new boss is: don’t bother.

This is welcome news, for three reasons. First, Andy Burnham is right: whatever your view of the ethics of the state sanctioning doctors to dispense lethal doses of drugs to their patients, the suggestion that before contemplating such a momentous step the government should first radically improve end-of-life care is surely correct. Hospices in the UK are underfunded. The notion that the suffering of the terminally ill can only be alleviated by a fatal injection, rather than by the love, care and medication that befit a member of a wealthy, civilised nation, is a grotesque counsel of despair.

Second, as even many of its proponents admit, the initial bill — introduced by the Labour MP Kim Leadbeater — was poorly drafted, light on precision and due safeguards. It had no business passing on to the statute book. The Lords, performing its constitutional duty to scrutinise legislation, saw fit to table more than 1,300 amendments, over 70 of them proposed by Lord Falconer of Thoroton, the bill’s sponsor in the upper house.

During scrutiny, the risks of such a seismic shift in the relationship between state and citizen were exposed. In Canada, where medically assisted deaths have been allowed for a decade, they now account for 5 per cent of all deaths, having risen from 0.6 per cent ten years ago. Nothing in the failed bill would have prevented a similarly sinister increase in England and Wales. The measure was opposed by all the relevant royal colleges and hundreds of disability charities. It was not included in Labour’s 2024 manifesto. The prospect of the bill being forced through the Lords under the provisions of the Parliament Acts of 1911 and 1949 is arrogant and undemocratic.

Third, Mr Burnham’s smooth and swift euthanising of this zombie proposal showcases his political acumen while demonstrating the absence of any such quality in his predecessor. Sir Keir Starmer, bizarrely citing lobbying by Dame Esther Rantzen as his motivation, said he supported the principle, but then failed to expend any authority to back Ms Leadbeater’s bill. Wes Streeting, then the health secretary, said it was a mistake. Shabana Mahmood, the home secretary, was disgracefully smeared by her own side as a religious zealot for voicing her objection. Sir Keir floundered. The result: a protracted mess.

Mr Burnham knows the concept of assisted dying is currently popular with his backbenchers. But he is clear-sighted enough about the legal and moral morass it entails. He has little personal enthusiasm for the cause and certainly doesn’t want the distraction. So the prime minister has found an elegant way, acceptable to his party, of signalling that this is not a priority. Assisted dying should be retrieved from obscurity only if any party can muster the courage to include it in its next manifesto. Given that many voters, rightly, regard this matter as a thick red line not to be crossed, such courage is unlikely to be summoned.

As Nuala O’Loan, Baroness O'Loan writes:

The Terminally Ill Adults (End of Life) Bill had no democratic mandate. It was a Private Members’ Bill, not a government initiative. There had been no pre-legislative scrutiny, no consultation, no proper impact assessment before the Bill was introduced. The result was widespread concern.

Finally published on 11 November 2024, a little more than two weeks prior to Second Reading, giving MPs virtually no time to assess its provisions, it ultimately limped through the Commons at Third Reading with a majority of just 23 votes — 314 to 291 — on 20 June 2025, with support from fewer than 50 per cent of MPs. In those seven months, it had undergone significant change and lost vital safeguards.

The duty of the House of Lords is to scrutinise, and to approve, amend or reject a bill. We do not have to pass a bill simply because the House of Commons did so.

Very specific and detailed criticisms and concerns arose among stakeholders and the public. Among those raising concerns, the Royal College of Psychiatrists said they could not support it; the Royal College of Physicians said that “it was not in line with good clinical and professional practice”. The Royal Colleges of General Practitioners, Pathologists, and Nursing, and the Royal Pharmaceutical Society, The British Association of Social Workers, The Law Society, the British Geriatrics Society, the Association for Palliative Medicine, Liberty, and the group Standing Together Against Domestic Abuse all made extensive criticism of the bill, as did Disability Rights UK, BEAT and other eating disorder groups, MIND, the National Down Syndrome Policy Group and many others.

