Adam Smith Institute

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A pointless 'privatization'

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a-pointless-privatization

According to Nick Timmins in the FT:

The private sector is to be invited for the first time to take over and run a big NHS hospital under plans backed by the Department of Health and the Treasury yesterday.

Needless to say, I'm generally a big fan of privatization, and an advocate of greater private sector involvement in the NHS. And yet the government's proposals do not exactly fill me with joy.

The trouble is in the way the scheme is set to operate. The government will offer a seven-year franchise on the hospital and invite private operators and NHS foundation trusts to take on its running and financial liabilities. But they will not transfer the assets of the hospital, and all staff will remain employees of the NHS.

Within that framework, you have to wonder what good the scheme will do. Sure, an organisation with private-sector expertise might be able to manage the hospital a bit more efficiently, but will they really be able to make much difference if the hospital has to be run more-or-less as it is now, with the same staff, and the same salaries and benefits (which will continue to be negotiated collectively with the Department of Health, rather than individually with the hospital's management)? No.

In the long run, I worry that politicians' obsession with 'private sector management expertise' (valuable though it is) does the cause of liberalization a lot of damage. They need to realize that the point of privatizing things is not just to introduce a new management with a better-developed profit motive. The goal should be to increase autonomy, choice and competition, and to focus services around consumer interests, rather than producer ones.

As things stand, the government's franchise proposal does not achieve any of those things.