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Home » Dr Shibley Rahman viewpoint » Will the catalysmic implosion of the market ideology now move onto the NHS?

Will the catalysmic implosion of the market ideology now move onto the NHS?

This week, David Cameron MP mocked Ed Miliband MP for sounding like a person who’d rung up a radio show whingeing.

Cameron replied, “And your problem is caller?”

The problem is a complete collapse of ideological position which has lasted decades.

Ed Miliband keeps up the moment today with the market failure of the energy oligopoly (see article by Patrick Wintour in the Guardian.)

It is argued that one of the precursors of Thatcherism was a revival of interest in Britain and worldwide in the work of the Austrian economist and political philosopher, Friedrich Hayek, who won the Nobel Prize for economics in 1974.

Alongside Milton Friedman, who won his Nobel Prize in 1976, Hayek lent great prestige to the cause of economic liberalism, helping to create the sense of a rightward shift in the intellectual climate, complementing the approach of Ronald Reagan across the pond.

These principles of dogma have seen successive Conservative and Labour governments reaching for the drug of privatisation and outsourcing.

But these drugs are not only failing to work. They are having devestating side effects which are killing the patient.

The markets have been outed for being far from liberalising. They create inequality. It is alleged that the austerity-based policies have led to a marked decline in mental health and rates of suicide even.

But it’s not the shocking Gas bill which has delivered the knock-out blow for the Conservatives’ religion.

“Here is the reality. This is not a minor policy adjustment—it is an intellectual collapse of the Government’s position.”

This was Ed Miliband’s verdict in Wednesday’s Prime Minister’s Questions.

Only a day previously, BBC Radio 4’s had played a voxpop of various members of the public speaking about ‘payday loans’ as a prelude to interviewing George Osborne MP.

“I don’t accept it’s a departure from any philosophy. The philosophy is we want markets to for people. People who believe in the markets like myself want the market regulated. The next logical step is to cap the cost of credit. It’s working in other countries. In fixing the banks, we need to fix all parts of the banks and the banking system. It helps all hard-working people.”

During the time of the previous Labour government, the King’s Fund was head-over-heels promoting competition.

It was known that, by shoehorning competition as a policy, private providers would make a killing.

All you had to do was to bring in a £3bn ‘top down reorganisation’, a 500 page Act of parliament containing no clause on patient safety apart from the abolition of the National Patient Safety Agency, and beef up a new consumer regulator (“Monitor”).

But meanwhile back to payday lending, an evidenced case of market failure.

“We’ve always believed in properly regulated free markets, where there’s competition, but where the market is properly regulated. That’s why we created a new consumer regulator.”

Far from being a loveable buffoon Boris Johnson, Johnson has revealed himself to be the toxic political mess he is.

Suzanne Moore, at the risk of being hyperbolic, called out Johnson as ‘sinister’.

Johnson had launched this week a bold bid to claim the mantle of Margaret Thatcher by declaring that inequality is essential to fostering “the spirit of envy” and hailed greed as a “valuable spur to economic activity”.

In an attempt to shore up his support on the Tory right, as he positions himself as the natural successor to David Cameron, the London mayor called for the “Gordon Gekkos of London” to display their greed to promote economic growth.

He qualified his unabashed admiration for the “hedge fund kings” by saying they should do more to help poorer people who have suffered a real fall in income in recent years.

And what’s wrong with greed being good if this improves patient care in the NHS?

The issue always remains ‘zero sum gain’. It’s a problem as it diverts tax-funded resources directly in the coffers of the private sector.

Arguably, it’s not just the failure of the market which is the problem, but ‘the undeserving rich’ who have never ‘seen it so good’ since Tony Blair’s New Labour period of government.

In August 2009, the then leader of the Opposition and Conservative leader, David Cameron, MP defended a shadow health minister for advising a firm which offers customers an alternative to NHS doctors.

Lord McColl was on the advisory board of Endeavour Health, which promised a quick and convenient access to a network of “top” private GPs.

It was claimed then that Endeavour Health is a company set up by two hedge fund advisers which purported to be Britain’s first comprehensive private GP network.

In a video yet to be deleted off You Tube, David Cameron argued that there was nothing ‘improper’.

This was interpreted at the time that the Conservatives “favoured private alternatives”.

Nonetheless, David Cameron claimed that the Conservatives was ‘totally dedicated to the NHS’, but he wished ‘to expand the NHS so that people don’t have to use the private sector’.

What actually happened was the Health and Social Care Act (2012).

In July 2013 in the British Medical Journal, it was reported that the private sector is in line to secure hundreds of millions in NHS funding from services placed out to the open market under the UK government’s latest competition regulations, a study has shown.

Research by the pressure group the NHS Support Federation found that contracts for around 100 NHS clinical services totalling almost £1.5bn (€1.7bn; $2.2bn) have been advertised since 1 April 2013, with commercial companies winning the lion’s share of those awarded to date.

Data from official tenders websites showed that only two of 16 contracts awarded since the government’s section 75 regulations of the Health and Social Care Act came into force have gone to NHS providers, with the remaining 14 going to the private sector.

A few days ago, it was reported tonight that David Cameron is intending to ban branded cigarette cartons, having originally decided last July not to proceed with the plans.

In the summer the Government said it was waiting to see how plain packaging worked in Australia, which introduced the measures a year ago, before making any changes. It has since maintained it is monitoring the situation.

That is the spin. Behind the scenes, it is well known that tobacco corporates have throttled public health policy.

In the third volume of Law, Legislation and Liberty, Hayek argued that there are not two but three kinds of human values: those that are “genetically ordered and therefore innate”; those that are “products of rational thought”; and values that had triumphed in the course of cultural evolution by demonstrating their suitability to the successful organization of social life.

Hayek believed that these values were a cultural inheritance, survivors of a competitive struggle, and essential conditions for the successful evolution of our society.

David Cameron is indeed right to be worried.

There has been a collapse of the ideological position that he and his predecessors, Margaret Thatcher and Tony Blair, stood for.

This is in relation to the markets.

This fundamentally changes the terms of reference for a market-based NHS.

Contagion is likely politically.

If payday lending or the energy markets are anything to go by, there could be trouble ahead.

So what’s the issue? The caller’s problem is that “the markets don’t work”, “they only make you feel worse again”.

And now the caller’s finally worried about the NHS.



My blog on dementia is here:

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