Episode 18: UK NHS privatisation, health and the public interest with David Rowland

Hello everyone and welcome back to Money Power Health. Before we delve into this episode, you will also see that we have launched a substack with essays on the themes of money power and health. You can sign up to that and read them, for free and ad free, in the link in the show notes. Today’s episode is about the quiet but profound transformation of the UKs national health service. This has been less through a single piece of legislation, but through decades of contracting, outsourcing, and creeping privatisation that often escapes public scrutiny. My guest is David Rowland, Executive Director of the Centre for Health and the Public Interest, an independent non-party think tank prmoting a vision of health focused on accountability and the public interest. CHPI has done some of the most rigorous work in the UK tracking how private companies have become embedded within the NHS, from clinical services to back-office functions, and what that means for cost, accountability, transparency, and ultimately, patient care.In this conversation, we talk about how privatisation actually happens in practice using examples from CHPIs work, and why headline debates about “selling off the NHS” miss the more important question: how market logics and profit-seeking reshape public institutions from the inside out. He discusses what it is like to work with with people who have been harmed through such arrangements and discuss why the impacts of privatisation are not evenly distributed.I hope you enjoy the conversation.  Links to some of the topics covered in this conversation are below: Profit leakage in eye care report: https://www.chpi.org.uk/reports/the-local-and-national-impact-of-profit-leakage-in-the-outsourcing-of-nhs-eye-care-services-to-the-private-sectorADHD outsourcing report: https://www.chpi.org.uk/reports/how-the-under-regulated-market-in-nhs-funded-adhd-servicesReport on the UK care home industry: https://www.chpi.org.uk/reports/plugging-the-leaks-in-the-uk-care-home-industryMusic in this podcast was by Daniel Maani. You can find out more about his art and music here: https://www.danielmaani.com

Hello and welcome back to Money Power Health.This week we are discussing business schools with Dr. Nora Campbell, Associate Professor of Marketing at Trinity Business School, Dublin, where she teaches in management theory, and science and technology studies. We delve into the historical role of business schools, the evolution of management theories, and the demands of current students. Norah shares her unique journey from studying French and German to marketing and eventually focusing on the commercial determinants of health. We also touch upon the shift from productivity and efficiency to sustainability and the potential future of education in business schools, how such institutions might reinvent themselves in response to ecological and health imperatives, and what the place is of critical scholarship in such spaces. We end with forward looking reflections, as Norah considers the importance of maintaining a balanced life and critically analyzing the structures within which we all work.If you would like to find out more about Norah's research, which spans nano-bio-info-cogno markets, climate change, and the food industry, here are some links to recent articles: The corporate political activity of the food industry in Ireland: an analysis and proposed solutionshttps://academic.oup.com/eurpub/article/34/Supplement_3/ckae144.1511/7843367Ultra-Processed Food: The Tragedy of the Biological Commonshttps://www.ijhpm.com/article_4359.html Here are some examples of her public writing:https://www.irishtimes.com/health/your-wellness/2023/01/30/it-delivers-a-taste-bomb-of-pure-pleasure-but-ultraprocessed-food-is-killing-us/https://www.irishexaminer.com/opinion/commentanalysis/arid-41626909.htmlAnd here is a link to her university profile:https://www.tcd.ie/business/people/faculty-professors/ncampbe/ The music in this podcast was by Daniel Maani. You can find out more about his music and poetry here: https://www.danielmaani.com

Hello and welcome back to Money Power Health. Justice and health are deeply intertwined, as the same social and economic factors that can significantly impact individual and population health, can also influence a person's likelihood of interacting with the justice system. Prisons are places with some of the most profound inequalities in health outcomes, and if we care about the ways in which gaps in money, power and health overlap, the wellbeing of all those touched by the justice system needs to be part of the conversation. In order to discuss health and justice in the UK I am joined today by two inspiring public health practitioners with a central interest in this area. Dr Nicola Dennis is acting consultant in public health working in the West Midlands, with a particular interest in health inequalities. Dr Chantal Edge is the National Lead for Health and Justice at the UK Health Security Agency and a Public Health Consultant by background. Both have been working together on the Chief Medical Officers upcoming report on the health of people in prison and probation in England. In this podcast, they help me understand who the justice system affects in the context of health, in what ways, how these intersect with wider social inequalities and childhood experiences, the importance of improving health in custody as part of wider rehabilitation, the challenges faced by inmates who seek healthcare in terms of access and stigma, and what efforts are underway to consider and mitigate these challenges. If you are interested in reading more about these issues, I include some links below. Here is a short animation produced based on work by Dr Edge and others on the experiences of prisoners seeking healthcare in their own words: https://www.youtube.com/watch?v=_IDag_RFus8 Here is a paper by Dr Edge and colleagues (including past guest Prof Martin McKee) reviewing the evidence regarding prisoners co-infected with TB and HIV: https://pubmed.ncbi.nlm.nih.gov/27852420/In a global context, you can find out more about key facts and figures from Penal Reform Internationals Global Prison Trends (2025) here: https://cdn.penalreform.org/wp-content/uploads/2025/05/PRI_Global-prison-trends-2025.pdfMusic in this podcast was by Daniel Maani. You can find out more about his music and poetry here: https://www.danielmaani.com/