The Government’s Suicide Prevention Advisor said it was “very dangerous”. The former President of the Family Division of the High Court said it was “lamentably short of providing adequate safeguards.” Lord Stevens, the former CEO of the NHS, said that there was “evident and substantial risk”.

In fact, for the two days we debated the general principles of the Bill, information provided indicates that 516 Peers attended at least one day, while 327 turned up for both. It was the beginning of a long and very difficult process.

At least 244 peers were directly involved in scrutiny of the Bill in Committee, and the average speech lasted less than 7 minutes, although we were allowed to speak for up to 10 minutes on most occasions.

92 peers tabled or supported amendments. Lord Falconer, the promoter of the Bill, tabled 76 amendments, some of which removed safeguards inserted in the House of Commons.

The Bill’s supporters said that we had only discussed 7 clauses in 14 days in Committee. Actually, we debated over 800 amendments and discussed the content of 46 of the 59 clauses in the Bill and all 3 of the Schedules.

These amendments addressed some of the major problems we identified, including the risk of individual and organisational coercion of the elderly, sick, the disabled, those with learning difficulties, those with mental illnesses, those who might be isolated and struggling with financial difficulties, and many others.

There was a huge risk of people opting to die not because they wanted to, but because they had been subjected to pressure to do so, or because people living with Down Syndrome and learning disabilities often have an “acquiescence bias” and a strong innate desire to please authority figures, so they were more likely to agree to something suggested by a doctor. There were no proper safeguards against this.

The NHS exists “to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives”, not to help people to kill themselves.

We considered the effect on practitioners who did not join their professions to help people kill themselves. The Bill provided a degree of protection against involvement but only for clinicians, not for all the other people who enable the NHS to work — the administrators, the porters, the cleaners: if they did not want to engage with assisted suicide they would face possible disciplinary action, and would have to go to an employment tribunal to fight for the jobs which they needed to pay their rent or mortgage to feed their children etc.

There were so many unanswered questions — where could deaths take place, is it to be inside or outside the NHS, which drugs are to be used to kill people, what will it cost, how is it to be funded, (we had been told by the Secretary of State for Health that if it is to be provided by the NHS then NHS funding will have to be diverted from other unspecified processes), where will all the doctors, psychiatrists, social workers come from? There were so many other problems and questions, but there is no space to list them all.

During the debates, we faced hostility and endless accusations that we did not care whether people suffered or not. However, it is precisely because we do care — about the most vulnerable in our communities whose lives would have been endangered by the Bill — that I, and so many colleagues, acted as we did. In the end, the Bill ran out of time and was lost because it was so dangerous.

A Fierce Public Warning

Peter Hitchens writes:

The BBC, which spends millions on giant salaries for star presenters most of us haven’t heard of, couldn’t be bothered, last week, to send a reporter to watch the sentencing of a terrifying killer in court.

So it missed a major story. The man, 50-year-old Simon Carter, had committed a ghastly, heartbreaking crime of a kind that would not long ago have been headline news across the country.

He had crazily and without reason or purpose beaten his 72-year-old mother to death, so ferociously that he had broken his own hand.

Bad enough already, you might think, even though, in these sad times, alas, crazy murders are all too common.

But there was an urgent and important new aspect to this killing. Carter was out of his mind thanks to the sort of marijuana habit that far too many people nowadays have.

It was a big enough story to warrant being there in person to watch the outcome if you are reporting it. But that’s not all.

So appalled by what he had heard, the judge, Steven Everett, was moved to issue a fierce public warning against those who seek to legalise this drug.

He appears to be one of the few judges who have been prepared to speak out on that issue. He warned that cannabis was a ‘terrible’ substance, which ‘caused and exacerbated’ mental health issues. And he said campaigns to decriminalise it – led by politicians including Labour’s London Mayor Sadiq Khan and the Green Party’s Zack Polanski – were ‘wholly misconceived’.

