After reading the government thread, I thought this would be worth a thread too. Does anyone here think that schools and hospitals would work better if privatised but still funded by taxpayers?
e.g: each hospital works individually with the money the government provides it. Of course there can be transfers of patients and doctors/nurses between hospitals, possibly with some sort of regional management organising it.
Neither simply because I believe that the existing PFI arrangements have lowered levels of service and not saved anyone any money (in fact I think the whole thing is a case of back handers, future board positions being secured, etc)... Not that I'm a cynic or anything.
What if it was done properly, not like PFI. If they actually got some proper consultants from McKinsey etc to help with it. Of course, a good idea implemented badly, is still going to be bad!Originally Posted by malfunction
I think they could work better, but that's a far cry from saying they would. And it would entirely depend on how you define "better". More efficiently? More profitably? Better patient/educational results? A mix?
In general, private sector managers are far better at running things, because they have to be. If they aren't, they either go out of business or get fired. But if you hand schools and hospitals, etc, to the private sector to run fully as the private sector does things, you're effectively saying that profit and/or company growth are the prime objectives, and is that socially desirable for schools and hospitals? I'd say not.
Done properly? Like the privatisation of British Rail for example?
I just can't imagine it working out well to be honest - I'm sure it's technically possible - and I'm pretty sure there are good private schools out there and maybe even a few good private hospitals but I wouldn't imagine that, for example, the government would hand the running of the NHS hospitals to Bupa (not that I'm singing Bupa's praises in particular) but would probably hand it to some newly created off-shoot company that somehow happened to be run 50/50 by ex-cabinet ministers and 'experts' from various business consultancy companies... "Carpet baggers R Us"
The trouble with PFIs is that any private company wants to make a profit at the end of the day, which will be from the tax payer’s money. But if private companies can manage hospitals properly then it’s not a bad idea, however the question that comes to my mind is that if a private company can do it why can’t the government do it properly? After all the government has to just break even and not make a profit.
I can’t comment on schools but with hospitals the biggest problem I would say is mismanagement, a lot of waste of money occurs for example over paying suppliers, way too many middle managers, and adding to that the NHS is now being sued on a regular basis. If the government tried to solve these problems rather then set those stupid targets then it may be better then handing over hospitals to the private sector.
Consultants are not a bad idea as long as they give some good advice and are not overly expensive. My local hospital hired a firm of consultants to help out and they charged something like £100+ per hour and were bloody useless.
Of course we want better healthcare and education. That is the true goal. But the other goal would be to prevent money being "wasted" as it is now. Performance related pay for those the hospitals that have spare budget left over and have increased the quality of healthcare?
There is no "profit" involved as there is no revenue external to government funding.
No private company is going to enter into an agreement whereby it can't make any profit. Optimistically this profit would be gained through greater efficiency, pessimistically profit would be gained by cutting corners. Also I would imagine that the private sector would try and agree favourable 'unit prices' for each job done - and if you look at what's happened to GP's wages there's obviously room for the government to cock up in this area.
Well the hospitals don't make profit... the govt pays the management, that is where they make their money
Thats just my idea, its not really private as such...
Any other ideas?
Hmm, tricky question... for schools, I'm inclined to say no - this is the place we put children for half the day for an awful lot of the first 16-18 years of their life. Ostensibly, the purpose of a school is to have students leave with some decent qualifications, but a school does a lot more than that.
For hospitals... some sort of privatisation might be good for cutting costs. But it would have to be done very carefully - I wouldn't trust the current government to do a decent job of privatising the NHS.
Frankly, there are numerous ways in which the quality of education and healthcare could be improved without resorting to 1) privatisation, or 2) throwing vast wads of cash at the problem.
"Well, there was your Uncle Tiberius who died wrapped in cabbage leaves but we assumed that was a freak accident."
Sounds to me like it won't truly be private then
well i did say its not really fully private...Sounds to me like it won't truly be private then
Privately run, publicly financed. Get someone external to the govt to do all the appointments.
I agree with your reasoning here... but surely as long as objectives are set out clearly it should not be a problem...
Consultants might do a good job?
Education/NHS is too large to organise efficiently. Hence, my suggestion of breaking down management into smaller groups. Though I am not sure how it is done at the moment...
I say both simply because governments could hardly run a whelk stall. Skools an' 'ospitals are mere political footballs to be kicked around at leisure by whomever is in power. They are simply used as crude tools to bash the opposition.
The NHS needs serious reform, that's why all the extra billions poured in haven't generated any improvement but simply lead to greater waste and inefficiency, MRSA and dirty wards. It's far too unwieldy to get value for money with 1 million people involved.
