The Greensill scandal shows just how little the government cares for the NHS

Might it have been better if, instead of lending money to nurses that had to be paid back with interest, those involved had advocated for a decent pay settlement for NHS staff?

As the Coronavirus pandemic took hold in this country last year, David Cameron was busy lobbying senior NHS leaders on Greensill’s latest project: a dubious scheme that would provide salary advances to nurses and NHS staff, giving them access to their salary ahead of payday.

It is shocking on two fronts. One, that the NHS should have its attention diverted away from the lifesaving work of tackling the pandemic; and two, that this scheme would be approved for use by the NHS just months before ministers would ultimately recommend a real-terms pay cut for NHS staff.

The Greensill plan to provide salary advances to nurses and NHS staff was presented as an act of altruism. By offering NHS staff daily payment, Cameron told people, the project “addresses one of your key priorities: helping all NHS employees’ welfare, morale and wellbeing”. Cameron’s claims for his payday lending scheme were grandiose – “This is of such potential importance in contributing to the priority of doing all we can to help NHS employees at the current time” – but it was Cameron, rather than the nurses, who was in line to secure a payday windfall. 

The plan was to offload the loan book: Greensill would securitise the loans, package them up to sell to investors, and make a killing from what were, in practice, more likely to be junk bonds. The parallels with the selling off of another form of loans, sub-prime mortgages, which triggered the global financial crisis in 2008, are both sad and frightening. 

Greensill’s plan was to expand into the social care sector as well, where staff are low-paid, and often on zero-hour contracts, and where – because the fragmented market is made up of private providers – the supposed non-profit offer would not apply.

Not only did Hancock appear to give the immoral lending plan a green light; Cameron later said that “As you can imagine, Matt Hancock ... is extremely positive about this innovative offer.” Key to the success of the plan was Greensill forging a partnership with NHS Shared Business Services (NHS SBS). As a provider of payroll services for hospitals, they were critical to Greensill and Cameron because they could provide thousands of the names, along with financial data, on which the scheme was based.

And doors were opened by Hancock’s apparent interest. Indeed, NHS leaders were being lobbied from the very start by David Cameron. Cameron met the most senior NHS managers, sent texts to officials, and ultimately succeeded in getting NHS backing for the scheme. Senior figures in the NHS were drawn into a meeting convened by NHS England chair and former minister under Cameron, Lord David Prior. Such was the scale of the lobbying that Prior arranged a meeting with Conservative peer Dido Harding, and former NHS trust leader Sir David Dalton became a paid advisor, promoting the app to trusts.

NHSX, the health service’s digital arm, whose job was to support hospitals and develop technology that could help keep the pandemic under control, was the next to be drawn in through emails from Cameron. Within minutes of receiving contact from Cameron, the unit confirmed it would “certainly look into the electronic staff records questions”.

Ultimately this meant that the NHS Electronic Staff Record, the integrated HR and payroll system for the entire health service, which holds data for 1.3 million people, began working with Greensill. Dozens of NHS trusts, which should never have been diverted from their efforts to control the pandemic, became involved in the payday scheme.

In one email, Cameron claimed that trust CEOs with whom he was now in touch were “extremely positive” about this “innovative” offer. At least 30 trusts may have spent valuable time considering the adoption of this untested scheme – a scheme that would never have been needed had nurses and other NHS staff been given the pay rises they deserve. Hours that should have been spent fighting the pandemic were being taken up on conversations about the scheme.

But these trusts did so because they succumbed to Cameron and Greensill’s lobbying, for which Hancock had opened the door. Senior NHS leaders from around the country endorsed the scheme and met with Greensill representatives. There were meetings with trusts in London, Essex, and Salford. After signing up to the pilot, the chief executive of the Royal Free, one of the biggest trusts in the country, said: “Why wouldn’t you do it?”

There are questions about how many NHS leaders and officials Cameron and Greensill lobbied. How many NHS trusts in total were approached about a scheme that was really a form of usury? And because a number of officials entertained such lobbying on the part of a commercial concern, ultimately the most serious questions to be answered are those for the secretary of state, about his oversight of, and role in, this lobbying. Under questioning in the Commons yesterday, Hancock tried to avoid scrutiny on the issue, claiming that these were decisions for individual trusts; but couldn’t explain why Cameron had described him, along with the trusts, as being “extremely positive”.

The Greensill scandal is not the only episode of impropriety faced by the health secretary. Yesterday in the House of Commons I asked him to tell the house why he never declared his personal links to Topwood – the document-shredding firm – who were still on Friday night (until it was curiously taken down) using the NHS logo on their website to promote themselves. I will be writing to all inquiries into this scandal to ask that they specifically look at both the health secretary’s role in the Greensill scandal and his personal role in the lobbying of the NHS during a pandemic.   

But there are two questions only Cameron and his money lenders can answer. The first is a question that Hancock should have asked himself at the very beginning: might it have been better if, instead of lending money to nurses that had to be paid back with interest, those involved had advocated for a decent pay settlement for NHS staff?

And the other question is why he considered that during a national crisis, a time when the virus was once again spiralling out of control, asking the NHS to help him and his team of get-rich-quick speculators who desired to make money out of the pandemic took precedence over helping those whose lives were at risk.

Jonathan Ashworth is the shadow secretary of state for health and social care and the Labour (Co-op) MP for Leicester South