He was incisive and specific, saying the case was evidence that those who talk about cannabis being a positive drug in the community are gravely mistaken.

He told the man who had beaten his mother to death: ‘You are not the first and won’t be the last with mental health issues to appear before me and say, “I smoke cannabis.”’ But if it had not been for the Daily Mail, which had an actual reporter from a reliable and experienced news agency in the courtroom, most people would not know.

Instead of arranging proper coverage of this event, the giant BBC supposedly dedicated to public service, relied rather pathetically on a police press release for its account.

Where do I begin? How can fair and accurate court reporting rely on the account provided by one side? In any case, it is not the job of the police to report court cases. They have other things to do.

Indeed, a police source told me they were not in court for the sentencing, which is why their release did not mention the judge’s comments.

I can’t begin to think how much trouble I’d have been in, in my court-reporting days on the Swindon Evening Advertiser, if I had done such a thing. You jolly well stayed to the end. The source also revealed that marijuana (possession of which remains a serious crime) didn’t feature in their investigations of this dope-infused crime.

Make what you like of that. Maybe if they cared more about it, there’d be fewer crimes of this kind.

Anyway, as a result, the BBC missed the story, which in my view very much deserved national exposure.

When I first saw the BBC account of the sentencing, and compared it with the Daily Mail’s far superior version, I thought the reason must be that the Corporation’s top deck were not that keen on reporting criticism of a drug that may possibly be used by some of its staff.

I was astounded to find that the true reason was, if anything, worse.

Many media just don’t cover the courts properly any more. An experienced freelance reporter explained to me that the BBC probably didn’t see the full story – as they have taken to cancelling contracts with on-the-spot agencies.

All serious newspapers and broadcasters used to make good use of such agencies, or even send their own people if the case was a big one – say, a son beating his mother to death.

A BBC source droned that they make decisions in line with editorial priorities and available resources at the time. News teams, the source added, follow clear editorial guidelines to ensure accuracy and this includes fact-checking with the relevant authorities. Or then again, not.

Apparently, on this occasion, they ‘fact-checked’ the police version with the Crown Prosecution Service. The CPS told me the BBC ‘just asked what mental health illness the defendant was determined by psychiatrists to have, and we confirmed schizophrenia’. As if this made things better, the BBC source said that their behaviour was something that many, if not all, media outlets do. Happily, not all.

I had long heard rumours about how the reporting of much of what goes on in this country is collapsing, as the provincial newspapers where I learnt my trade 50 and more years ago shrink or decay. But I had never seen it so starkly illustrated as in this court case, which badly needed to cause a national controversy, and now won’t.

It is amazing to recall that the small evening paper in Swindon where I started work in 1973 had a full-time librarian and a treasury of cuttings going back at least 70 years, in which the history of the town was stored.

Every one of us was carefully trained in law and shorthand, and our first attempts at court reporting were always supervised by an experienced senior reporter.

The same went for all the other things we wrote about. I was actually an indentured apprentice, like a character out of Dickens, and could not be released from this bond until I had served my time, satisfied my superiors at many tasks, and passed various tests and examinations.

The national company that owned my paper and several others would pay for us to spend occasional weekends in a Victorian country house in the Chilterns, where we were lectured by experts and old hands, and spent the final day putting together an imaginary newspaper, under heavy time pressure. I don’t think it was that exceptional.

As a result, the whole country in those days was covered by a safety net of reporters who, though not perfect, kept a constant eye on things that badly need to be exposed to the clear light of day, if they are to stay healthy.

I suspect this is vanishing fast, because the advertisers and readers, who once kept local papers going, have deserted them, and all we have instead are websites.

Oh, and the BBC, which still has billions in licence fee receipts and can afford to do what the old newspapers often can’t.

So why doesn’t it?

Has Nigel Farage Peaked Too Soon?