Schools now are no more than producers of statistics which enable the government of the day to champion how good they are, espousing the virtues of greater GCSE passes whilst children leave school unable to read, write or add up.
By privatising both you would get rid of the dross. People always claim that by privatising you would end up with cut backs for profit but that is not true. What private companies do is to be efficient otherwise they fail. A simple idea is the "school voucher". Parents would get a ticket worth X amount which they would put towards the cost of their child's education. A school would have to provide a,b,c etc as per the regulations and would have a contract between the parent, the pupil and the school. If they want to top that up then fine. You'd quickly find that teaching standards would increase, behaviour would improve and the ghastly NUT would dissolve.
Governments are poor at running services but generally do a good job of regulating them. The trick is to ensure that the poorest in society have access to education and medical care.
Let me ask you two questions.
Would you prefer to be treated in a private hospital or the NHS?
Would you prefer your children to be educated in a private or state school?
"Reality is what it is, not what you want it to be." Frank Zappa. ----------- "The invisible and the non-existent look very much alike." Huang Po.----------- "A drowsy line of wasted time bathes my open mind", - Ride.
I think that what CAN actually work is properly run partnerships; yes there are a lot of PFIs that have been poorly run, but that's a question of implementation, not principle. Done properly, a PFI scheme or other form of public/private partnership can free up specialists like teachers and doctors to do what they do best while the private sector partner(s) do what they should be good at, building and maintaining the building and providing other facilities management services. That said, I work for a company that has done a number of PFI schemes which have gone well and are popular with the staff and end users and are also involved in three of the LIFT Schemes, which so far seem to be progressing well. I DON'T believe that the provision of the teaching or health services should be privatised; on the education side there's simply too much scope for abuse by vested interests (I'm thinking of the extent to which, for instance, the new City Academies are being allowed to diverge from the national curriculum), and on the health side, privatisation'd lead almost inevitably to a US-style system. I don't want to see a situation where a fifth of our population are excluded from healthcare, and where a significant proportion of the remainder are crippled by spiralling insurance costs.
In answer to iranu's questions, I, my wife and our daughter have been treated well and effectively by NHS hospitals, so I'd say NHS. As far as the school's concerned, I recognize the problems that iranu describes, but I'd rather that the state sector was fixed rather than trashed. Over-regulation and target-obsession are things that can be fixed WITHOUT privatisation; it simply requires that the government of whatever party chooses to do it. I'd rather my child could go to a state school, but one that was run effectively.
Last edited by nichomach; 29-03-2008 at 12:40 PM.
Getting a PFI contract is just seen as a license to print money, most of them seam to be aquired in ways which don't strike me as above board (this could be my lack of understadning), as i've only ever come accross them from the credit end (ie financing the people who are financing the government).
I'm hudgely in love with the idea of a free market, yet i don't see how it could easily be applied to health. Here's why:
I know i often joke that youkles should be punished for living in wales, but if you've got no other hospital for twelvety miles, then you've got no choice, as such the hospital in free market ideas would just become a cash generator for its owners, its too expensive and difficult to get government backing to set up a competitor as such why is it in their intrest to provide good health care, it wouldn't be, regardless of targets etc. (asside: if anyone belives new labour's health targets have done ANY good in the NHS, i'll send them to a certain hospital which i was less than impressed with (so far the private health bill putting right the damages is actually quite low at 2k, if it wern't against my morals to sue the nhs....) but mabye i'm emotional about that point).
I'm apparently above average intelegence, i've got paper that says so, so it must be true. After hours spent reading stuff on the net, and emotional blackmale getting a med student friend to explain to me non hodgkins lymphoma, i still can't begin to understand it properly. How could i make an informed choice about where to get treated? Let alone my dad (who's the sufferer). Its a bit of a leamon market (The Market for Lemons - Wikipedia, the free encyclopedia) as such the hospitals will be able to make money by exploiting your ignorance.
then my last point, you get what i call insurance syndrome. Been a skilled employee in a shortage area, i get a rather impressive health plan, the 'problem' is that its in the health companies intrest to find things wrong with me. At first that sounds excellent, a thing that can only be good, the 1 hour physical before i can get gym machines 'unlocked' for my key seams draconian, but a good idea in principle. The problem becomes that the health company wants me to have treatments, the more expensive the better, because the insurance will pay, if you have a practically bottomless pitt of cash, its not hard for health companies to try to justify all sorts of needless ideas. This is a very common problem, just look at vitimin supliments, damn expensive, try and find a nutritionalist who's not in the pocket of such a company say that their needed if your having anything approching a healthy diet.
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