Hello, and welcome back to Money, Power, Health. Today we’re talking about research and advocacy in tobacco and alcohol policy with someone seeking to hold the industries in question accountable—not just through research, but through advocacy and policy engagement.My guest is Dr. Gayle Amul, a researcher and advocate whose work focuses on alcohol and tobacco industry interference in public health policy. Gayle is currently a Senior Adviser for the Alcohol, Drugs and Development Programme at FORUT, a Norwegian NGO. She’s also deeply involved in alcohol policy research in the Philippines, working with the University of the Philippines National Institutes of Health through their Health Promotion Program.Gayle is one of the founding members of the Community of Practice on Alcohol and Substance Use in the Philippines and sits on the advisory board of a tobacco control researchfellowship focused on smoking cessation, led by the Ateneo School of Government. We also talk about Gayle’s journey from political science into global health, her reflections on navigating academia as a space for action, and what it means to be a pracademic—someone who bridges research and advocacy in meaningful ways. Whether you’re a student, researcher, policymaker, or advocate, her insight are helpful in thinking how we can use academic tools not just to describe the world, but to help change it.I hope you enjoy the conversation.You can find examples of her research below: Comparing tobacco and alcohol policies in the Philippines and Singapore: https://pmc.ncbi.nlm.nih.gov/articles/PMC9606809/Analysis of flavor descriptors of tobacco products in the Philippines and implications for LMICs: https://link.springer.com/article/10.1186/s12992-024-01072-6Cigarette packaging as a commercial determinant of smokking: Perceptions of graphic health warnings among Filipinos: https://www.sciencedirect.com/science/article/abs/pii/S0277953624010700Corporate social responsibility as a commercial determinant of health: Case study of the alcohol industry in the Philippines: https://www.sciencedirect.com/science/article/abs/pii/S027795362500499X  

 Hello everyone and welcome back to Money Power Health.This week, we are discussing so called “forever chemicals” or PFAS, a group of more than 10,000 man-made chemicals used in a wide range of industrial applications and consumer products. Of core interest to public health, they are resistant to degradation, meaning they persist in the environment, contaminating water and soil, and ending up in our food chain and bodies, accumulating in people, animals and plants. The rate and spread at which this is happening, combined with the health effects of such chemicals, some of which can affect reproduction and foetal development or cause cancer, has led to a range of new regulatory proposals to eliminate or reduce their use around the world. However, such developments face strong and coordinated lobbying efforts by the manufacturers of these chemicals. To discuss this issue, I am joined by Vicky Cann from Corporate Europe Observatory and co-author of their Chemical Reaction report which documented extensive lobbying in collaboration with a global group of journalists and media outlets. We’ll discuss how industry lobbying is shaping the fate of PFAS regulation in Europe, what this means for public health and the environment, and why the Commission’s receptiveness to corporate influence raises urgent questions about how we protect democratic decision-making from commercial capture. I hope you enjoy the conversation.  You can find a recent article by Vicky Cann alongside Hélène Duguy from ClientEArth on forever chemicals in the EU here: https://corporateeurope.org/en/2025/05/forever-chemicals-are-everywhere-so-why-isnt-eu-banning-them-all The full report she discusses in the podcast is here: https://corporateeurope.org/en/chemical-reaction and news coverage of it is here: https://www.theguardian.com/environment/2025/jan/14/industry-using-tobacco-playbook-to-fend-off-forever-chemicals-regulation Information on the forever lobbying project she references is here: https://foreverpollution.eu/lobbying/ Links to the core FOI documents (now deposited in the Industry Documents Library: https://www.industrydocuments.ucsf.edu/chemical/collections/forever-pollution-project/ You can sign up to the Corporate Europe Observatory newsletter here: https://corporateeurope.org/en/newsletter   

