Arthurian Legend

"Once back here I got to thinking - 'how do I get out of this?' Perhaps the really haunting spectre is that I would have to turn my back on the lake, and the prospect of the sword." Alan Clark, Diaries - 19th May 1999

Thursday, 1 March 2007

Polls and Polling (1)

Some while back, ConservativeHome ran a breathless editorial hailing the fact that according to a recent poll (I think it was an ICM one), the Conservatives had edged ahead of Labour by a couple of points in the confidence that the public had in the Party to manage the NHS. I think that the relative results were 29-27 in favour of the Conservatives.

Big deal, I thought. OK, so it's not bad news, but with the margins of error that exist, hardly a ringing endorsement. I decided to dig a little deeper and look at the full poll results. What I was shocked to see - what the big story should have been - was that around 41% of the people surveyed trusted NO POLITICAL PARTY to run the NHS.

Now, as a libertarian Conservative, I can fully understand that. I don't trust politicians to "run" the NHS - whether Labour or Conservative - in the same way that I wouldn't trust them to run the supermarkets, make my clothes, produce the music I listen to or write and publish the books I read.

Now, I know that it is not as simple as saying:

"The largest group among you trust no politician to run healthcare, and quite rightly so. We can't. Therefore, we will return most of your NHS tax money to you to help you to buy personal health insurance or enable you to join another healthcare scheme that will provide you with healthcare when you need it. That scheme or insurance will be able to buy services from whichever GP, hospital, clinic or consultant they wish, and there will be free entry into the market to provide those services, subject to minimum government-specified standards, to oblige all providers to compete to provide value for money and high quality services, therefore driving up standards for everyone."

Those who are reading this who are Conservatives know (or ought to know) that in the vast majority of cases that would improve standards, reduce waiting times, and cut the unnecessary waste from a system where "everything is free"). It would also encourage charity on the part of healthcare providers to treat the poorest for free. It would also eliminate the huge costs of 'health tourism'.

Now, there is hardly anyone who disputes the need to then provide specific assistance to some people who would genuinely be unable to afford to buy insurance or other protection, and would need some subsidy. But it would be far more effective to give direct cash subsidy to those people than have a masssive NHS centralised bureaucracy to run healthcare instead without any open market competition.

But apart from some in the DirectDemocracy group in the Conservative party, and perhaps David Laws in the Lib Dumbs, no major political figure seems to be edging in that direction and making that argument - despite the clear evidence that people do not trust politicians to run healthcare.


nick drew said...

Well we are in Policy Moratorium mode for the next while, as strongly endorsed by Mr Mania.

However, you are right, this is an issue that needs thinking through. As I posted on CU's Road Pricing thread, it is broadly a matter of historical accident which services are charged at the point-of-use (often with rebates for those deemed in need) - e.g. charging rent for social housing; and those services that are 'free' (at the point-of-use).

Given the social housing precedent, I see no reason why clever politicians can't carefully plan a move in the direction of that model for more services (health, education). Credit where it's due, Blair has had a crack at this with university fees - which I don't suggest was either clever or carefully done, but hey, it's done.

Do we have any clever politicians?

Arthurian Legend said...

Thanks Nick.

One of my favourite Conservative politicians is Douglas Carswell. He is incredibly bright and eloquent, and has thought through in quite some detail policy proposals relating to education, healthcare, local democracy/taxation and Britain's relatioship with the EU.

He is a driving force behind the DirectDemocracy movement in the Tory party, but sadly as a signatory to the Better Off Out campaign Cameron will not accord him a front bench job any time soon.

It's not so much "historical accident" that has determined the manner and pattern of public sector provision, but what the Conservatives have to date managed to undo of the 1945-1951 Atlee Government legacy. Not enough...