Privatisation: can anyone give me an example of where it's really worked well?

I'm not sure I can see how choice would work under the proposed reforms.

As I've said before, when you're in the back of an ambulance requiring emergency care, how are you supposed to evaluate the health care providers available?

Furthermore, how does the ambulance decide which hospital to take you to? Will they be privatised too? Linked to particular hospitals even? Will they be paid per patient delivered?

When it comes to routine testing, how will choice work?

If you're suspected of having cancer, will you get to choose to have all of your tests/scans done in one location, as you can now? Or will GP's be scouring the market place looking for the best deal for each individual test in order to stretch their budgets? If that's the case, won't GP's (or someone employed by them)be spending a whole lot of that budget on comparing costs and services and the patient won't have anymore choice at all?

Himalya - I agree, it was the competition (or sometimes just the threat of it) which led to the improvement in BT.

The dramatic technology developments also meant the organisation had to cope with constant changes and some global threats.

Possibly a similar story with BA.

Wubbly - I guess the point of the article (for me anyway) is it illustrates the value of choice and accountability in improving service levels.

It is not suggesting that people in the developing world get better healthcare than we do.

jack, in terms of that article, I'm simply querying how 'better care' is measured.

For example, how do their cancer outcomes measure up.

Why does the average family visit every two weeks? That would seems excessive to me. I suppose the healthcare providers get paid for every visit, which might explain it

I agree that BT is an example of a good privatisation - mainly because technology change and regulation also meant that it went from being a natural monopoly to a player in a competative market. That is not true for example for the railways.

Chippy - I said I wasn't comparing our NHS with that of the developing world. (The article doesn't either).

Can't work out if your post is deeply ironic (in that case ) or just ill informed in that case .

Claig .

The Bae workforce would probably disagree with the term successful privatisation. Unless huge redundancies, lost contracts, SFO inevstigations and an operating loss in 4 of the last 10 years are good things.

'And comparing state provided healthcare in India and state education in Nigeria to that in the UK is ridiculous.'

exactly, everybody knows they are far superior

Jackstarb -the article you cite is a piece of off the cuff journalism and would not stand up to peer review. It cites one report (although not properly) and anecdotal evidence of a single teacher asleep in his classroom. Haqrdly a great sample. The author has departed from serious academic research into the world of media soundbites and immediacy.

Try and find some proper research to back up your opinions before passing off this piece of hack journalism as fact.

And comparing state provided healthcare in India and state education in Nigeria to that in the UK is ridiculous.

Wubbly - are you saying you don't understand why millions of the worlds poorest people choose to pay for private health care?

I thought the article was clearly written and it seems easy to understand and referenced plenty of research.

I guess the question is - who is best to decide what better care is? Some central committe or the millions of individuals who actually experience the health care.

To be fair - the last government gave it it's best, if expensive, shot. And achieved some limited success - but not enough.

I'm not defending the latest proposals - mainly, to be honest, because I can't claim to understand them fully. But IMO - in it's current form the NHS is never going to come close to meeting the needs of it's patients. And I think the significant efforts of the last government proved that.

good post wubblybubbly.

'What is 'better care'? Is this better medical outcomes, or providing a cup of coffee whilst the patient is waiting?'

classic. It would be funny, but sadly it is probably true.

jack, I read your link and I'm mystified by it.

What is 'better care'? Is this better medical outcomes, or providing a cup of coffee whilst the patient is waiting?

I have no interest in choice, none whatsoever.

Most people using the NHS are ill or elderly or both. You really think someone reeling from a cancer diagnosis or in the back of an ambulance with a heart attack has the wherewithal to start researching the pros and cons of various health providers?

Slug - I totally agree that competition is an essential requirement of the true free market. With privatised monopolies a regulator tries to simulate competition - with mixed results.

Jamtoday - did you read my earlier post and link as to why millions of poor people choose private health care over state provided health care.

It all comes down to choice and accountability. I think it is now widely recognised that public services need these features in order to drive up service levels.

I would say that health care is too important to be left to centralised bureaucrats far removed from the sharp end of provision.

Jackstarb are you saying that someone needs to oversee demand in the public services, or gaps can occur in services that people rely on?

This is exactly the point, it doesn't matter if one day there isn't a particular brand of biscuit any more, but it does matter if the local hospital goes under.

This is why everyone is worrying about the government's health policy - consortia are too small to ensure stability in provision.

And in health stability matters - looking after the nation's health isn't a game.

Thanks claig, it's a pity about my spelling though.

I no longer use British Rail
Much as I would love to take my money

agree with slug

jackstarb, that argument only works if you actually get competition. Take the case of the railways. i no longer use British Rail. I use Network South East. I have no choice in the matter as no other company runs trains on my line. Much as I would live to take my money and use another, more efficient operator, I can't.

So...prices are higher, there's little or no accountability, the service is worse, my needs and preferences are ignored by a company that has a monopoly....I'm failing to see the advantages here.

I think most people (even the last government) recognise that accountability and choice are two ingredients that give the private sector the edge over public sector delivery of services.

Much of public service design is an attempt to build these features into public service delivery. Target setting and league tables being the obvious examples.

The great thing about the free market is individuals can make their needs and preferences known by their willingness to pay.

With public services some central organisation has to estimate this demand and requirement, and control (and ration) the delivery by setting targets.

The objection to privatisation conflates two issues. The first is that private businesses tend to operate far more efficintly and effectivley than a public sector organisation. That is good thing and a key objective of privatisation is to capture the benefit to society of that economic efficiency.

Unfortunately, there is no guarantee that society as a whole will capture the benefits of economic efficiency from privatisation. This especially happens where a privatised firm is a monopoly or near monopoly. In that case, without very strict and effective regulation, the private monopoly captures the benefits and feeds it to shareholders and senior employees by extracting higher prices and lowering service quality and raising manageent pay and bonuses.

Regulation is extremely hard to get right and to some extent regulation by Govt agencies is really no better than just having the reglated firm owned by the Govt. In extreme forms of regulation such as that which imposes hard price caps and overseas and mandates investment decisions the firm has no latitude and operates as if owned by Govt.

Ahh newwave. You are what i like to call an idealist. Your ideas all would work in an ideal world. But in practice would never.

Some industries are best suited to near monopolies. Do you really want dozens of water companies all digging up the road to supply your house with water? Would that be efficient? Ok so they don't compete with each other like for example Tesco's & Asda would but they can't be very much out of step with other water companies in the UK. Plus thats what OFWAT is there for. Now you may argue OFWAT is ineffective but thats a different debate.

You start controlling prices and you take away the very freedom of the markets to set prices. Not only is it a slippery slope, who sets the price? A politician? You trust them do you? Are they experts in what it costs to supply you with water? Or would they base their decision on how many votes they'd get?

As for Tesco's being a monopoly. They have a market share of about 30%. They are competing fiercely with Asda, Sainsbury, M&S, Amazon, Morrison, Aldi, Primark. Yes they are big. But that size enables them to bring you & I prices we like to see. If you don't like them go to a competitor. You can easily do it. Therefore they are not even close as a monopoly.

So let me ask you a simple question Newwave and I will use your example.

Who do you trust more to run Tesco? David Reid/Terry Leahy.....OR George Osbourne/Ed Balls?

British Aerospace - BAE Systems was a successful privatisation. They are hugely successful.