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Home » Dr Shibley Rahman viewpoint » The Bangladeshi fire explains why Tony Blair's view of the NHS market is wrong

The Bangladeshi fire explains why Tony Blair's view of the NHS market is wrong



 

 

I am doing a Dan Hodges. But this time it is against his ideological pin-up Tony Blair, who knew the price of everything but the value of nothing. He was the future once, but now is not the time for clichés.

 

Tony Blair once said, ‘I don’t care who is providing my NHS services, as long as they are the most efficient’. He would, had his views been alive and relevant today, might equally have been applied to competitive tendering in the legal services sector. That sector too has also seen an ethos where profit rules; in a weird Darwinian ‘survival of the fitness’, human rights cases of massive social importance such as in housing or asylum are considered the lowest caste, compared to share acquisition of a multinational corporate. This is the attitude of anyone who would rather sell their own grandmother, than to look to a sustainable future.

 

“I don’t care who makes my T shirt as long as it’s the cheapest.” I would be very surprised if Primark and Matalan suffer a massive loss of trade as a result of public reaction to the collapsing sweatshop in Bangladesh. The similarity with the Texas fertiliser explosion is that there is no such thing as protection for workers by the Unions. Any country which has been trying to water down or to make workers’ rights non-existent, in the name of ‘industrial relations’, should think twice about whether they deserve to be called ‘a civilised country’. In this era of a maximum number of underemployed people with non-existent employment rights, and corporates making a killing weathering the recession, the public have to think: whose side is the government actually on?

 

ATOS are still achieving millions of profits, even though it is widely reported that administration of welfare benefits has caused immense mental distress as they have been do badly done; hence talk of why people cannot record their own assessment interviews as legal evidence, and the proportion of decisions made by ATOS which are overturned by the law courts on appeal. Add to that the staggering reports of people committing suicide because of their welfare benefits decisions (where it is incredibly difficult to prove causality); nonetheless, there is now a growing case of a link between mental illness and government policies of austerity in many jurisdictions.

 

Does it matter that the world has no morals but makes money? It does depend on your point-of-view, but will impact upon whether you feel that a leading sugary soft drinks multinational should be advising the current Obama administration on obesity. The building collapsing in Dhaka, and the subsequent fire, has brought out much disgust, which occasionally hits the mainstream media. But it all subsides again – attempts have been made to revisit history, so you will never find a clear account of the Bhopal explosion of the Union Carbide plant.

 

This issue of ‘corporate social responsibility’ has been advanced most prominently by Prof Michael Porter at Harvard, and emphasises that corporates living as responsible members of society is not simply a matter of marketing and PR but extremely important for society. Broadly speaking, proponents of corporate social responsibility have used four arguments to make their case: moral obligation, sustainability, license to operate, and reputation. “Reputation” is odd when applied to the current NHS, because, despite efforts by the King’s Fund and the current Tory-led government, attempts at making the NHS ‘consumerist’ have largely been overwhelmingly unsuccessful. Porter, in Harvard Business Review in October 2006, wrote: “In stigmatized (sic) industries, such as chemicals and energy, a company may instead pursue social responsibility initiatives as a form of insurance, in the hope that its reputation for social consciousness will temper public criticism in the event of a crisis. This rationale once again risks confusing public relations with social and business results.”

 

Legally, private limited companies have a duty for their directors to promote the ‘success’ of the company, i.e. profitability in the narrowest sense, under the Companies Act (1996). The idea of improved competition driving quality is strangled at birth by the fact that imperfect markets do nothing but encourage collusive behaviour in pricing, little choice in product, and massive profits for the shareholders. The concomitant ‘improvement’ in quality is barely noticeable. This has been the consistent outcome of all the privatisations in England, such as gas, water, electricity, and telecoms, where the consumer has suffered in an overpriced, fragmented service; Royal Mail will be next.

 

The Bangladeshi Fire is a human tragedy of unfathomable proportions, and is entirely driven by a consumerist culture where people appear do not care how the product arrives on the table, so long as it is there most ‘efficiently’. Of course, employment laws are there to protect the welfare of T-shirt makers, but this is what the Conservative government call ‘unnecessary red tape’ when applied in this country. The fire also poses serious questions about how we do business while Cameron pursues his ‘global race’. If Britain is not careful, it can easily outsource functions to abroad, and make as much of them as cheaply as possible. Diagnosis of dementia could be through an automated innovated server in Thailand, delivered by a multinational, with its head office in one of the Channel Islands to avoid tax maximally, to deliver healthy private equity profits. While it may not be the Unions that hold the country ‘to ransom’ any more, the power behind closed doors of private equity and bankers is not to be underestimated in the pursuit of profit.

 

Before going down the commodification of healthcare and the “Tony Blair dictum”, spend one moment thinking about exploding fertiliser plants in Texas or buildings collapsing in Bangladesh, as the lessons for business there could be salient for our increasingly privatised National Health Service (achieved entirely undemocratically.)

 

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