I've just stumbled across this fine manifesto at Nurses for Reform:
NFR believes it is no longer acceptable for nurses to sign up to careers in public sector healthcare only to find they are unable to access the resources and autonomy they need to do their work. It rejects bland egalitarianism in favour of competition. And it believes in people - not politics.
NFR believes that the government should re-cast the NHS as simply a funder of last resort alongside an insurance and self-funder based market. It believes that the state should set free – through a range of full blown for and not-for-profit privatisations – all NHS hospitals. Moreover, NFR believes that all hospitals in Europe should be allowed to openly compete with each other. If a hospital fails in this market it should either close or be taken over by a more successful organisation.
Significantly, NFR believes that all hospitals - as independent entities - should be allowed to pick and choose from a dynamic and fluid labour market. The totally counter-productive idea of national pay agreements should be abandoned forthwith...
Today, too many nursing trade unions and representative bodies fail nurses because they invariably stick to old and out dated agendas. Instead of championing substantive reform - and in doing so, championing the rights of consumers - they default to short term platitudes such as demanding more tax payers’ money or new forms of legislative favour. Such an approach is not only disastrous for nurses but it is catastrophic for patients...
I particularly like the closing sideswipe:
For NFR America does not represent a free market healthcare system. It has a highly planned, regulated and government funded system which takes - through state programmes such as Medicaid and Medicare – a historically greater proportion of GDP than our own NHS.
This is much the same as Health Minister Dick's manifesto, and the bit I've boldened is much the same as what I have always said, e.g. yesterday at LFAT:
The NHS is two completely separate issues, which the Lefties in particular like to conflate and the Tories are too thick to counter it.
Issue 1 is how healthcare should be funded. I’ve nothing against ‘the taxpayer’ funding a large part of it, e.g. via vouchers (quite how large that part should be is open to debate); with voluntary private payments out of your own pocket or out of private insurance.
Issue 2 is who should provide healthcare. As we know, The State is pretty **** at providing anything apart from ‘core functions’ (which are always worth doing, however badly). Ergo healthcare should be provided by competing providers.
A bit like in most European countries. Or possibly New Zealand.
Where the Lefties have hijacked the debate to say that healthcare has to be provided by The State because IF NOT then poor people won’t be able to afford it – that’s actually only addressing the funding side (and I tend to agree with them on this) AND NOT the provision side (and I hotly disagree with them that The State should be the main or sole provider).
About That Closet
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oo many nursing trade unions and representative bodies fail nurses because they invariably stick to old and out dated agendas. Instead of championing substantive reform - and in doing so, championing the rights of consumers - they default to short term platitudes such as demanding more tax payers’ money or new forms of legislative favour. Such an approach is not only disastrous for nurses but it is catastrophic for patients...
... but good for trade unions.
Once you get competition, the unions have nowhere to go. In a modern age of mobility, if you don't like your job, you can leave and go elsewhere.
Add to this that any overunionised business gets beaten by non-unionised opponents, and you can see why the unions like to spread so much fear about privatisation.
It seems quite likely to me that a voucher-funded (and presumably mostly insurance based) healthcare system will end up being more inefficient than the NHS. There's a great deal of bureaucracy there and layers of management.
Matthew, that's what the rest of Europe do and it works fine.
The layers of management are kept at bay because providers are competing - either to provide the best care or make the most money (or both). For roughly the same level of spending they have vastly better service and outcomes.
Ta for the link.
I sometimes wonder if Labour are being deliberate in their misdirection regarding the NHS and the 'free at the point of delivery' claim, or they actually believe it.
There are other ways of providing care free to the end user than the state being the sole provider.
What appears to be holding us back from a better system is a deeply-ingrained mistrust of the private sector, generally installed in the less well-off by socialist hysteria.
IE a myth.
Which European countries have a voucher system?
DP, I think most politicos and commentators are so stupid that they believe that the only way to have provision that is "free at point of use" is to have state provision*. Which leads on nicely to my answer to Matthew's comment ...
Matthew, all of them, as far as I am aware (I've only ever lived in Germany, but other people say that other European countries are much the same).
It's not literally a voucher with a cash amount written on it, but basic care is free (or subsidised) at point of use (and the hospital settles up with the statutory insurance company) and if you want extras you pay for them via additional private insurance or out of your own pocket.
*What about the AA or RAC? That's "free at point of use" as well, isn't it?
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