what you get here

This is not a blog which opines on current events. It rather uses incidents, books (old and new), links and papers to muse about our social endeavours.
So old posts are as good as new! And lots of useful links!

The Bucegi mountains - the range I see from the front balcony of my mountain house - are almost 120 kms from Bucharest and cannot normally be seen from the capital but some extraordinary weather conditions allowed this pic to be taken from the top of the Intercontinental Hotel in late Feb 2020

Friday, November 30, 2012

Why is public management so boring?

In the last three years I have apparently written almost 700 posts. The right-hand column indicates the most popular posts – alternately of past 7 or 30 days (less often of all time).
I wish I understood what this tells me about the interests and (internet) behaviour of my readers. And I get frustrated that what I consider good posts are rarely rated in these statistics. Democratic Discontents and A Citizen’s Bible are two good (and linked) examples. In the first (long) post two years ago I argued that, despite the number of publications on different aspects of British politics (many academic), there were extraordinarily few studies which actually dealt with the question of how well (or badly) the country is actually governed. I identified four such critical works - most written some years ago.
The second post (a year ago) was on similar lines but focused this time on the literature of public administration (or management) as its now called. There, of course, is revealed part of the problem - the compartmentalisation of knowledge and the amount of academic scribbling around narrow issues written not for the general public but to embellish academic reputations and careers.
For a proper understanding of how (well or badly) a government system is working you need to look at politicians AND officials and their interaction. Of course, you need to do more - you need to look at the interactions with the wider world - not least commercial and financial.
For those of you who haven't read my second post on the need for a rethink of the public management discipline, here it is again in full -
As both mainstream economics and psychology are undergoing major challenge and rethinks, it is time that the scholastic discipline of public management had this sort of overhaul and public examination.
The only popular book on the subject I can think of was Reinventing Government (1991) by David Osbourne and Ted Gaebler – which was, however, American and did not attempt an overview of the topic but rather proselytised for neo-liberalism.
Economics and psychology, of course, are subjects dear to the heart of everyone – and economists and psychologists figures of both power and ridicule. Poor old public administration and its experts are hardly in the same league! Not only does noone listen to them – the scholars are embarrassed to be caught even writing for a bureaucratic or political audience.
And yet the last two decades have seen ministries and governments everywhere embark on major upheavals of administrative and policy systems – the very stuff of public administration. But the role of the scholars has (unlike the 2 other disciplines) been simply to observe, calibrate and comment. No theory has been developed by scholars equivalent to the power of the "market”, "competitive equilibrium” or "the unconscious” – unless, that is, you count Weber’s "rational-legal bureaucracy” (1890s) or Robert Michels "iron law of oligarchy” (1911). Somehow Lindblom's "disjointed incrementalism" of the 1960s never caught on as a public phrase!