Even GB News is clearly having doubts when Tom Harwood writes:

In May last year, when Keir Starmer dragged the nation’s political press along to a glass manufacturing centre in Warrington, everyone was a little baffled. While some expected a grand new announcement, a new policy, perhaps even a new direction for the government – new policy came there none.

Instead, the then Prime Minister had orchestrated the whole jaunt in order to devote his speech in its entirety to one Mr. Nigel Farage. By this point, Labour had been consistently behind in the polls for a month, following an unrelenting downwards trend since the general election ten months earlier.

But at this point, Labour wasn’t that far behind. Starmer didn’t just make the speech to warn of what he saw as the dangers of the rise of the Reform Party. He also very deliberately framed the debate as Labour vs Reform. He declared Nigel Farage the Leader of the Opposition.

At the time, it was obvious to many why Sir Keir chose this risky gambit. He thought that given a straight fight Labour was likely to beat Reform. He knew that at the time his personal ratings held up best against Nigel Farage. Not that this would last long.

Arguably rather than boosting his own party, all the gambit served to do was to boost Farage’s ratings up higher still. When the then Prime Minister made his speech, Reform was polling in the mid-20s. In the months after, the party rose above the 30 per cent threshold.

Andy Burnham has taken the opposite approach. This week he invited the leaders of the Liberal Democrats and the Conservative Party to engage in cross party talks in his bid to create a new consensus on public funding of social care. Left out of those talks? The man who had led more than 350 opinion polls in a row.

Out in the cold

Instead of bigging up Nigel Farage and Reform, as Keir Starmer once did, Andy Burnham is leaving them out in the cold. It doesn’t help Farage’s case that he has taken himself off the pitch by calling an unnecessary by election, effectively banishing himself from our television screens and radio sets thanks to Britain’s anachronistic broadcasting rules around elections. Yet, Burnham is clearly operating as if the Farage ascendency is not inevitable.

And just as the new Number 10 has taken this new approach to the Reform party, something else has changed. For the first time since April 2025 there are now polls that show Reform knocked off its first place spot in the polls. Suddenly everything looks a lot more competitive. And not just in one direction. There has been much commentary of Labour’s polling advance – the Burnham bounce – yet that isn’t the only shift we are seeing. This week’s latest Yougov poll put not just Labour and Reform, but the top three parties in a statistical tie. 22-22-21 for Reform, Labour, and the Tories (remember them), respectively.

The research agency More In Common has for some time been tracking the rise in Kemi Badenoch’s personal approval ratings. And it is true to say the Tory Party has now risen beyond its nadir or 15-16 per cent in the polls some months ago.

Indeed in the three latest polls (from YouGov, Survation, and More In Common) the Conservatives are now just one, two, and three points behind the Reform Party.

Britain has had history of an insurgent third party looking ascendant – practically all dominating – as the SDP-Liberal Alliance peaked at over 50 per cent in some polls in 1981. But the Gang of Four peaked too early. By 1983, the party came third in both vote share and seat share, and the same old two party politics – once declared dead – was back with a vengeance.

This Parliament could still run for another three years yet. Whisper it, could the next election yet become a traditional Labour-Tory affair once again? Don’t rule it out.

Not Optimistic

Paul Sagar writes:

I’ve seen things you people wouldn’t believe. I’ve seen things Andy Burnham wouldn’t believe.

While lying paralysed in a hospital bed, I have watched NHS nurses telling agency staff to just stand over there and do nothing, because they were so incompetent they were making things worse by trying to help. I’ve had the terrifying prospect of trying to explain to somebody who can’t speak English — and yet is working in a spinal unit in a hospital ward — in the middle of the night, why I desperately need them to get the nurse. Because if my autonomic dysreflexia isn’t arrested, I’m going to have a stroke and then die.

