Privatisation. It’s a word which strikes fear into the hearts of progressives everywhere. Perhaps understandably so; previous governments have made a complete mess of privatising our NHS. From signing contracts for building hospitals without reading the small print to providing poor healthcare, privatisation has often been a failure.
That doesn’t mean it can’t be done though and it certainly doesn’t mean it isn’t needed. The uncomfortable truth is that our beloved NHS is unsustainable. Expenditure on healthcare has rocketed from £75 billion in 2000 to almost £130 billion in 2013. As healthcare improves, the number of elderly patients served by the health service increases. It is a vicious cycle.
So what is the liberal solution? Let’s look at the solutions politicians are currently trying. Increasing taxation regularly to fund the NHS is fundamentally illiberal and unsustainable – it puts an unnecessary and unfair burden on workers. The only other option is borrowing the funds. That is clearly also unsustainable as it is merely kicking the problem into the long grass.
As far as I can tell there’s only one solution and it’s pretty radical. More private companies need to bid for public contracts if the NHS is to stay afloat. This cannot be done in the same laissez-faire way it has been under previous governments. It needs a strong healthcare regulator which is there to impose heavy fines on hospitals which fail to provide excellent service. This healthcare regulator should meticulously assess applications for contracts and ensure companies have robust plans to provide fantastic patient care.
There is an argument that paying profit-making companies is more expensive than having state-run healthcare. Of course, we are paying private companies to make profit. However, basic economics means that private companies have to be efficient in order to win contracts. While government bodies tend to overspend, private companies cannot afford to do so. If properly regulated, private companies will spend your hard-earned money more efficiently than a government body ever would.
Let’s take a look at our friends across the channel. According to the WHO France has the best healthcare system in the world. France’s healthcare system is a public-private cooperative in which 35% of hospital beds are provided by private companies and the rest come from the public sector. The French pay compulsory health insurance, which is effectively a tax as it is a set proportion of income. Patients then pay around 30% of the cost of healthcare check-ups or consultations. Personally I believe that healthcare should be free at the point of use so I’d rather the state paid the costs. The point is that the current system cannot provide sustainable healthcare in the modern world. We have to explore other options.
Privatisation is needed. Fast.
* Thomas Shakespeare is a Lib Dem activist and a member of Liberal Youth