We get a lot of questions from EveryDoctor supporters, but some topics come up again and again.
One of the most frequent is the Tony Blair Institute (TBI). Many of you want to know what this organisation is, and where it stands on NHS privatisation.
To help answer these questions, we’ve investigated what TBI has been lobbying for and how it’s funded. You’ll find our research set out in the FAQ below. If you’d like us to dig further into the organisation, let us know.
What is the Tony Blair Institute?
The Tony Blair Institute for Global Change (TBI) is a non-profit organisation founded by its namesake in 2016.
After leaving office in 2007, the former prime minister pursued various philanthropic and commercial activities. The latter included advising US bank JP Morgan and insurance group Zurich for six-figure salaries, as well as oil company PetroSaudi.
In 2016, Blair decided to fold all his ventures and instead focus on a single organisation, TBI.
Since then, TBI has grown rapidly. By the end of 2023, it had 874 employees, operations in 36 counties, and offices in London, Singapore, Abu Dhabi, Nairobi, Washington DC and Brussels.
Okay, but what does it actually do?
TBI says it is “a not-for-profit, non-partisan organisation helping governments and leaders turn bold ideas into reality. We do it by advising on strategy, policy and delivery, unlocking the power of technology across all three.”
In other words, it provides paid advice to foreign leaders, which appears to be a rather lucrative business. In 2023 alone, it reported more than £107m in turnover, of which £92m came from its advisory services.
At the same time, it also functions as a think tank. In the past year, it has published dozens of policy papers aimed at influencing UK government policy on subjects ranging from climate to technology to health.
TBI also makes money from partnerships with companies including Elon Musk’s Starlink, British AI startup Faculty AI and US tech giant Oracle. According to its annual report, the organisation appears to have secured contracts for some of these partners as part of its advisory work with foreign governments.
Who is coughing up that money for advice from TBI?
TBI says it provided advice to 24 countries in 2023, though it doesn’t list them all. It has been criticised for working with the authoritarian governments of Bahrain, the United Arab Emirates, and Saudi Arabia, even after the murder of journalist Jamal Khashoggi in 2018.
What about the UK?
The current Labour government doesn’t appear to have directly contracted TBI, but then again it probably doesn’t have to, given the close relationship between the two.
Starmer has said that Blair regularly texts him advice and both his team and cabinet include Blair-era government veterans. Among them is cabinet secretary Pat McFadden, who worked as a political secretary to Blair, and the tech minister Peter Kyle who was a special advisor under Blair. McFadden, whose wife works for TBI, has described the organisation as “a useful resource for different members of the shadow cabinet”. The health secretary Wes Streeting appeared last year at a conference organised by TBI and is reportedly one of Blair’s “emissaries” at cabinet meetings.
Okay, but what does any of this have to do with the NHS?
Well, health is one of the policy areas in which TBI has a lot to say and it appears to have shaped the government’s plans for the health service.
How so?
For one, TBI’s director of health policy contributed to the NHS 10-year plan as a member of one of the government’s working groups (more on that here). There’s also striking similarities between some of the proposals in the plan and prior policy recommendations made by TBI.
What exactly are TBI’s positions on the NHS?
The NHS, in the eyes of TBI, is “not just an important part of British society”, it is “an economic asset for life sciences and more broadly for enterprise, offering new opportunities for the private sector, particularly with AI technology, to develop products and services”.
The organisation believes that the private sector should play a much bigger role in the NHS. To give one example, it has pushed for the NHS App to allow private healthcare providers to promote and sell their services on the app. Both ideas were taken up by the government in its 10-year plan.
It also believes that pharmacies, and even gyms and supermarkets, should be paid to provide services currently provided by the NHS.
Lastly, TBI wants to integrate AI deeply into the NHS, even suggesting that it should serve as a first point of call for health advice and that staff headcount could be reduced in favour of AI.
Anything else?
TBI has a lot to say about NHS data. It wants the government to commercialise the vast amounts of data that the NHS collects by setting up an independent body to manage it. This body, partly financed by the state and by private investors, would then sell anonymised patient data, offering preferential terms to investors as a sweetener.
It also wants the government to digitise health records and store them on a national database that uses cloud computing. The organisation is pushing for the record system to be “interoperable” so that private healthcare providers can access and contribute to it.
Right. Why exactly does it seem so focused on tech?
TBI says that “the greatest opportunity for governments today is the technological revolution.”
But some critics argue that far from taking a “non-partisan” approach, the organisation continues to reflect Blair’s own ideological belief that the private sector should play a leading role in delivering public services.
Journalists have pointed out that TBI’s promotion of technology happens to align with the interests of some of its corporate donors, which include Microsoft, Amazon and Uber.
One of TBI’s biggest donors is the tech entrepreneur Larry Ellison, who has given the organisation more than £250m through his foundation. Ellison is the co-founder of US tech company Oracle, which sells healthcare record software.
TBI previously told the Guardian that there is “no conflict of interest, and donations are ringfenced” and that £178m given by Ellison is to “support effective governance work in Africa”.
However, the organisation does appear to recommend the use of private partners to some of the governments it works for, according to its annual report.
The Tony Blair Institute presents itself as a ‘not-for-profit, non-partisan organisation helping governments and leaders turn bold ideas into reality’. But our investigation reveals an organisation with deep ties to both government and big tech, promoting policies that would fundamentally reshape the NHS. As TBI’s influence on healthcare policy grows, the question remains: whose interests are really being served – the public’s, or private enterprise’s?
EveryDoctor is enormously concerned about many of the organisations and individuals who are advising Keir Starmer and Wes Streeting about their plans for the NHS. We will continue to hold politicians to account and advocate for the welfare of all patients and staff.
