Two recent initiatives bring home how risky large government is for taxpayers.
First, the proposals for increasing the role of paramedics working for the ambulance service. Yes, the roles are laudable and the outcomes may or may not be more efficient, but think about how this change is being market tested. Because the innovation is being proposed by a monolithic nationalised industry it becomes a major political item; with all doctors, all health service workers, all the media, lots of patient groups and vast cohorts of administrators having their say. What a stupendously inefficient way of making change happen. About fifteen years ago I can remember a report about paramedics in Orange County California bringing in portable defibrillators on trial. There was no fuss, just a few dedicated doctors and paramedics working together to see if they could save more patients' lives and crucially, no extra cost to local taxpayers.
We're going to pay through the nose for the debate about paramedics - and this tax money will go nowhere near any paramedic or patient, it will go into endless meetings as each interest group tries to second guess what part of this change might affect them badly. Operational efficiency and patient benefits are more than likely going to be a very small part of this gabbling.
Second, the same process is at work in the identity card debate. This monolothic proposal brings in the mighty monster of the IT procurement process inside government. This is a never never land of special interests that has a track record of cost over-runs second to none. Once again, the taxpayer becomes the fall guy as arcane debates about the requirement, the technology and the useage processes see government stumble into the unknown at our expense.
That big government is risky is a notion we should all be remembering - the worst part being that they take risks with our money.
Eben Wilson, Editorial Director