Those behind the marketising prescriptions of New Public Management (NPM) were not from the public admin stable – but rather from Public Choice Economics and from the OECD – and the role of PA scholars has been map its rise and apparent fall and (occasionally) to deflate its pretensions. At its best, this type of commentary and analysis is very useful – few have surpassed Chris Hood’s masterly dissection of NPM 20 years ago. This set out for the first time the basic features of (and arguments for) the disparate elements which had characterised the apparently ad-hoc series of measures seen in the previous 15 years in the UK, New Zealand and Australia – and then suggests that the underlying values of NPM (what he calls the sigma value of efficiency) are simply one of three clusters of administrative values – the other two being concerned with rectitude (theta value) and resilience (lamda value). Table 2 of the paper sets this out in more detail.
The trick (as with life) is to get the appropriate balance between these three. Any attempt to favour one at the expense of the others (NPM) will lead inevitably to reaction and is therefore unstable.
This emphasis on the importance of balance was the focus of a very good (but neglected) paper which Henry Mintzberg published in 2000 (which I’ve mentioned before on the blog) about the Management of Government which starts with the assertion that it was not capitalism which won in 1989 but "the balanced model” ie a system in which there was some sort of balance between the power of commerce, the state and the citizen. Patently the balance has swung too far in the intervening 20 years!
Incidentally I see from Mintzbergs (rather disappointing) website that he is working on a book on this theme with the title Rebalancing Society; radical renewal beyond Smith and Marx. Mintzberg is a very sane voice in a mad world – ás is obvious from this article on managing quietly and his ten musings on management.
Hood elaborates on these three sets of values in the book he published at the same time with Michael Jackson - Administrative Argument (sadly out of print) - when he set out 99 (conflicting) proverbs used in organisational change.
In 2007, Russell Ackoff, the US strategic management guru, published a more folksy variant of this proverbs approach – The F Laws of management short version of which can be read here. We desperately need this sort of approach applied to the "reformitis” which has afflicted bureaucrats and politicians in the past 20 years.
One of the few claims I feel able to make with confidence about myself is that I am well-read (see the (admittedly out-of-date annotated bibliography for change agents on my website). But I know of no book written for the concerned citizen which gives a realistic sense BOTH of the forces which constrain political action AND of the possibilities of creating a more decent society.
A book is needed which –
• Is written for the general public
* is not associated with discredited political parties (which, by definition, sell their souls)
• Sets out the thinking which has dominated government practices of the past 20 years; where it has come from; and what results it has had (already well done in academia see the Pal paper on the role of the OECD in marketing the privatisation of government)
• Gives case studies – not of the academic sort but more fire in the belly stuff which comes, for example, from the pen of Kenneth Roy in the great crusading Emag he edits and eg the tale which should be shouted from the rooftops of the collusion of so many public figures with the activities of the cowboys who run privatised companies which are trying to muscle in on (and make profit from) public services.
Perhaps I should try to produce such a book? Various authors have already put in place some of the building blocks – eg Peter du Gay ("Come back bureaucracy"); Chris Pollitt (in The Essential Public Manager); some of the work on public value by Mark Moore and others; even Geoff Mulgan's Good and Bad Power (which, sadly, I found impossible to finish.
The painting is by Stanley Spencer 

