Privatisation can teach us a lot about preparedness

In 1989, England’s government-run water utility was split into regional companies and privatised.

The timing was unfortunate. A year later, England was gripped by a two-year drought, the worst in 100 years. The new water companies were reduced to rationing water, banning all but essential uses, putting standpipes in the streets and running water tankers to the most affected towns and villages. Complaints abounded, and naturally, privatisation was blamed.

Shortly after, I met the Chief Executive of one of the new companies. As is the way of these things, running a water utility is a specialist job, and like many of his colleagues, he had worked in the old government-run service. I asked him about the crisis.

He looked rather wistful. “When we were in state ownership,” he said, “we were geared up to survive a one-in-five-year drought without imposing emergency measures. Now we are in private ownership, we realise that surviving a one-in-a-hundred-year drought isn’t good enough.”

Today, Covid-19 is the biggest killer since Spanish Flu in 1918. Like droughts, pandemics happen periodically, and we need to be prepared for when they do. Were our health and social care managers—public employees just as the old water board managers were—prepared for this one? Plainly not. After this is all over, the management—and the manageability—of our healthcare system needs urgent reform.