I’ve had the rather different experience of returning to my ward to find a care worker asleep on the radiator. If the worst three words in the English language are “rail replacement bus”, then the most terrifying for a long-term hospital inpatient are “agency staff”. NHS rules dictate that a certain number of care staff have to be on the ward floor to support nurses as a legal requirement — even if the agency staff recruited to be in line with the law make the work of the nurses harder. When I learned that these agency staff were trained over Zoom before being sent into hospitals, I wasn’t exactly surprised.

Lying behind this sorry state of affairs is the uncomfortable fact that the British electorate wants to have its cake and eat it, three ways over.

There is, for one thing, growing awareness and concern that the social care sector is in crisis. But taxes are already at a historic high, and people don’t want them to go up yet further. And although this is not polling quite as highly as it was last year, there is a clear preference for reducing the level of immigration.

This is what pointy-headed academics like me call a trilemma; it is impossible to satisfy all three preferences simultaneously. If you want more care workers there are two options. You could make starting salaries a lot higher so as to encourage far more people from the existing British population to become carers. Or you can keep starting salaries pitifully low, so that the only people who will take these jobs are immigrants so desperate for the work that they will turn up anyway.

The problem with the first option is that the only way to do this is to raise taxes in order to directly fund social care. And given that it will cost literally billions, it really will mean putting taxes up. The problem with the second is that it makes reducing immigration levels particularly difficult, given how many immigrants will be needed to cover work in social care, especially with an ageing population. And of course, if we halted immigration tomorrow, the entire NHS would collapse.

But something has to give. My own preference would be to raise taxes and pay the care workers more. This isn’t primarily to reduce immigration at the net level (which I’m personally pretty relaxed about, because I’m a wet centrist of dad-age, and I think that the net economic benefits of migration outweigh the costs of cultural conflict that arise). It is because I think that if we pay carers more, we will get better quality carers — wherever they were born.

And I speak here not just as a pointy-headed academic, but also as somebody who has (to use the jargon that I hate) “lived experience” in this area. As regular readers will know, in 2023 I suffered a rock-climbing accident that left me tetraplegic — paralysed from the collarbones down. Ever since, I have needed 24-hour, on-call care to help me with everything from going to the toilet, having a shower, preparing food, getting dressed, and making sure that if my body starts trying to kill me (which it very much can and does), somebody is close by to stop it doing that. I spent eight months in hospitals, four months in a nursing home in Enfield, and ever since I’ve lived independently, but with 24-hour assistance.

Now, before we go any further, an important point that must be emphasised. It is by no means the case that all nursing homes, and all care agencies in the UK are bad. Far from it. Indeed, I have been one of the lucky ones, who has received good care at all points.

The nursing home in Enfield was genuinely excellent — which of course is not the same thing as enjoying living there, but everything is relative in such cases. When I first moved back to Waltham Forest, I initially received care from a small-scale, locally managed agency, who did extremely well by me. I frequently spoke to the Managing Director herself, who went out of her way to make sure that her staff were not just looking after me properly, but helping me to adjust to the challenges of my new life. After about a year, we agreed that I would do better if I moved to a specialist agency that provides care only to people with tetraplegia. That is who I am with now, and it has allowed me to regain a level of independence I didn’t think would be possible.

But it is important to emphasise that I am very much one of the lucky ones. Not least because my local authority has competent and empathetic NHS social care administrative staff, who signed off on a more expensive spinal agency taking over my care. This is not the norm. I have heard many horror stories, from others in my situation, about how their local authority basically wouldn’t agree to pay for appropriate care, usually through some mix of callousness, bean counting, and incompetence. But note: it is not an accident that the care I receive from my specialist spinal agency is the best available and the most expensive. They charge more, so they can pay their staff more, which means they can recruit better people. It’s also much easier for them to turn away candidates who are not up to scratch.

Now compare this to what most people, and their families, have to confront: the fact that vast numbers of social care workers in this country are not being employed directly by the NHS, but by unscrupulous private nursing homes and even more unscrupulous agencies.

