• Plans part of attempt to ready party for a 2019 general election
  • Idea to nationalise private healthcare comes from shadow chancellor John McDonnell
  • Documents also moot nationalisation of gyms and fitness facilities

Labour is considering adopting plans to bring all GP practices and private healthcare providers into public ownership, according to an internal party discussion document seen by HSJ.

The plans are the product of an attempt to ready Labour for a 2019 general election.

The proposal to end the independent contractor status of most GPs is the brainchild of Labour policy director Andrew Fisher. He wrote in the discussion document that “the continued existence of general practice outside the NHS is an affront to our commitment to public healthcare. Let us finish what Bevan could not.”

His comments echoed those of Labour MP and GP Paul Williams, who told HSJ last month: “I’d love to see the NHS being completed by the addition of general practice”.

The idea of nationalising the UK’s private healthcare sector comes from Labour shadow chancellor John McDonnell.

HSJ understands Mr McDonnell is nervous that Labour would not be in a position to grow the NHS’ capacity fast enough to meet voters’ expectations – and that even moderate progress would require diverting funds from expensive pre-existing commitments such as ending student loans.

In the discussion document, Mr McDonnell argued: “Nationalisation of healthcare providers such as Virgin, Care UK and BMI would be very popular with Labour voters. It would also provide value for money – as we would argue that in many cases the price paid for these businesses need only cover the buildings and other capital assets.

“Staff who did not already work for the NHS could be moved into the service under the Transfer of Undertakings (Protection of Employment) ‎regulations. Customer contracts would be worthless as there would be no providers to honour them, and – in any case – the NHS would soon be delivering the best healthcare in the world.”

The moves to nationalise healthcare provision are an extension of those recently announced by Labour local government shadow Andrew Gwynne, which pledged a future Labour government to ensuring that “at risk” people are served by publicly-owned organisations whenever possible. The nationalised primary care and acute providers will be brought under control of People’s Care Networks – which replace sustainability and transformation partnerships and have an entirely elected board.

However, Mr Fisher urged caution on making the moves public, fearing it might spark further defections to the Independent Group. He suggested Labour take no official position on the NHS prior to the election and instead publish a series of “17 tests and four, maybe five, red lines” which needed to be met to ensure the NHS could be “deemed a genuinely publicly funded service.”

The document also mooted a nationalisation of gyms and fitness facilities, noting that a centrally-managed primary care system could prescribe attendance to improve public health.

The discussion document raised the possibility of “significant opposition to the plans from the British Medical Association, as in 1948”.

However, an expert briefing paper, prepared by the Socialist Health Alliance and the Keep our NHS Public collective, explained “most younger GPs will be in favour of nationalisation and it is only the older senior partners who will strongly object”.

Declaring a determination not to “stuff their mouths with gold this time”, the document talked of a campaign to “shame” the BMA into backing a fully publicly-owned NHS.

Labour activist and former BMA council member Allyson Pollock is understood to be working with the leadership of the influential pressure group Momentum to launch the campaign this summer.

In a “communications codicil”, Labour press chief Seamus Milne added: “As Paul Mason commented on our relations with the so-called ‘Independent Group’, those senior GPs will soon learn Jeremy Corbyn’s Labour party is ‘not part of your cheese and biscuits circuit’. Comrades Mason and [Guardian columnist Owen] Jones will expose their hypocrisy!”

HSJ understands the BMA intends to respond by seeking support from other professional bodies. A campaign with the slogan ‘First they came for the GPs. Are opticians and chemists next?’ is being prepared.

The discussion document also stated that plans to reclassify NHS England chief executive Simon Stevens as a “national asset to stop him doing a David Miliband” have proved impractical. However, the show trial of Jeremy Hunt for crimes against junior doctors is still slated to go ahead.

Asked to comment, Labour health shadow Jon Ashworth said: “What now?! Oh, for christ’s sake – I mean, er, vive le revolution!”

The full Labour discussion document can be read below.