The history of the NHS and the wider welfare state is a record of failed attempts to curb the costs of the over-optimistic promises made by politicians.
Throughout is history (arguably from 1911 or more normally since the 1942 Beveridge Report) no-one has been able to control the costs of a service where the demand is infinite and the benefits are not linked to contributions.
We have been conditioned by the idea of a free and universal health system but in reality this never existed. Right from the outside, governments were warned about having an open-ended burden of the NHS and not surprisingly the first three years of the NHS were not the success people like Bevan had suggested. From the start there were problems with cost over-runs, lengthening waiting list (the socialist alternative to charging for the service!) and the realisation that this was a system that didn’t work/couldn’t be funded. So WITHIN three years, charges were re-introduced leading to Bevan’s resignation.
Who should pay for health care then became a political hot potato with costs being scrapped/introduced/scraped etc over the next 20-30 years….so the debate is hardly a new one.
Turning to today, there was a study by the LSE’s CEP that concluded that, “in an organisation the size of the NHS hundreds of lives appear to be being lost because of poor management.” The authors concluded that, “NHS managers seem to be incompetent compared with managers in the private sector.”
Tim Harford (of The Undercover Economist fame) concludes that, “A better diagnosis is not that the NHS is missing some elusive quality of private sector-iness, but that it is missing any sort of competitive pressure, the sort of competitive pressure that most businesses (outside banking) have to cope with every day…Competition raises standards – something that should be music to the new government’s ears.”
I have some sympathy with the CEP conclusion. The sad fact is whatever system you chose, if you put monkeys in charge, you will end up with a mess.
