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Home » Dr Shibley Rahman viewpoint » The illusion of choice

The illusion of choice



An ongoing onslaught by David Cameron has been that the state became too big through Labour. Yesterday, somebody remarked on Twitter, “BREAKING NEWS: Cameron to replace top-down bodies with top-down bodies”.

Three policy developments, the English Baccalaureate, NHS corporate restructuring and the Big Society, arguably provide evidence for a ‘top-down’ approach which actually encourages the state producing less rather than more choice.

The English Baccalaureate
In a less than successful interview recently on Victoria Derbyshire’s show on Radio 5, Michael Gove explained to the listener his perception of the “English bac” scheme.

Michael Gove recently promoted extensively an English baccalaureate qualification to recognise the achievements of GCSE students who complete a broad course of studies. The “English bac” apparently would not replace GCSEs, but would be a certificate to reward pupils who pass at least five of the exams, at grade C or above, including English, mathematics, one science, one foreign language and one humanity. OFQUAL has previously criticized the over-reliance of this qualification on GCSE results, but presumably will be given greater powers to oversee the diploma.

One wonders how Einstein or Bach would have coped under a system. More worrying is that it is the Government (or rather Michael Gove’s elite) who are imposing a value set on what they think is important in education on the rest of the education system including comprehensive school teachers. They are giving parents and headteachers little choice in this in fact, nor possibly OFQUAL in whether it’s a good idea or not.

Corporate restructuring in the NHS

My second example concerns a massive issue, which is indeed being sold to voters as reducing the state and increasing choice. Nothing could potentially be further from the truth.

The NHS in England is to undergo a major restructuring in one of the biggest shake-ups in its history. A huge new NHS (independent) Commissioning Board will oversee GP commissioning, sitting above as many as 500 consortiums (sic) of GPs to set standards and hold the groups to account.

Furthermore, it is proposed that this new system also will give patients more information and choice. “HealthWatch” will be set up to compile data on performance. Experts in this area have long criticized that the quality of data concerning benefits (often mixed up with outcomes) has been extremely poor, such that it could be dangerous if GPs use these data to guide their commissioning policy. This is a longstanding problem which is not addressed by the NHS corporate restructuring, which is estimated to cost £3bn in its first year.

The BMA and the King’s Fund seem to have had no choice in this, and how much choice is actually given to real patients and GPs is yet to be seen.

The Big Society

My final example concerns what possibly is the flagship policy of the Conservatives.

According to the Big Society’s own website,

The Big Society is a society in which individual citizens feel big: big in terms of being supported and enabled; having real and regular influence; being capable of creating change in their neighbourhood.

Again, the Big Society is sold as creating ‘an enabling and accountable state’. However, the Big Society as a whole might be fairly innocuous if it simply was an extension of the volunteering, pro-bono practices which are longstanding; or indeed a development of social enterprises policy.

The unique selling point of the Conservatives’ approach to the ‘improvement of society’ is in fact its focus on venture capital, which is a point hardly ever addressed.

Venture philanthropy , also known as philanthrocapitalism , takes concepts and techniques from venture capital finance and high technology business management and applies them to achieving philanthropic goals. It has a strong focus on measurable results: donors and grantees assess progress based on mutually determined benchmarks. There is also a high involvement by large corporate donors with their grantees. For example, some donors will take positions on the boards of the non-profits they fund. Critically, the venture capitalists are the ones who choose where they wish to spend the money.

Do financially-strapped worthy projects in the community get a chance to participate in this choice?

Conclusion

I feel that all these examples demonstrate a ‘top down’ approach to government picking winners, giving an illusion of choice.
This is a big painful pill for Labour to swallow as it is David Cameron’s PR team who fill the airwaves with the message that the State is too big, with the assistance of their Liberal Democrat accomplices. The Coalition is also busy spending our money implementing these ubiquitously unpopular schemes with little consultation. I am confident that they will be ultimately punished for this faulty ideological rhetoric, once the public realize they have been spun a tissue of lies, as they have been with the economy.

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