We are not just talking about people with spinal injuries, but the huge range of conditions that require assistance for daily living: Alzheimer’s, strokes, advanced multiple sclerosis, severe learning disabilities, and a hundred other conditions that those of us who don’t suffer from them have probably never heard of. If you need social care in this country, the overwhelming likelihood is that you are going to receive it from an agency primarily concerned with one thing: extracting as much money from the NHS as it can, to feed back to its private equity masters.

The best way to do that? Pay staff as little as possible. Give them as little training as you can get away with. Don’t worry about the local authority kicking up a fuss; they can’t fully cover the cost of social care already after two decades of austerity, let alone check that you’re doing a good job. They’ll just give you the contract if you say you’ll cover it. Provided your staff don’t literally murder a client in front of the neighbours, you’re probably in the clear.

British people won’t take the work, because they have better options than the 12-hour shifts, low pay, and stressful conditions you are offering? No worries. Just exploit immigration visa exceptions for care work, and import low-skilled people from abroad. They can’t speak English? Whatever. Send them out to vulnerable people anyway. Money in the bank, Frank.

If you think I’m making this up, just ask anybody who has had to rely on one of the bigger agencies for social care provision. Like my friend from spinal rehab, who was injured at almost exactly the same time as me, with almost identical care requirements. Unlike me, however, he was not one of the lucky ones. In fact, he asked me not to use his name, because he’s scared of recrimination.

My friend has been shunted around large-scale care agencies for the best part of three years. He will tell you about the carer who ignored him as he screamed “Stop!” because his catheter was being ripped out through poor physical handling. He will tell you about the carers who don’t even try to understand what he’s saying to them (in English, which they can’t speak), and just walk away mid-sentence, before ignoring him for hours, alone in his own home. He will tell you about the one who refused to unblock his catheter, saying he was lying about experiencing autonomic dysreflexia — the life-threatening medical condition that if not resolved would have killed him. (That time he just about managed to manipulate the catheter himself. Next time, he might not be so lucky.) And yes, he complains to the agency. No, nothing ever changes. They just send fresh incompetents.

All of which makes me, I’m afraid to say, pretty pessimistic about Burnham’s promise to take the social care crisis seriously. For a start, he’s already ruled out raising taxes. And yet he claims to agree that social care workers need to be paid more. Well, Andy, how are you going to afford them?

The more fundamental problem is that the recent noise out of the new No. 10 about social care is all vibes and no concrete policy. And that’s because concrete policy is hard. In this case, really hard. As far as I see it, the only realistic chance of breaking the trilemma is not only to put up the wages of care staff (so that we get better quality people from the UK and overseas), but to remove from the equation the private equity funds that stand behind the large private agencies, more interested in their top line than you flat-lining.

This does not mean straightforward nationalisation. There are huge pitfalls with doing that, and some private agencies deliver very good services: as a general rule, the ones who are smaller scale, both in provision and staff size, and not backed by private equity. Let’s not turn the need for reform into a case for demolition.

Burnham in his first week declared that he wanted to reverse 40 years of neoliberalism. There are good reasons to think he’s using the wrong word here: neoliberalism started to die in 2008, and has been dead as a dodo since 2016. What we currently live under is something worse. Zombie-neoliberalism: the legacy of Margaret Thatcher and Tony Blair fed through the meatgrinder of austerity. Indeed, the failure of Britain’s social care system is the archetypal case. We pay higher taxes, so that private actors can get rich, while providing substandard care to the most vulnerable people in society.

Our new Prime Minister is absolutely right to want to change this. The question is: does he have the courage of his convictions? Because the rich don’t like to give up their power and their privilege, no matter how many people with severe mental and physical disabilities suffer as a result. Those who gain from private equity’s deep reach into the NHS are going to fight him on this. And they are going to fight him hard. Will he stand up to them? And if he does, can he win? I’m not optimistic.

