Getting the language right for the Health Service
Critics of the way the National Health Service is organised often get sharply rebuked for questioning such a sacred cow. How gratifying then to hear Patricia Hewitt on the BBC this morning tip-toeing through this minefield using the New Labour language of "consumers, choice and independent provision".
The TPA has consistently called for the use of choice in public services to allow us as taxpayers to verify claims by tax-funded services that they are as good as alternatives might be. It's our money, and we want to be able to see that it is being spent wisely. Alternatives in provision are the starting point for this.
It's good that New Labour might allow us to choose, but it is only a first step, and this is why the public service unions are so set against even taking that step. If choice is a good thing for us acting as consumers of health, then logic dictates next that we be allowed to consume using our own money - choosing an "opt out". The best way to make that work is to ensure that our money follows us as patients, as is partly proposed now, but with the crucial leap to separation of payment from provision. We have to use health services as choosy buyers looking for results which we as individuals pay for.
That puts the incentives in the right place, for us to seek out the best services, for the providers to devise new top quality services knowing that it is our money we are spending.
Note that this does NOT mean that ways are not found to distribute available funds so that the less well off are helped to get the best care. But such fund transfers would be just that, money to help those in need. That would be a lot less taxing on our incomes. Subsidising producers and, much worse, turning them into planned monopolies lording it over both resources and funding has 50 years of observable evidence that it is a rotten deal for taxpayers.
The TPA will continue to press for choice through opt outs, putting our money into our hands, to consume services through direct contract wherever possible. We also believe in compassion for the unfortunate and damaged, but let's be transparent about that sort of goodness in giving - suppliers of caring services too can choose their prices - when we pay for services rather than being taxed for them.