June 04, 2008

This form of privatisation won't work

Labour is planning to privatise the NHS. Iain Dale thinks that this is great as from a partisan point of view it is Labour burning one of their trump cards. They will no longer be able to try and create scary stories about the tories seeking to privatise the NHS and replace it with an American system since they already did. I think that this is crap, because it will not work.

There is nothing special about private sector managers. Simply replacing one set of managers with a different set will not make a bit of difference. The problem is not the management, the problem is the system. The system will still be the top down centralised unresponsive monster of old. It will continue to fail for exactly the same reasons it always has no matter who is in charge. The private sector is better than the public not because it has some magic managers pixie dust sprinkled over it but because it is a competitive market and the inefficiency gets weeded out in a darwinian process as the firms that do not give their customers what they want loose their customers and eventually go bankrupt. That is what keeps the private sector sharp, being made up of firms that are generally much smaller and closer to their customers with the constant fear of where the next pound is coming from. The NHS has none of that and therefore will never offer the responsiveness of a private sector company, because it does not need to, no matter who is in charge.

If they where finally serious about actually reforming the NHS rather than fiddling with the edges and spraying more money on it then they would be looking at the bits that actually work, the GP practices for example, and seeing how they could make the rest of it more like them. Rather than looking at the GP practices and seeing how they can be made more like the rest of the failing edifice with their Polly Clinics scheme.


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