Now we've won, let's kill what works!


The victory of Jezzbollah and the Corbynistas appears to be turning politics in a French direction. That is, let's not worry about whether something works of not, let's check that it conforms with theory. And so it is with the various market reforms in the NHS. As Kristian Niemietz points out:

So when Corbyn used his acceptance speech to congratulate the Welsh government for ending the “internal market” in the Welsh NHS, declaring that this is “something we want to do in the rest of Britain”, he was not setting out a new policy stance – he was merely expressing a fait accompli. It was not Corbyn who exorcised the ghost of NHS reforms past. His party did that before he was even nominated. Which is strange, because these reforms were a qualified success story.

Quite so, one of the things in recent years was that NHS England had rather more of that market reform than NHS Scotland or NHS Wales did. Entirely unsurprising to people like us NHS England also did rather better over those years than NHS Wales or NHS Scotland. But for Jezzbollah and fellow travellers markets are inefficient: so they must go, whether they worked or not:

The Scottish and the Welsh NHS are the closest thing to a counterfactual, because they are still more or less run like the old (and, if the Corbynistas get their way, the future) English NHS. Even though they are, in per capita terms, better funded and generally better staffed than their English counterpart, their performance lags on most measures. Rates of mortality amenable to healthcare are higher than in England, waiting times are longer, and hospital infections are more prevalent.

Niemietz has a fuller paper exploring the subject at that link.

It's entirely possible for people to paint our own love of markets as being simply ideological. Enough people do that enough of the time that of course it's possible. But our commitment to them is actually practical. We're entirely happy to admit that there are times when competitive markets are not the solution. We do know our history and that time of competing private armies was called the Wars of the Roses and it's not generally held to be a happy time. But we do support markets when they work.

As they do in the provision of health care to the populace. Those parts of the NHS system that have been flirting with markets provide more and better health care than those that don't. We really do not see this as evidence that markets should be removed from the provision of health care. However French and conformant to theory our politics becomes.