It's strange to see Liberals forget how to be liberal

Perhaps it’s that qualifier, Democrat, that causes the problem:

The Liberal Democrats would force GPs to see every patient within a week, as they say NHS waiting times are a major factor putting voters off the Tories in their target seats.

….

Sir Ed said that his seven day policy would be enshrined into law and added to the NHS constitution to make sure it happens.

The basic authoritarian mindset is that if all the really clever people in government tell everyone else what to do then we’ll gain the best of all possible worlds. The Fat Controllers pass laws, make punishments, shout, pull the policy levers and the wishes of Sir Topham Hatt become reality.

The liberal looks at this same world and these same policy goals and realises that people do not work that way. The way to get people to work like Stakhanov is not to shoot those who don’t but to give a medal - and the bigger assigned flat, reduce the waiting period for a car to only 5 instead of 10 years, etc - to those who do. Even the Soviets worked that out, eventually.

That is, the most basic lesson in all of economics, incentives matter, is true. So, create and mould the incentives to get people to undertake the desired action.

The seven day law, the constitution, this must be backed up by punishment when the appointment doesn’t happen. Who is going to get punished and how? Anyone really see jailing doctors as a cure for anything?

The liberal instead looks at this same situation and notes that doctors currently get paid by the number of patients that they don’t see. GPs are, largely enough, paid the capitation fee, an amount per person who is registered with them for the appointments which do not, in fact, happen. The incentive therefore is to have a large list and few appointments. Lots of patients who produce revenue by not having appointments is the income maximisation strategy here.

To gain the Hatt goal, of GPs actually seeing patients, the solution is to change those incentives. Pay GPs for having appointments, not a list of those they don’t allow to have appointments. Then watch behaviour follow the money as GPs and their systems swivel to maximise incomes under the new set of incentives.

The authoritarian and the liberal both have those visions of the good society, as here the desired outcome might even be shared. The difference is in the method used to gain it - the authoritarian would force, the liberal tempt. The advantage of that second method is that it works - as every priest since at least Aaron has bitterly complained, temptation works really well with human beings.