Thursday, November 29, 2012

What hope for democracy?

The castration of democracy by corporate power has been a recurring theme in my blogs – and I did on one occasion even suggest that the lack of fundamental policy differences between parties made us little different from Communist China
And this time 2 years ago I gave a link to a book, The Climate Change Challenge and the Failure of Democracy by David Shearman, without appreciating that its critique of liberal democracy and its apparent inability to challenge corporate interests has the authors arguing in considerable detail for a more authoritarian system of government. Naturally the book has been useful to those denying climate change – allowing them to claim that climate change is a plot by fascist big government.   
M Greer ( as a "peak oil" writer) seems to have been one of the few to subject the book’s argument to a more serious analysis
It’s worth glancing back over the last decade or so to get a sense of the way this book fits into the broader process by which climate change activism ran off the rails. In 2001, despite fierce opposition from business interests and right-wing parties generally, it was very much in the ascendant, and some form of regulation of carbon emissions looked like a done deal. Opposition from the White House and well-funded think tanks notwithstanding, the movement to limit CO2 emissions could have become the sort of juggernaut that extracted the Endangered Species Act and a flurry of other environmental legislation from another conservative Republican administration thirty years earlier. That it did not was, I think, the result primarily of three factors.
The first was the astonishing political naivete of the climate change movement. Most of the leading figures in the climate change movement are used to the very different culture of scientific debate and simply have no notion how to address the very different needs of public debate in society that does not share their values.
This latter point leads to the second primary factor in the failure of the climate change movement, which is the extent that it attempted to rely on the prestige of institutional science at a time when that prestige has undergone a drastic decline. The public has become all too aware that the expert opinion of distinguished scientists has become a commodity, bought and sold for a price that these days isn’t always discreetly disguised as grant money or the like. The public has also been repeatedly shown that the public scientific consensus of one decade is fairly often the discarded theory of the next. When you grow up constantly hearing from medical authorities that cholesterol is bad for you and polyunsaturated fats are good for you, and then suddenly he medical authorities are saying that polyunsaturated fats are bad for you and some kinds of cholesterol are good, a certain degree of blind faith in the pronouncements of scientists goes out the window.
The mental whiplash caused by sudden changes in scientific opinion, each one announced to the public in terms much less tentative than it generally deserves, has played a larger role in hamstringing climate change activism than most of its supporters may find it comfortable to admit.
 I’ve come to think that a third factor has played at least as important a role in gutting the climate change movement. This is the pervasive mismatch between the lifestyles that the leadership of that movement have been advocating for everyone else and the lifestyle that they themselves have led. When Al Gore, after having been called out on this point, was reduced to insisting that his sprawling mansion has a lower carbon footprint than other homes on the same grandiose scale, he exposed a fault line that runs straight through climate change activism.
I long ago lost track of the number of times I’ve heard people in one or another corner of the activist scene throw up their hands in despair and describe the task of organizing people to seek some form of change or other as being like trying to herd cats. In point of fact, herding cats is one of the easiest things in the world. All you have to do is go to the place you want the cats to go, carrying with you a can of tuna and a can opener. The moment the cats smell the fragrance of the tuna, they’ll come at a run, and you’ll have your herd exactly where you want them. Now of course that strategy assumes two things. It assumes that you’re willing to go to the place you want the cats to go, and it also assumes that you have something to offer them when they get there.
That sums up what has been one of the most critical problems with the climate change movement: it has been calling on the world to accept a lifestyle that the movement’s own leaders have shown no willingness to adopt themselves, and thus have been in no position to model for the benefit of others. That’s left the movement wide open to accusations that it means its policies to apply only to other people – accusations that have not exactly been quelled by the efforts of various countries, the US very much included, to push as much of the burden of carbon reduction as possible onto their political and economic rivals. I trust I don’t have to spell out how such suspicions will be amplified by Shearman’s cheerleading for exactly the sort of authoritarian politics in which some people’s carbon footprint would inevitably be more equal than others’.
For a wide-ranging discussion of the relationship of democracy to climate change see here.
And Stephen Holmes - the political scientists who focuses on post-communism - has written a very thoughtful piece on the reasons for the current disillusionment with democracy. It is quite remarkable to find an American writing in these terms -

To understand why citizens today, throughout the world, cannot easily control politicians by democratic means, we need to look at the way in which various extra-electoral forms of dependency of politicians on citizens have recently been eroded. To oversimplify, we can say that the citizen-voter has leverage over ruling groups only when he or she is also a citizen-soldier, a citizen-worker, and a citizen-consumer. The few are willing to share power and wealth with the many only when the many voluntarily cooperate with the few in their war-making and profit-making. When volunteer armies with high-tech weapons replace citizen levies, one of the main motives for elite interest in public welfare is substantially weakened. The flooding of the labour market by a low-cost Chinese workforce has also reduced the interest of the American and European capitalist class in the health and education of American and European workers. Taken together, the disappearance of the citizen-soldier and the diminished status and clout of the citizen-worker have considerably reduced the leverage which the citizen-voter can bring to bear on society's top decision-makers. This erosion has become a total destruction in the case of Russia, where the hydrocarbon bonanza (sold to foreigners) has liberated the ruling elite from citizen-consumers as well. 


