To Fundamentally Reform

TUESDAY, AUGUST 11, 2009

To Fundamentally Reform

"We need to fundamentally reform the way public services are delivered."

To fundamentally reform? What kind of talk is that?

I mean, we understood George had received an expensive education at one of Britain's very toppest schools. Surely a school like that doesn't have the mottoFide et Literis for nothing, does it? What would his old English master have said?

I'm afraid the Major was so appalled he was quite unable to concentrate on the rest of George's speech, and was forced to repair to the 19th hole for immediate medication.

Fortunately, Tyler is made of sterner stuff. And for the sake of understanding what had been billed as a key speech on public sector reform, he was prepared to overlook the odd grammatical infelicity.

So reformwise, what did George actually have to say?

First, he said that the coming spending cuts make fundamental public sector reform all the more important:

"Without fundamentally improving the productivity of public services, the quality of those services will deteriorate as budgets are squeezed."

Spot on - as we've blogged many times.

Second, he said Gershon-style "efficiency savings" will not do the trick:

"... to pretend that efficiency savings alone will suffice when the country is borrowing one pound for every four it is spending, is to take the public for fools. It is deeply dishonest and it condemns those who claim it to the sidelines of the real debate. The truth is that we need to fundamentally reform the way public services are delivered."

Again, spot on - as we've also blogged many times.

Third, he confirmed that Dave's government will "legislate early" to introduce those school vouchers:

"We will, as they have in Sweden, give parents the ability to take the money the education bureaucracy currently spends on their behalf and allow them to take that money to the new school they want.

...we will allow new providers to set up state schools where there is demonstrable demand from parents."

Hurrah for that.

Fourth, on the NHS, the Tories will be... umm...

"... making the case for progressive reform in health, achieving improvements through patient choice and professional autonomy, bringing productivity gains through diversity of provision and an effective roll out of payment by results."

Hmm.

And how exactly does that differ from all the good intentions we've heard over the last decade? In theory we already have patient choice and professional autonomy and diversity and payment by results. In theory.

The problem is that while Whitehall holds all the purse-strings, the theory don't add up to a row of beans.

No, if Dave and George are going to deliver "fundamental" reform in healthcare, they will need to be much more radical.

As we've blogged many times, they need to break up the lumbering dysfunctional NHS and replace it with a range of continental-style social insurers. That's theonly practical way to inject meaningful competition and customer choice, which is the only practical way to drive higher productivity.

If we're to stand any chance of preserving service standards in the face of the forthcoming spending cuts, Dave and George will have to raise their sights.

They need to boldly go where no man has gone before.

They need to explore new worlds beyond the NHS platitude zone.

PS I'm sure I've quoted it before, but I just love Raymond Chandler's famous riposte to the proof reader who attempted to unsplit one of his badly busted infinitives: "By the way, would you convey my compliments to the purist who reads your proofs and tell him or her that I write in a sort of broken-down patois which is something like the way a Swiss-waiter talks, and that when I split an infinitive, God damn it, I split it so it will remain split