Many of the misleading and paternalistic arguments against reform of the NHS are the same arguments which were used to oppose the privatisation of the utilities in the 1980s. Some opponents argue it will reduce standards, others dislike the idea of any profit being made and still others are enthralled by the idea of a benevolent state monopoly looking after us. Amidst the chaos of such confused logic and regressive thinking, the interests of patients and taxpayers have been sidelined.
Yet what is actually being proposed, allowing businesses and charities to compete with NHS hospitals, is far less radical than the privatisations of the 1980s. But it is a step in the right direction. People who believe in the intrinsic value of liberty should always support more competition as it means greater freedom of choice over consumption options. It is unfair to deny patients the right to choose another healthcare provider if they feel it will give them a better service. It becomes tragic, when we see the appalling conditions experienced by many elderly patients as shown by the Care Quality Commission’s recent report.
The increase in specialisation within the NHS itself that further competition would promote would drive up standards. Private firms or charities delivering especially good care in a particular service such as hip-replacements will drive NHS hospitals to shed their uncompetitive services and focus their resources on areas where they believe they have a competitive advantage. This should reduce wasted costs and increase the quality of choice for consumers.
If we are happy for our very important water, gas and electricity supplies to be no longer in the hands of a state monopoly, then there is no compelling reason why our healthcare should also be. If we have accepted that the profit motive is the basis for innovation, investment and progress in all other markets, then why shouldn’t we harness that in healthcare? Why should we not allow profit making and competition with state-run services if it drives the search for more creative and cost effective health services? Why should we be content with the status quo when Singapore’s system with substantial private sector involvement delivers superior outcomes for 3% of GDP compared to the UK’s 9%?
If we believe in liberty, if we want to see rising standards and if we want lower costs, then we should support more competition in healthcare.
Adam Memon won second place in the 2011 Young Writer on Liberty Awards.