Dave B wrote:In the case of the NHS the incentive should, ideally, be only to provide the best possible service - bnot saving money or making a profit. Yes, budgets have to be met etc.
In an ideal world, we wouldn't need the NHS. We'd all be fit as fiddles. Unfortunately, that's not the case. Wouldn't it be wonderful if things were simple? But they are not. And cheaper services mean more money for other things. If money is saved, or services improved, then great. Why the hang-up about money?
In the case of a shop I expect the owner to take a profit. In the case of the NHS I expect any money left over to go back in or to the exchequer (or wherever). Hopefully it would be used to provide even better service. Likewise efficiencies should also benefit the basic source of funding - you and I - in terms of less tax or better service.
Do that, and the improvements disappear.
Why? Define improvements in this context.
If you do not give scope to the private sector by allowing them to make a profit, then they won't participate. (I should perhaps have said that improvements won't materialise.)
If ïmprovements" are better services roll them out!
Which is what the last few governments have been doing.
Private companies do not have a good record running public services from the evidence so far,
Hmmm... Don't they? You hear about the failures, but not the successes.
Please list us some notablen successes in the scale of a hospital, a large service such as Probabtion, benifit assessing etc.
From my personal knowledge, blood tests for major cancer hospital, shoulder operations and general surgery, physiotherapy. And that's just my experience.
chances are they have cost the tax payer more than they saved?
Why? If the private alternative is more expensive, why do it?
I will admit that I keep thinking of the canteen services at my last place of work. The company paid all utility charges, wages, maintanence etc. etc. but the staff were "managed" by Sodexo. So they also paid a management fee and we paid a similar price for one banana as a hand of five in the local Co-op because Sodexo controlled all food sources, and pocketed the discount in their regional office. It looked like maximising profit to me, the service did not improve when the Sods took over.
You'll always pay more in a canteen than in a supermarket. And why did the company use Sodexo? So that they could get on with their business, rather than run a canteen. If they were not satisfied, then fire the company and try another. Not something you can easily do in-house.
Let's include governmental costs (extra Civil Service effort, legal fees) and compensation of any other kind;
By all means include all relevant costs. But in no other industry are you suggesting that everything should be micro managed by the state.
But I suspect we still end up paying extra for privatisation fuck-ups, which will be inevitable I feel.
And the public sector doesn't make expensive cock-ups?! How about the NHS computer system? Nuff said.
plus possible loss of jobs etc.
Jobs are great for those in them, but for everyone else, they are a cost.
Yes, jobs are a cost, we have to pay wages. But we get a service from those jobs, is that service of the most cost effective to the end user (us) if part of cost is an excess that goes into the pockets of those who did not contribute directly?
Besides questioning the idea of "not contributing directly" the answer to your question is often yes. You do not seem able to countenance that possibility. As soon as any improvement arises, you want to remove the very thing which has given rise to that improvement.
And you seem to want to preserve jobs, just for the sake of there being jobs. Even though their contribution is not required. That is, by definition, "not contributing directly" .
Remember my tale of the privatised hospital cleaning? Wages reduced, employee standards reduced, constant professional monitoring required - and still basic hygeine levels fell. So they took it back in house to protect the patients . Thus service above profit or savings - alien to the privatised world.
Yes, I remember your tale. Do you remember my explanation, Ronald Coase and his Nobel prize? Whether or not any firm provides services in-house or not is a completely separate question to whether the private sector should be involved. For example, I would fully expect a private hospital to employ its own cleaners, rather than hire another firm. They certainly wouldn't ask the state to run their cleaning services, would they? But a firm of insurance brokers, say? I would fully expect them to outsource their cleaning.
I have to admit that I do not remember your explaination, it was probably academic in nature and bore little relevance to the individual experince.
Sorry, can't help being boring.
Doesn't make it wrong, though.
Nick, the number of times your answer seem to be irrelevant, for a self coinfessed follower ofb things economic that's not so good. My mistakes vare bborn of experience and emotion I admit, but treat people like beans on the counting board and you do humanity, and Humanism, a disfavour.There has to be balance, but it is too far in the favour of the "haves" aty the moment.
Sorry, Dave, but you don't have a monopoly on what you think constitutes Humanism (not that I think it should have a capital H) I have no doubt that your heart is in the right place (with a bit of help from the NHS
) so I don't need to comment on that, but the NHS does use up billions and billions of beans, and can't function without them. So when I see a complete lack of understanding about beans, then I'll comment. Not sexy, maybe, but beans are still vital in producing the outcomes we want. You might be happy with a warm fuzzy feeling about hospitals. But that doesn't provide the best health system because too much is wasted if the system of provision is ignored.