Andrew Bartlett writes:

Please explain the logic by which you argue privatization would improve the health service in Britain... Surely you can't be arguing for that competition will improve the services in areas where there can be no choice, merely the replacement of a single NHS hospital by a profit making hospital? Explain please.

I understand entirely why you might not like the idea a for-profit company acting as a local monopoly. But having a health service where the provision is not done directly by government does not necessarily mean that you have to make hospitals for-profit institutions. It may not be obvious but, for example, BUPA is actually a charity - the British United Provident Association.

Certainly in a number of very important areas, distance to the hospital is important. But for many treatments, the distance is less so. If a local hospital is failing to do the operations quickly, or to a sufficient standard, or has a large number of cases of MRSA infections, the ability of patients to choose to go elsewhere will act as an invisible hand to get the local hospital to pull its socks up. For money to follow the patient is essential.