Monday, November 26, 2012

The disease of managerialism

One of the reasons I blog is that I see myself very much as “a child of my times”; someone who felt in the early 1960s the power of what economics, sociology and managerialism had to offer the world and therefore switched his university studies from French and German to economics and politics; someone who got into positions of power and influence in government and advanced the mission of managerialism; who now sees not just the mistakes this new belief system have led us into but the unforgiveable hubris and arrogance of the new rationalists of the mid 20th century; and who wants to warn the younger generation of the Faustian bargain our generation struck.
My post a year ago today looked back on the grip social sciences took on our minds in the 1960s
For the past 4 years or so the discipline of economics has been under severe attack – but somehow its more powerful sibling (managerialism) has managed to evade critical popular attention. A year ago today I picked out one book which spilled the beans on the new religion. Its title was A very short,fairly interesting and reasonably cheap book about studying organisations which I view as far more explosive than The Communist Manifesto. I did my best to give a summary -
  • "imagine a world where the thing which dominated it (God; the Party) was written about in one of three ways. One was like a bible, very heavy and orthodox. The second was amusing and readable but didn’t tell you anything you couldn’t think for yourself. The third seemed to say some things you wouldn’t think yourself and suggested flaws in the Bible but you couldn’t understand it because it was so obscurely written. Such is the literature of organisations - in which we live our lives and yet are served by only Textbooks; pop management; and unreadable scholarly books or articles".
  • Writers on organisations belong to one of two schools – those who believe "there exists an observable, objective organisational reality which exists independent of organisation theory (OT). The task of OT is to uncover this reality and discover the laws by which it operates – and perhaps then to predict if not control future events. They tend to favour quantitative research. These are the positivists. Then there is a second camp which denies this scientific view – they might be called constructivists or relativists since, for them, organisational reality is constructed by people in organisations and by organisation theory”.
  • The history of organisation theory you find in textbooks generally starts with the concept of "bureaucracy” as defined by Weber and with that of "scientific management” as set out by FW Taylor - both of whom were active in a 25 year period from the late 1880s to the end of the first world war, one as a (legal) academic in Prussia, the other as an engineer and early consultant in American steel mills in Pennsylvania.
  • Weber was curious about the various motives there have been over history and societies for obedience. Why exactly have we accepted the authority of those with power? His answer gave us a typology of authority we still use today – "traditional", "charismatic" and what he called "rational-legal” which he saw developing in his time. A system of (fair) rules which made arbitrary (privileging) behaviour difficult. But this was an "ideal type” (ie a model) – not necessarily a precise description or prescription. Indeed studies from the mid 1950s showed just how much informal power there was in bureacracies.
  • Taylor worked in an industry where it was normal for workers to organise their own work; and where owners tended to be Presbyterean and workers catholic immigrants. Taylor reckoned there was a lot of slacking going on – and applied a "scientific” approach to devise standards and measures of performance (time and motion) as well as "scientific” selection of workers and a strict separation of workers and managers.
  • This caused strong reactions not only amongst workers but from many owners and only survived thanks to the production needs of the First World War
  • The "evacuation of meaning” from work was intensified by Fordism.
  • the "human resource” approach to management which followed was not the fundamental break which the textbooks portray but rather a cleverer legitimisation of management power – as was the cultural management (and TQM) of the latter part of the 20th century.
  • Although managers call the shots, their organisational fashions always fail – because of unintended effects
  • Business schools do not produce better managers – but rather  breed legitimisation; self-confidence; a shared world-view and a common (mystifying) language
  • One quote perhaps captures the author's (Chris Grey's) argument - 
For all the talk about new paradigms, contemporary organisation theory and management method remain remarkably unchanged from their classical roots….because the underlying philosophy of instrumental rationality and control remains firmly in the ascendant
In the 1970s we had people like Ivan Illich and Paolo Freire exposing the emptiness of the doctrines which sustained the power of education and health systems. We now desperately need people like this to help us tear apart the arbitrary assumptions which sustain the legitimacy of the new priests of technocracy. Daniel Dorling's recent book Injustice - why social inequality persists is exceptional because he tries to identify and then challenge the belief systems which sustain our present inequities.
There are hundreds of thousands of academics receiving public money to teach and research so-called social "sciences" in universities and public institutions. The vast majority of them, whether they realise it or not, have been part of a large brain-washing exercise. A few of them only have broken ranks - not just the economists I have mentioned but those (generally American) sociologists who, for a few years, have been advocating what they call "public sociologies". Michael Burrawoy has been one of the main protagonists. Noone, however, should be under any illusions about the difficulties of making an intellectual challenge on this field of management and organisation studies in which so many brains, reputations and careers are now entrenched

In the same month last year I also traced the history of the critique of economic growth and consumerism.

