The Pin Factory Blog

If you want an example of how anti-development councillors are harming the public, look no further than Basingstoke. There, contrary to the wishes of the Coalition government, the council seems determined to prevent any significant house building at all.

For those utterly hostile to new housing that might sound OK, until you realise the massive waste of local taxpayers’ money this has involved.

Back in 1995, the council bought a 2000-acre plot of land at Manydown for the purpose of building new houses for £10 million. It paid a premium for the land because it was land destined for development – previously farmland with little in the way of natural interest.

Now the council has decided that it won’t allow any development on Manydown at all, and is proposing – ludicrously – to force any new housing into the Loddon Valley. This is a place designated as a “Site of Importance for Nature Conservation” and which is protected by the Convention on Biological Diversity. The council’s position is ridiculous, like proposing that coal-fire power stations be built in the Lake District or that we demolish Stonehenge.

So why is it taking this position? Well, two of the councillors living near Manydown are being the most vocal in their campaign against development. Perhaps they are worried that they will lose their seats. If so, it’s a pity, because development done right can actually improve local areas, bringing prettier neighbourhoods and better amenities.

For the most part, radical reform of government services cannot occur. Large organisations are inflexible and, in the face of changing circumstances, those that can no longer well function die, and are replaced by the growth of new organisations or existing small organisations into large organisations which, although equally inflexible, are suited to the current environment. As such, reform of the NHS is impossible. The NHS cannot be fixed.

I think it is in fact not merely a matter of reform being impossible. It is also, I suspect, a matter of the British public paying very large amounts of tax and seeing, on the whole, very little for it. The NHS is a very visible service where those who pay feel they are in fact receiving something for all that they pay, and so there is massive resistance to anything which would on the face of it reduce the service provided. The NHS's visibility makes it seem like better value for money than it really is.

I propose, then, a mechanism for making the NHS irrelevant, an approach which requires no reform of the NHS proper and which will not fail in the face of the public's desire to see something for its tax money.

There are now those who pay twice for health care: those who contract to private health care providers, but still are forced to pay for the NHS through their taxes. Clearly, these individuals have removed the burden and costs of their health care from the NHS. Why, then, is it that some individuals pay twice, while others (users of the NHS) only "pay" once? This is clearly unfair, and should be resolved.

I propose a simple reform that leaves the NHS untouched: people who contract to a private health care provider should receive a full tax rebate of the money taken from them for their public health care provision.

As individuals depart from the NHS, the part of tax which which forms healthcare will decline. Accordingly, the rebate will decline. Eventually, with a competitive market of health care providers where the NHS is but a player, the anomaly of its funding being intermediated by the state could be removed and those contracted to the NHS could then, as they would with other providers, simply pay directly.

For this to work, no reform of the NHS is required. The NHS simply becomes a player in the private health market, subject to success or failure by its own merits. Individuals may chose to use the NHS, should they wish; equally, they may wish to use another health provider. Contracts are no longer being imposed by the state. Freedom would be introduced to the healthcare market.