Hi everyone and welcome back to Money Power Health. We often tend to think of our health as the product of our own energies, something we alone are accountable for. But in reality, our health is to a large degree shaped by the conditions we find ourselves in, the quality of our air, the wealth of our parents, the food we have access to, our opportunities for work, our time for exercise. Schools and education are a key part of this. Schools shape how we see the world and interact with each other at a critical stage in development. Most people might assume that schools are a place in which commercial influence is largely absent. That however is far from the case. Children are a key market, and brand loyalties formed in childhood can persist into adulthood, and standards of behaviour, of consumption, taste, and definitions of coolness, risk, fun are all being formed during this time.  In part due to this, there is now a long history of the manufacturers of unhealthy products funding the development of lesson plans, initiatives and activities in primary and high schools that involve issues like fossil fuels, firearms, alcohol, gambling or smoking. This has significant strategic value, and in order to understand more about why this happens, and what it means for children and young people, I am very pleased to be joined by someone who has led on several studies examining the nature and purpose of such funded materials in schools.  May van Schalkwyk is a research fellow in commercial determinant of health in the Global Health Policy Unit and Centre for Pesticide Suicide Prevention at the University of Edinburgh. She also has an honorary public health consultant role with Public Health Scotland and is an honorary research fellow at the London School of Hygiene and Tropical Medicine where she completed her PhD in 2023 and is a member of the commercial determinants research group.  May originally trained as a clinical doctor and then specialised in public health medicine. Her research aims to explain how commercial actors influence ideas, knowledge, science and policymaking. She publishes research on the tobacco, alcohol, gambling, fossil fuels, opioid, pesticide and firearm industries, including on the influence of youth education and safety programmes as a form of corporate political activity. Full disclosure: May and I are good friends and go back some time, having met at the London School of Hygiene and Tropical Medicine, and worked together for over seven years researching the commercial determinants of health, including some of the articles we will be discussing. You can find out more about the topics we have discussed, including some of May's recent research articles, in the links below: Alcohol industry funded school programmes: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259560https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00341-3/fulltextGambling industry funded school programmes: https://academic.oup.com/heapro/article/39/1/daad196/7565070https://www.sciencedirect.com/science/article/pii/S235282732200101XLink to public-facing videos May has made about research on the commercial determinants of health: https://www.youtube.com/channel/UCfnKnt8BHlSgTIdK7jfGwfg 

The alcohol industry is a significant commercial determinant of health, shaping global consumption patterns through aggressive marketing, lobbying against regulation, and expanding into new markets, particularly in low- and middle-income countries. With its substantial influence on policymaking and public perceptions, the industry has contributed to a global burden of alcohol-related harm, including chronic diseases, injuries, and social issues. In this episode, we are joined by Dr. Emeka Dumbili, a sociologist with a central interest in the shaping of social norms regarding substance use, to discuss the ways in which the alcohol industry is seeking to shape social norms around drinking in West Africa.Emeka is an Assistant Professor and Ad Astra Fellow at University College Dublin. He completed his PhD in the Department of Sociology and Communications, Brunel University London, exploring the interplay between media consumption, the gendering of alcohol, and aspirational drinking amongst young people. He held a lectureship position at the Department of Sociology and Anthropology, Nnamdi Azikiwe University, Awka, Nigeria. He was a Georg Forster Research Fellow of the Alexander von Humboldt Foundation, Germany. Between 2016 and 2017, he was a Mildred Blaxter Postdoctoral Fellow at Brunel University London. In 2019, he was awarded the ACU (Association of Commonwealth Universities) Blue Charter Fellowship to explore plastic pollution in Nigeria. Some recent articles by Dr Dumbili and colleagues: "Alcohol industry-sponsored music festivals, alcohol marketing and drinking practices among young Nigerians: Implications for policy" https://www.sciencedirect.com/science/article/pii/S0955395924000690?via%3Dihub"Perspectives of community leaders/members on factors hindering alcohol regulation in Nigeria" https://www.tandfonline.com/doi/abs/10.1080/09687637.2023.2247540"Making sense of ''drink responsibly'' messages: Explorations of the understanding and interpretations of young Nigerians who use alcohol" https://pubmed.ncbi.nlm.nih.gov/35290927/

Hello everyone, and welcome back to Money, Power, Health with me, Nason Maani. This week we are speaking to Dr David Blane, a GP in Pollokshaws and Clinical Research Fellow at the University of Glasgow, and the academic coordinator of the Deep End GP network. As you know, in this podcast we have spoken about the ways in which the wider physical and social environments people find themselves in can profoundly shape their health, and how these environments are shaped by inequality and powerful commercial forces. In some ways, we have been talking about mich of what shapes health occurs outside of healthcare, and I have been contacted by clinicians who know only too well how frustrating it can be to attempt to treat patients, only to send them back into the conditions that made them sick, and to try to devote themselves to making their communities healthier, when those wider conditions are worsening, particularly for the most vulnerable.   Yet, healthcare can, and should engage with these forces, and one example of an initiative that has sought to do so in inspirational and innovative ways, is the Deep end GP here in Scotland. Today I have the great privilege of speaking to Dr David Blane, senior clinical lecturer in General Practice and Primary care, and academic coordinator of the Deep End GP group in Scotland. Glasgow in particular suffers from extremely high levels of health inequality and deprivation, and it is there that The Deep End GP network, while pools the experience and ideas of GPs in the most deprived areas, was established with the goal of increasing advocacy, mitigating burnout, and providing practical, grassroots interventions to improve patient care in areas with the highest patient need. Together, we explore the origins of the project, how these relate to cost of living challenges, and how one keeps going in spite of sometimes challenging circumstances. I hope you enjoy the conversation. More information on the Deep End GP Network can be found below:The Scottish Deep End Project:https://www.gla.ac.uk/schools/healthwellbeing/research/generalpractice/deepend/Link to latest Deep End reports, manifesto and newsletters:https://www.gla.ac.uk/schools/healthwellbeing/research/generalpractice/deepend/reports/Davids profile:https://www.gla.ac.uk/schools/healthwellbeing/staff/davidblane/Julian Tudor Harts 1971 article on the inverse care law:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(71)92410-X/fulltext

