![]() |
||||||
![]() |
||||||
|
|
| Heading to an early grave in a Trabant
A radical seeks to probe to the roots of every problem, then cut and graft wherever improvement can be made. As we learned after the death of communism, today’s biggest agent of improvement is competition to use changing technology most effectively. The East German makers of polluting Trabants, for example’, had petrified, courtesy of their state monopoly, into being less than one-sixth as productive per dollar spent as their neighbours making world-competing West German Volkswagens. Britain’s trouble this summer is that we are turning sullenly anti-competition in vital fields. We should have thrilled to hear last week that the American cancer-treatment firm Salick may compete to provide technology for ‘the National Health Service. The Americans waste twice as much money on health care as Britons, partly because their doctors have an incentive to treat both hypochondriacs and the terminally ill in the most expensive possible ways. However, they are devising ways better than the British in some specialities, such as cancer treatment. When my daughter was dying in Britain of breast cancer in 1987-89, I agonisingly knew this. Even if firms such as Salick were to offer treatment only to rich private patients who pay, I would rejoice at any lives saved as would anybody sufficiently Christian not to’ regard the death of a millionaire’s loved child with a whooping egalitarian's delight. Actually, though, Salick and the others offer their therapy in America at a flat annual fee to competitive health maintenance organisations, who thrive only if they convince their subscribers that they have the best record of curing patients at least cost. Now that Britain has fund-holding GPs and hospital trusts operating a similar competitive search, Salick and the others see openings here. Remember doctors’ salaries in Britain are lower, the scope for increasing efficiency at the worst British hospitals much greater, and remember the foreign firms already involved in kidney dialysis’. In the nine years since 1985, when the Welsh Office invited foreign kidney dialysis units to operate in the NHS in Wales, such dialysis treatment has increased fivefold there, easing pain at relative bargain cost. Yet the reaction from the worst politicians and professors last week was: we must, stop American technology from taking over “our” NHS. This is populist posturing of a sort that is costing lives, a depth I cannot fathom. Last week’s second spasm against competitiveness was much less wicked, but as glitteringly silly. The Liberal Democrats want to “ear-mark” various taxes, so a tax on alcohol and tobacco would fund some NHS projects. Anybody favouring those projects would then presumably aid them most by getting blind drunk every night. The right question about public expenditure is usually: how can we best spend the least money to the most competitive advantage of those we serve? When last week’s A-level results are translated into school league tables, you will find the most successful schools have operated thus. Fee-paying schools often have to, or go bust; but the best state schools operate with the same ethos, while the worst are those with funds incontinently and erratically thrown at them. Once the money for any state project depended each time on something accidental, such as receipts from a particular (probably frequently raised) tax, we would slither into running public services as inefficiently as East Germans built Trabants. A 32-year-old suicide has just been found hanging from a tree near Huntingdon. DNA tests showed he had murdered a waitress last month, and raped a pensioner at Christmas 1992. From 1986 to 1990 he was in prison for violently raping a bound and gagged schoolgirl. If his DNA had been recorded on a database while in prison, police think he might conceivably have been linked to up to 32 other serious crimes (including six killings) between his release and suicide. Although fingerprints are recorded, an effective compulsory database on even sex convicts’ DNA would apparently require a separate act of parliament another sign of how we impede routine technological productivity in public jobs. Do you thrill to the fact that public servants from all countries failed to arrest Carlos the Jackal for 30 years? He has been living openly in a dozen communist or Islamic states, popping into the West to commit an alleged 83 murders, but diplomats in the host countries have thought it would be rude to keep proper tabs on him. Better news is that another 21 British jails have now been listed as possible candidates for privatisation. The ones chosen will be those with today’s highest costs per prisoner, worst records in brutalisation or in less serious indices such as the number of escapes. A campaign has been fed to the press that privatised jails have done worse on all these counts than public ones, especially on escapes. Like most anti-privatisation propaganda, it is entirely untrue. In last week’s batch of rail strikes, a small number of emergency signals staff kept a third of the trains running. If we had competing Railtracks, one of them would surely, have said: “Any signalmen who stay out on the next two days of strike will be deemed to have left our employ. We will keep the trains running with those of you wise enough to heed this threat, plus new recruits easily trainable on the computers that do your now fairly unskilled job.” Instead, there has been a wave of public support. for the strikers and indignation that they may be being offered less money than tentatively hinted before the strike started. Since they have lost Railtrack up to £100m, their future earnings will naturally be depleted by some of that £100 that now is not there. If you argue that Railtrack should have made higher offers to strikers before losing the £100m the answer is that this would bring triumphant strikes from more groups of public workers every other week. It seems clear that British opinion this summer has turned, further against privatisation of the post office (although continued nationalisation will lose most postmen their jobs as we turn to electronic mail), and against privatisation of British Rail (just look at it), and against introducing more competition with other public disservices. This is the least logical direction in which opinion could have lurched. |
|
Brilliant? Batty? Start a discussion on the Norman Macrae Message Board
Home | Message Board | Commentary | Friends & Family | Future History | Biography | Books |