Finally this important article on Social housing in Scotland which show how even one of the last bastions of social democracy has been infected by the neo-liberalist disease.

The painting is, of course, an Honore Daumier - The Mountebank Musicians


Wednesday, November 21, 2012

wine as medicine

November seems to be the period for testing the Sofia medical systems – this time last year I blogged about an experience with the excellent Military Hospital here which resulted in a diagnosis of excessive uric acid and a savage diet for a month with no wine.
I’ve been suffering for some time from some degeneration of the knee tissue – result probably of rowing, jogging, tennis and badminton over the past 50 years (did I tell you I trained with the Azeri youth badminton team a decade ago??!!). It was in Baku I had my first treatment of the knee with electrodes (20 years earlier I had a guy with a hypnotic medallion massage the knee briefly and cure a pain which physiotherapists had not been able to shift.
Since I came off a Kyrgyzstan mountain/hill climb in 2006 the knees have been weak and no one has been able to give me a decent diagnosis – let alone treatment (despite MRS etc) In April, however, a Sofia specialist ran some doppler and other tests and reckoned it was linked to some spinal weakness – so here I am now having some excellent physiotherapy in the Military Hospital. The Doctor who supervises the treatment gave me on Monday the most thorough and professional examination which I have received in a decade – and has me now undergoing a 10 day course of magnetic, electric and manual treatment. And in a section of the hospital whose walls are adorned with paintings (for sale). Great idea! So hats off to the Bulgarians – not least because we exchange tips about Bulgarian wine as it proceeds.  Pavel Banyia is the place I had been advised to go for the best Spa experience (in the heart of the country) but it was fully booked. Her advice was Hisar - for both the thermal waters and wine (StareSel).

Speaking of which – as I walked back from the Hospital (aided by my antique vanity cane – which is great for smacking badly-parked cars!) I discovered another of the charming regional wine shops which are scattered around Sofia. So far I have come across shops selling Vidin; Magura; Karnovat wines and today I passed I tiny shop which had a huge advertisement about Belogradchik wines (like the first 2 in the North-East). I had driven through the village (Borovitsa) last year but not stopped and decided this time therefore  (blindtaste) to buy 2 litres of a Chardonnay/Sauvignon Blanc mix – for less than 5 euros. Back home, the taste was impeccable!!  
And a lovely little wine shop with quality wines at reasonable prices has opened at the Russian monument on the corner of Makedonski and Skobelev Bvds (although its situated in the latter, its address is the former!). It's the initiative of a young man - and is typical of the attitude and spirit here. It's love of wine which has driven him - not big business connections. I wouldn't find this in Bucharest.
I'm also glad to see that one of the Bulgarian wineries - Light Castle - is supporting Astry Gallery - being one of the sponsors of Vihra's latest annual 30x30 exhibition.   