Hello everyone, and welcome back to Money Power Health.  Today I have the great privilege of speaking to Rebecca Cassidy, professor of social anthropology at Goldsmiths, on the gambling industry and her experience of working on gambling industry research.  The gambling industry has experienced tremendous growth in recent years, particularly through online and mobile gaming, and is increasingly consolidating globally. Gambling has significant health and social implications for both users and their families, particularly as the industry relies on a small proportion of players for the majority of gambling revenue. Notably, a significant proportion of gambling-related public health research is industry-funded, as are most academic conferences, despite a clear conflict of interest. Professor Cassidy and her colleagues were among the first to step into these spaces, and critically examine how the industry had coopted gambling research, terminology, and outcomes, and so besides being something of a hero of mine, her experience and example is relevant to anyone who has to stand up and say the unwelcome, but important truth about the root causes of health problems. I hope you enjoy this conversation as much as I did.  You can find out more about the work she refers to below. The report Fair Game on gambling research: https://research.gold.ac.uk/id/eprint/11731/1/Fair-Game-Web-Final.pdf  Her book, Vicious Games: https://blackwells.co.uk/bookshop/product/9780745340395?gC=5a105e8b&gad_source=1&gclid=CjwKCAjwkY2qBhBDEiwAoQXK5e8ilKkXnT5UqoYDR8RressAYaK72CcDuitgLkPtZEdBB_WAFBKFFBoCFm4QAvD_BwE A recent paper she co-authored on a public health approach to gambling regulation: https://linkinghub.elsevier.com/retrieve/pii/S2468-2667(21)00098-0 Music in this podcast was composed and performed by Daniel Maani. You can find out more about his music here:  https://open.spotify.com/artist/4GDF0XnCn78nce0gesJoC7 And here: https://open.spotify.com/artist/0Gs6V1gnUYEkZLfU2kjBdK See you in the next episode. 

Hello and welcome back to Money Power Health.    “Think global, act local!” “Be the change you want to see in the world!” “Every little bit counts!” We can all get on board with such sentiments, right? Well, todays guest Grant Ennis, would question that. He is the author of the book "Dark PR: How corporate disinformation undermines our health and the environment". In this new book, drawing on his experience working in the environmental, philanthropy, and public health sectors, he lays out the costs of commercial efforts to influence citizen action and discourse, individually and cumulatively. The book offers a wide-ranging appraisal of the narratives that he feels hold us back, the costs of our approaches to issues such as subsidies and tax breaks ,and, argues for the need to think more structurally, to organise, and to unite in broader coalitions if we wish to improve health in foundational, structural ways. I hope you enjoy the conversation. The book is available from Dajara Press in print or ePub: https://darajapress.com/publication/dark-pr-how-corporate-disinformation-harms-our-health-and-the-environment and from Audible as an audiobook: https://www.audible.co.uk/pd/Dark-PR-Audiobook/B0CCT1WMQ2 The publication he mentions led by Mark Petticrew is available here: https://jech.bmj.com/content/71/11/1078 and our related paper on the pollution of discourse and the need for effective counterframing is here: https://www.bmj.com/content/377/bmj.o1128 Dr. Terry Lynn Karl is the researcher he mentioned from Stanford in relation to electorialism: https://cddrl.fsi.stanford.edu/people/Terry_L_Karl The asian disease experiment was published here: Tversky, Amos, and Daniel Kahneman. "The framing of decisions and the psychology of choice." science 211, no. 4481 (1981): 453-458. The full quote from Arundhati Roy that he refers to is here: [the] whole idea of 'you have to be a saint first and then be political' is [a] way of making sure that a whole lot of people are not political.” (Roy, Arundhati. “Interview and Q&A with Arundhati Roy.” In Earth at Risk: Building a Resistance Movement to Save the Planet. Oakland, CA: PM Press, 2013) Music in the podcast was composed and performed by Daniel Maani. You can find out more about his music here: https://www.danielmaani.com