Why the surprise over NHS Direct?
As the Independent reports on NHS Direct pulling out of providing 111 services I wonder how the government might not have seen this coming?
Probably because faith in the free market is unshakeable across government as it chooses to ignore evidence of its failure. The free market is seen by many as the only way forward to address future resourcing issues. However, the re-branding of healthcare as a commodity ignores some simple ‘free market’ truths, pointed out by the economist Adam Smith several hundred years ago; the purpose of the free market is to generate wealth for those who own the means of production, or the ‘masters of mankind’ as Smith christened them, it is not a charitable endeavour but a single-minded system driven by cash not compassion, who Smith suggested had a ‘vile maxim‘ of “all for ourselves”. The ‘masters of mankind’ in Smiths time were the merchants and manufacturers who supported policy that enabled them to make more profit, they were not concerned with how such policy and their actions might impact on others. Today the ‘masters of mankind’ appear to be companies like NHS Direct or ‘big pharma’, financial institutions and banks, insurance companies, private healthcare providers.
This really should not come as a surprise as we have already seen some of the potential problems that can arise in the marketisation of social care. At a macro level those private institutions who have already taken over some areas of care provision have been found lacking, which does not bode well for extending this strategy accross healthcare. Take, for example, HSBC who were fined £10.5 million last year for mis-selling care bonds to older people. The Financial Services Authority found unsuitable sales had been made to 87% of customers, with the average age of those who purchased bonds being 83 years of age, many of whom having already died before the scandal came to light. Whilst £10.5 million might sound a lot it’s not for a company who was recently exposed as allowing the laundering of at least 7 billion dollars of drugs money through its bank and has set aside 700 million dollars to cover fines.
The selling of care related products and services by the private sector can leave individuals vulnerable in a variety of ways, look at the doubling of the number of private care homes going bankrupt leaving older people without secure housing or care provision. Latest reports in The Independent suggests nothing had changed as the bailiffs are set to move in on some care home providers.
Arguably, the ‘free market’ is anything but ‘free’. A favourite of Mrs Thatcher, economist Friedrich Hayek compared the free market to a ‘game’ where there are winners and losers suggesting trying to regulate the market in the name of social justice was a waste of time. The current government, and opposition, appear to believe there is only one game in town when it comes to the future of our health and social care sector, they are wrong.