We need a more mutual society, not a big one
In July 2010, The Slog took Andrew Lansley’s NHS proposals apart, adding that they only made sense as a form of creeping privatisation. Today, David Cameron writes in the Daily Telegraph, pretty much confirming that this is what’s going on.
The key phrase in Cameron’s piece is ‘….introduce competition in some public services – as we are now doing with schools and in the NHS – the state will have to justify why it should ever operate a monopoly…’
So choice and diversity (the old bollocks still appearing in every other paragraph) and competition are now morphing into breaking the monopoly.
This is how and why giving GPs a ridiculous 85% of the NHS budget will work: because the hospitals will be sold off to the private sector. ‘Patients will have the choice of which hospital they get treated in’ the Prime Minister writes. In our health authority, they do already; but setting that aside, beyond a preference for Exeter over Glasgow if you live in Dorchester, the ‘choice’ is meaningless.
When private business enters former State sectors, choice is always heralded, but rarely delivered. The rail services offer a choice of ripoff inefficiency, there’s a choice of five banks by whom you can get screwed, and although you can buy gas and electricity from whomever you wish, both users and shareholders have lost out relatively compared to the fat cats at the top. Privatising a life-supplying substance like water was and remains utterly mad: they’ve all shirked the infrastructural repair tasks, all put our bills up, and all taken home obscene bonuses.
Selling council houses to working class people created a generation locked in negative equity, and about to plunge into that region again. Selling hospitals to private operators (no doubt for a song) will indeed cut bureaucratic costs and devolve decision-making more sensitively. But there will be no central strategy, no centres of excellence, and absolutely no guarantee that patients will have more choice than they have now.
Does this make me Old Labour to the core? Emphatically not. The NHS is funded, organised and staffed according to the crazy ideas and self-seeking needs of civil servants: it should’ve been broken up years ago, rather than indulging in lachrymose drivel about ‘our NHS in the best of health’. It is a money-pit as currently configured.
My problem with the Lansley-Cameron plan is that as well as being devious, it is back yet again to the old Tory mantra: a free market profit motive generating cloices for the customer. This simply hasn’t materialised, but massively increased costs to the customer have. So it will be if these plans go through.
When I talk about a mixed economy, I mean an economy of mixed motives. In a great many areas, the profit motive alone is a recipe for disaster. It always was – but in the context of our contemporary culture of greed, cheating and feckless customer service, it is guaranteed to produce a double-disaster.
I too would take ownership of ALL services away from the State – and give it to mutual societies: genuine public ownership bringing dividends to the members, but without the mandarins who lack any commercial perspective. It worked with building societies until they all went mad (the Nationwide, which didn’t, has not cost the taxpayer a penny), it works with JLP, it works for the Coop Bank and supermarkets.
There is an alternative, if only people would think and analyse for a minute or two. But that’s never going to come from either Conservative or Labour Ministers, because they remain wedded to their arcane and antiquated ideas about how the world goes round. And as we’ve seen with the LibDems, they’ll do whatever keeps them in power.
We need a smaller State in order to live within our means – means so wilfully squandered by the current political Establishment and its investment banker allies. We need a smaller State to break dependency, and return personal responsibility to the People. But we urgently need a bigger economy in order to help repay our debts.
Handing everything over to a straightforward profit-and-shareholders model of capitalism is nothing short of a dereliction of duty to the community at large. Using mutual models for key services and small businesses will deliver both service and growth far more quickly than over-lent banks and neurotic bourses.
The bottom line in these reforms, as always, is that absolutely everything has been taken into account – except what the ordinary users and taxpayers want. Over and over Lansley boasts of how many GPs he has spoken to: but his ideas display the BMA agenda virtually intact, rather than the needs of a changing population.
And this disconnect between the elite and the rest of us – be those elites spongers, bankers, boozers, politicians, media types or Islamists – is why radicalism is the only course for those of us aiming for fundamental rather than superficial change.
The fundementals remain:
Change the Party system, vote for AV (it’s better than nothing), seek out new ideas, control the privileged minorities, break up the banks, diversify away from bourse-driven globalism, devolve more power to communities, give responsibility back to individuals, give education higher standards and cultural goals, fire half the Civil Service, reintroduce a thriving Mutual sector….and hand the benefits back to the Citizens.
And one concluding note: ‘everything designed to be more efficient’ in Cameron’s Big Society does not include either the Judiciary or the Security Services. No – the right to keep watch over us and bang us up for 40 days without trial is to remain firmly within the State’s sweaty grasp.