July 18th, 2010
|07:08 am - The triumph of the libertarians|
I feel so sad at the moment about everything I see in the news. Cuts to the BBC license are surely Murdoch's first step to break up public broadcasting, because people favour it over his product. 'Shaking Up' the NHS is surely an attempt to begin the replacement of community with profit-led medicine. Radio 3 and the NHS are like a baseline to my life 'no matter how bad it gets I will still have this' which is now being threatened. For what?
And across the board I see over-hasty libertarian ideology being imposed on systems which have grown up organically over time, interwoven with our society: imperfect, complex, but surprisingly effective.
The NHS might well be, in terms of the results it delivers with the money it gets, the most efficient health service on earth. And yet the Tories are convinced that hasty and sweeping organisational reforms will make it even more so. Things that have happened lately have shown there are serious drawbacks to the commercial approach: the banks, the pension funds, BP.
The credit crisis-induced recession, a disaster brought on by monumental private sector inefficiency – if inefficiency is a sufficient word to cover that thoughtless spiral of hedonistic incompetence for which no proportionate retribution has been exacted.I think we need to move to a less risky, less profit-seeking, approach; obviously that's not going to happen. But surely, we shouldn't be piling the risks on when we don't need to. There is so much that can go badly wrong, again, in the private sector.
I'd even be opposed to an incautious precipitous plunge in the 'right' direction (the right direction as far as I am concerned), because of the organic interdependence of our systems mean it could so easily misfire. What I see behind the scenes at the moment is just reckless, thoughtless ideology without any reference to reality, and it's an extreme and mistaken ideology too in my opinion.
(quotes above from David Mitchell in the Observer. I wrote this, then went to read his article, and found he was making some of the same points)
You listen to Radio 3? For some reason I always had you down as a Radio 4 person....
From my perspective as somebody who has worked in the NHS for 15 years now I have to say they've been 'shaking it up' ever since I started. And whilst the NHS might be doing okay in terms of the money it gets, the overall quality of care that's being provided is rather underwhelming. If government funding is going down then many foundation trusts will try to cash in on the - very few and far between - areas where they can generate income to offset the services that are not cost effective but essential.
Unfortunately most people seem to want first class health care but they don't want to pay for it...
No, I find Radio 4 a bit too middle class.
I have a lot of time for the NHS. I have had several hospital stays over the years, and I found 2003 better the 80s and 90s, and 2005 better than 2003. This may be partly through better clinical practice - for example in later years I was given much freer control over my own pain relief, and I think this is a change in policy. The general cleanliness of the hospitals improved too, and the openness of the surgeons and others to discuss and listen to my views.
Now there's a conservative attitude. Seriously, you're right.
Yes, I have a literally conservative attitude, because I want to conserve what I think is good, like the BBC and the welfare state. The conservatives, meanwhile, say they have to destroy. I don't understand it.
Well, just in general, any change, even a good one, will cause some disruption and stress. So any proposed change needs to show that it will bring more improvement than what it 'costs'.
And as you say, it is those who call themselves 'conservatives', who are wanting the most change/destruction in many things that have evolved to work.