I have been pondering much about the state of the NHS and how this government has (without mandate) gone about the systematic dissembling of this great public service into a set of increasingly privatised units. This is well outlined in Dr Éoin Clarke's excellent blog on the 100 Ways David Cameron betrayed the NHS. I have been doing my bit to uncover systemic conflicts of interest in my local Clinical Commissioning Group.
So where do we go from here? How will a future Labour government help return the NHS to its core values without yet another wrenching and radical reformation of the unhealthy mess that will be left behind by the coalition government. One of the biggest difficulties, it seems to me, is that the web of outsourced NHS services (which I might add began under the last Labour government but which has grown exponentially since) will be very difficult to unpick. That is what makes privatisation such a canny and strategic political move: commercial contracts are hard to 'un-ratchet' as it were by dint of their shear number, complexity and legality.
There are economic minds greater than mine whom I am sure are working on this (and we saw some evidence of this with this story yesterday: Labour wants NHS patients to treat themselves - although that is a somewhat cynical headline for what ought to be a good news story about empowerment & independence, in my book). But the challenge remains: how to un-ratchet privatisation in a way that will not lead to dangerous (literally, politically and otherwise) or hugely costly consequences...?
So here's an idea:
Why not give all citizens the right to be treated/served/policed/helped (etc) by a public official (rather than an outsourced one). "Citizen choice" will be the watch words. If people choose to support a privatised corporation where a good slice of their taxes will be helping to buy a new sail for the hedge fund owner's yacht, then so be it. But equally if people want to be served by hard working employees of a state owned, funded, transparent and publicly accountable organisation, then we should also have that right too. Oh, and by the way, the privatised corporations will have to pay for the administration needed to make this scheme work.
So this principle can apply to you whether you are a patient, victim of crime, an offender, social care user and so forth. As Paddy McGuinness would say: the power is in your hands.
Could this work? What do you think?
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