To entirely miss the point of NHS privatisation

Well done to The Guardian here for really missing the point of NHS privatisation. Their numerical complaint seems odd to begin with:

In some sectors the proportion of private spending is many times the overall average of 7.3%, with 44% of all spending on child and adolescent mental health going to private providers, and 30% of mental health budgets overall.

And as far as we know about these things 100% of GP services are contracted out and always have been. Shrug. As ever, the question is what is best done inside a command and control organisation, what best contracted out to the market on cost, efficiency, specialisation grounds? You know, the Coasean question about why we even have production organisations at all?

But it’s this that irks:

Evidence that private providers are failing in their duty of care to vulnerable young people is mounting. In April, Priory Healthcare was fined £300,000after pleading guilty to criminal charges related to the death of Amy El-Keria. Another of the company’s hospitals is set to close after being rated inadequate. While poor practice is not limited to private providers, on accountability and transparency measures they fall far short.

No, that’s the wrong way around. On accountability and transparency the market wins, hands down.

How many NHS wards or hospitals have been closed down because they turn out to be terrible? Or inadequate, or a bit not very good? The answer, as we all know, is none. How many private sector things get killed off for being a bit not very good?

Well, that’s the point, isn’t it? One thing the market is inordinately good at doing is pushing out, bankrupting, closing, those things which, by any absolute standard are pretty much fine but which also happen to be just worse than others. Nothing particularly wrong in that absolute sense with House of Fraser, varied spinning mills, that NHS sandwich maker. They were just not quite as good as others at doing those things so bye bye and off they went.

Yes, we talk about how markets increase productivity, quality, lower price and so on. But they do these things through competition. That is, by killing the businesses which aren’t as good as the others. Which is a great deal more accountability and transparency than we get from a tax funded monolith like the NHS, isn’t it? Stafford Hospital is still in business even if it’s called County Hospital now. The Priory’s place, on the other hand, is out of business entirely for being a bit not very good. That’s pretty accountable there.