Monday, November 19, 2012

Bulgarian Wine - as Culture

Well I certainly learned a lot more about Bulgarian wines over the weekend – both in the biblical sense (experience) and intellectually. Particularly about the more pricey wines I would never normally buy. You can such great quality here for 2/3 euros a litre that I would never pay more than 8 euros a bottle! I discover (through a great little book "Catalogue of Bulgarian Wines 2013" (available for 15 levs probably at branches of Casavino here) that there are at least 97 independent wineries in this small country – each with several brand names with its own range of wines. And 250 of them were available for tasting over the weekend (as this was the elite, this suggest that there are more than 500 different wines in the country!)
I was more disciplined yesterday, perfecting the swill and spit – and, even then, physically not able to taste too many reds because of the semi-revulsion my body has developed to them. One exception was a fascinating anti-oxidant red wine – Alfa Vita – which adds a strong medical tone to its marketing. It certainly was smooth and tasty. The CEO I spoke to (also the driving force behind the local Academy for Wine) was kind enough to give me a bottle in exchange for a copy of my booklet on Bulgarian realist painters! And advised me to drink 50 ml or so for breakfast!! At 5 euros a bottle, it’s just what the doctor ordered!   
One of my goals yesterday was to savour the Roses on offer – I have never been a great fan of these but, as my taste for reds has declined, so the few Roses I have come across have become more interesting. And there is a great choice here!
Two stalls left the greatest impression - Villa Yustina (established only in 2006 and located in a village in the Rhodopes foothills near Plovdiv) by virtue of the enthusiastic and helpful approach of their sales guy Vencislav Lyubenov. And the stall of the well known Katarzyna Estate (located on the Greek/Turkish border) - by virtue of it being the only one whose staff (women) were encouraging feedback from their customers.  
The wine fair was so popular the second day that it was almost impossible to move from stall to stall!
As each visitor left, they were presented with free copies of the (massive glossy) DiVine magazine which sponsored the fair. Intriguingly the cover picture is of champagne bottles in a picture frame – is this a case of the wineries bidding to be included in the European Capital of Culture?

There is a serious argument to be made for eating and wine drinking as a serious cultural pursuit – perhaps the Divine magazine should consider having a few pages on Bulgarian painting (and other cultural material) in each of its future issues?  Interestingly there was a good place on Kurnigradska St (almost at the corner with Vitosha) which offered a heady mix of paintings, wines, books and musical performance. It is now not more - not at least at that address - although a new little gallery has opened in Tsar Samuil St (off Solunska) which mixes wines and aquarelles!!
The aquarelle is - of course - an......Ilyia Beshkov - from the superb 1950s book I bought from Alexander....

Sunday, November 18, 2012

The vocabulary of wines


This will be a short post since I am heading out to Part II of a marathon wine-tasting which I alighted upon by accident as I was out cycling yesterday and saw large banners with images of wine bottles hanging from the building of the Central Military Club. Divino was organised for the first time last year by the leading wine magazine, called DiVino. Now comes the second edition. Wineries can participate only if invited, therefore quality is ensured. If you want to learn besides tasting, you can sit in any of the masterclasses or lectures. Bulgarian grape varieties, pearls of Burgundy and many other topics satisfy your thirst for knowledge. If you look hard enough you should see me somewhere in the picture.
It was a glorious way to spend a couple of hours and taste wines I didn’t know about – complete with a little notebook they give you when you pay your 12 levs with all the wines thoughtfully listed (in English no less). There are apparently about 200 wines available – and my notes suggest that I tasted almost 50 of them. Needless to say I have no real memory of this – but if I am to do the event justice I will have to swill and spit a good few of the remaining 150!!
It was nice talking with the various people on the stalls – and also a couple of sommelliers. I was stuck for words to describe the taste – and am basically looking for value for money – stunning taste which does not pall as you drink it for a good price. It is, obviously, the season for wines - so hardly surprising to find a  good articles here on the lexicon of wines.

Another good example of why Sofia is a great place to live!

Friday, November 16, 2012

Privatisation exposed!

