The micro-politics of hospital privatisation


Mindful of a likely change of government in 2010, Nurses for Reform believes that the NHS should be renamed the National Health SYSTEM and that it should work through the universal supply of independent hospital care and treatment. Simply put, there should be no hospitals in this country owned by the state or managed by its agents.

Cheaper and Better
There was once a time before the industrial revolution when food production was onerous and costly. Many could not afford a nourishing, diverse or pleasurable diet and all too often people went hungry.

There was a time before the invention of the steam, internal combustion and jet engines when options for travel were limited and any significant distance remained the preserve of the rich.

There was also a time, not so long ago, when telephones were rationed and lengthy calls were beyond the means of most people.

Yet today, thanks to open and innovative markets, people can afford diverse food, extensive travel and outstanding telecommunications. What was once beyond the dreams of avarice are now part of every day life and taken for granted.

Universal Independent Hospital Provision
That is why the next government must liberate health provision from the rationed and expensive world of top-down of un-innovative state control. All NHS hospitals must be returned to the independent sector, not least so that such provision reflects actual needs and not the political whims of vote-motivated politicians. At a practical level this means the following key points:

  • In the post-bureaucratic age the Secretary of State for Health must no longer have any say over when or where hospitals are built, opened or closed.
  • Following the planned changes in education, local planning laws must be reformed so as to enable a much greater diversity of - and investment in - independent provision.
  • The planned Independent NHS Board should oversee the return of all UK hospitals to diverse forms of independent ownership (for-profit and not-for-profit).
  • Health censorship must be outlawed and patients must be empowered with greater access to information. In this context hospitals, doctors and other health professionals including pharmaceutical suppliers should be free to advertise and build trusted brands. Only by allowing reputations to be built openly from the bottom-up will the government be able to realise a lighter touch in regulation.
  • To encourage openness, diversity and greater opportunity for staff, employers and patients, an incoming Conservative administration must also adopt the principle of subsidiarity when it comes to human resource management. Hospitals, care homes and all other health facilities should be able to set pay and conditions for staff as they think appropriate and take the lead in all medical and health training. National collective pay bargaining and professional monopolies should be abandoned in favour of a more post-bureaucratic approach.

By putting these key initiatives in place not only will there be a vast improvement in the provision of healthcare but, these changes will enable further micro-political changes to health funding. Overall, these reforms are necessary so that healthcare is pushed through the beneficial reforms that we now enjoy in so many other areas of our daily lives.

Dr Helen Evans is a fellow of the Adam Smith Institute, and the director of Nurses for Reform.