Nor should he be, as Sarah Marsh writes:

A US private equity firm will take control of NHS patient records in a deal experts say should “ring alarm bells” amid concerns sensitive health data is increasingly being handed to private companies.

The investment firm TPG has bought Optum UK, the healthcare technology business behind the electronic patient record system used by most GP practices in England, in a deal worth about $400m (£300m).

Doctors, campaigners, MPs and human rights groups say the transfer of a company handling millions of NHS patient records to a US private equity firm has taken place with little public scrutiny.

A spokesperson for the campaign group Doctors’ Association UK (DAUK) said: “Private equity now owns the plumbing of English general practice. The GP records of more than half the country sit on a system controlled by a firm whose business model is returns for investors, not care for patients, and the public found out after the fact.”

It added: “We have been here before with Palantir. The difference is that this time the buyer is a private equity giant whose overseas hospitals stand accused of pushing patients into debt … We want the government to set out what safeguards exist, what happens to the data if TPG later sells the asset, and why none of this was put to parliament.”

Helen Morgan, the Liberal Democrats’ health spokesperson, said such deals were “being rubber-stamped without any scrutiny or protections for patients”, adding: “Time and time again, patients are seeing the government hand over sensitive NHS data to US tech firms, leaving our public services dangerously exposed.”

The MP called for the government to listen and “start backing British tech instead”.

Concerns have also been raised about TPG’s track record after hospitals linked to the firm in Africa were accused of pushing patients into poverty through excessive medical bills.

Earlier this year, an investigation by the International Consortium of Investigative Journalists (ICIJ) examined hospitals in Kenya owned by Evercare, a healthcare group backed by TPG’s Rise Fund.

The investigation reported allegations that some patients were left with crippling debts and in some cases were required to provide land deeds as collateral for unpaid medical bills. A spokesperson for TPG said it strongly disagreed “with the facts and characterisation of the allegations in the ICIJ’s report”.

They added: “We’ve made more than $100m of investments across Evercare over six years, which have led to substantial gains in quality, accessibility, and accreditations, as well as patient rights and protections. Any suggestion that TPG or Evercare prioritises profits over patients is incorrect and ignores the extensive clinical governance and patient’s rights policies we’ve instituted.”

The former Oxfam health policy lead Anna Marriott said the deal should “ring major alarm bells”. She said: “It is deeply concerning that a private equity firm with a highly controversial track record in healthcare internationally can take control of sensitive NHS patient data with so little public scrutiny. / “NHS patients have no say over who holds their medical records, which makes it the government’s job to guarantee their safety. This deal should ring major alarm bells. Private equity’s penetration of our health service is fast outrunning the regulatory guardrails needed to protect patients, workers and the public interest.”

TPG acquired Optum UK from the New York-listed healthcare corporation UnitedHealth Group. The business includes EMIS, whose software is used by more than half of GP practices in England, making it one of the NHS’s most significant providers of primary care technology and giving it responsibility for managing the electronic health records of millions of patients.

A spokesperson for EMIS said: “We have a longstanding commitment to the NHS and the wider UK healthcare system. Data security and patient privacy have always been at the core of our operations, supported by rigorous controls, strict access requirements, and compliance with all applicable regulatory and contractual obligations.

“The acquisition was reviewed and approved by the UK government through the applicable channels in accordance with the National Security and Investment Act 2021. Any suggestion that this acquisition changes patient data protections disregards nearly three decades of upholding only the strictest compliance standards – a commitment TPG shares and has a demonstrated record of reinforcing through investment in the systems that further strengthen those safeguards.”

A spokesperson for TPG said: “Assertions that TPG could in any way access, control, maintain, or utilise NHS patient records are entirely false. A change in ownership of the company has in no way changed how patient data is stored, protected, or governed, nor has it altered the legal, regulatory, contractual, and operational safeguards that apply. TPG is committed to upholding and reinforcing EMIS’ independent standards of data protection, patient privacy, and service to the NHS.”

The Department of Health and Social Care did not provide a comment.