This article by Alex Nunns on the “patchwork privatisation” now underway across NHS provision provides a useful and comprehensive overview of what is going on in the service below the radar screen of daily politics.

Although written from a statist and socialist perspective this material nevertheless provides NFR and its pro-market supporters with great cheer. For as the NHS slowly nose dives into the sand it demonstrates that Labour politicians are now increasingly turning to market ideas for solutions. I believe Nunns is right when he says that the government wants to recast the NHS as a funder and a kite mark but no longer the owner of the facilities in which treatment and care is provided. But this is only a short term and limited victory for us. In the years and decades ahead it is vital that all healthcare funding is opened up to a highly diverse and competitive market and that state regulation is itself replaced by a system of bottom-up consumer driven reputation.

As such, the General Medical Council and the Nursing and Midwifery Council should loose their professional monopoly status. Monopolies are bad for consumers and are always propagated by elites seeking legislative favour and the short term politics of collective self interest. NFR believes they encourage elite professional conservatism and should be swept away.

Today, it is time for more enlightened nurses and doctors to point out that everyone would benefit from a world in which the seeking of legislative favour is treated with the cultural contempt it deserves. In reality legislation does nothing to protect patients and to further the de facto delivery of high quality services. As with any other business what matters are the incentives, resources and the focus on consumers. In the real world these are built bottom up – not top down or at the behest of a vote seeking politician standing at the dispatch box of the House of Commons.

For NFR healthcare is too important to be left to a government monopolist. That said, if you do happen to be one of those strange people who believe that healthcare needs to be underpinned by certain degree of monopoly then I would counter with the suggestion that just as the market delivers better hi-fis so in time it will deliver better monopolies.

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