Time was when Chile (under General Pinochet) was the test-bed of how far right-wingers could go in destroying a society and country. Now it’s become the turn of England – with its successive neo-liberal Governments pushing privatisation as far as it can go. Not just railway and health services – but now even policing. Thank God for Scottish Devolution which has spared my country from this madness – although, sadly, not the rail privatisation nonsenses which I blogged about a month ago.
"Railways now cost the British taxpayer some three times more (allowing for inflation) than did state ownership and costing the passenger some 4 times more (and greater inconvenience) than equivalent travel in the rest of Europe. It is a marvellous case-study of, variously, policy development (on what evidence was the policy brought in and discussed?); democratic accountability (who wanted it – and has supported it?); civil service management (skill preparation) and neo-liberalism.
It was a mad scheme from the start (in 1993) – totally against basic economic theory (or what remains of it). Rail is a natural monopoly. Services cannot run against one another. So sections of the system are put out for tender by the State for 10-15 year “franchises”. About 2,000 companies are involved in these contracts and sub-contracts – with all the bureaucracy (let alone profit-taking) this involves. And that is before we bring into play the new regulatory systems set up to monitor targets and ensure that the customers and government were not being “taken for a ride” (excuse the pun) by the private monopolies. I do not pretend to understand the complex (and ever-changing) process by which public assets were sold up, franchises awarded and regulatory systems managed. A 2004 paper by Prof Stephen Glaister seems to give a lot of the detail – if you have the patience to follow it all.
The last 13 years have seen a lot of problems – train collisions; bankruptcy of RailTrack; huge rise in complaints – but they are small beer compared with the scandal which has now erupted over the contract for the West Coast line (London to Glasgow) which has just been cancelled due to irregularities (so typical for procurement processes)"
The biggest privatisation disaster was undoubtedly the Private Finance Initiative (PFI), originally unveiled by John Major’s government but massively expanded under New Labour. Under PFI, private contractors pay for construction costs, leasing the finished project to the public sector for up to 30 years. The attraction was a financial con: PFI contracts take borrowing off the Government’s public sector balance sheet. They are expensive, not least because of the costly lawyers and consultants involved in the contracts, and because borrowing is twice as expensive for the private sector as it is for the Government.
The long-term cost to the public purse is shocking. Not long after the last election, it was reported that the NHS would end up paying £65bn to private contractors for hospital building, even though completion cost just £11.3bn. Back in May, the House of Commons Public Accounts Committee found that “the current model of PFI is unsustainable”, because the contracting process was so expensive, and the risk was transferred to the public sector even as investors enjoyed high returns - 22 NHS trusts reportedly face bankruptcy after being saddled with PFI debts.
As the recent failure of G4S to provide security at the Olympics underlined, the “private is best” dogma is kaput. But the era of failed free-market fundamentalism will not end unless Labour rejects its own history of privatisation. A break with the past is not just necessary - it would be popular, too.
Treating hospitals as businesses…. has only got hospitals into trouble as they struggle to transform themselves into commercial enterprises, more interested in their profit margins than in their patients. It is a recipe for disaster to expect hospitals to behave like fast-food chains or clothing stores. Hospitals should be focusing every shred of their attention on improving their services for patients, here, in this country. Hospitals are not businesses; they are places that are funded by us, for us, when we become unwell.
Like the grubby men in string vests and gold sovereign rings who sit outside brothels beckoning gullible tourists, the Government is now attempting to pimp out the NHS to foreigners…..
It’s not the NHS as a product that is revolutionary and worthy of export, it’s the NHS as a concept. The main appeal of the NHS to people around the world is the fact that it is a cheap, effective and equitable way of delivering healthcare. It is the notion of a system that is free at the point of delivery, regardless of ability to pay, that makes it valuable. The great irony of all this is that if we wanted to export the real ethos of the NHS, as opposed to what might be represented by some bland, meaningless logo, then we would be going around encouraging foreign governments to reject market principles and develop a socialised model of healthcare. And this isn’t going to happen.
The reason why the NHS has not been replicated around the world is that attempts to introduce socialised medical models are strangled by corporate interest. Emerging, proto-capitalist economies are rich pickings for the multinationals that are already lining up to take over running their health systems. The idea that the NHS might become one of the circling vultures ready to swoop in before a fair, cheap model of healthcare delivery can be established makes me feel ashamed.