We have discussed the strange agreement in much public debate that there are a defined number of public services which need to be in public ownership or control owing to their importance to our lives. These include the obvious ones of health and education, where it is a generally agreed fundamental that the state should pay for the care and education. There is no need for the same state involvement in water, rail travel, and electricity  where customers pay. The danger is they want monopolies in the utilities, when customer choice is crucial to higher standards, more innovation and lower prices.
Health and education are special cases. All main parties agree healthcare and schooling should be available free to anyone who needs them, so all agree the state has a big role. There remains choice and competition for those with good incomes, with some people opting to send their children to fee paying schools or to buy private healthcare despite their eligibility for the free public service. The state allows a smaller private sector to compete whilst charging patients and pupils. The state also harnesses substantial private sector involvement in these services. Both main parties have accepted all drugs are supplied to the NHS by competing companies, many for profit. Both have accepted substantial private provision of meals, cleaning and other essential services within health and education. The NHS continues with many GPs as private contractors. The large pharmacy based sector provides healthcare for profit for more minor aliments.Labour introduced the idea of the NHS buying in medical capacity from private hospitals and clinics.
The other ones on the list of those who think the state should own or run them are all privatised utilities where customers have always paid all or most of the bills for what they use. Instead of offering everyone free or subsidised water or electricity, money is given to those on lower incomes to help them afford these bills for essential needs.  There are competitors to many of these offerings. Rail travel faces formidable competition from road and air travel with much larger private involvement. Competition was deliberately built into the privatised models for telecoms and energy, to provide more forces for innovation and better prices. Water was not given so much competitive challenge which has lessened the favourable impact of privatistion. Some say these are natural monopolies.
The truth is there is no natural monopoly. It is easy to have competing producers of electricity. You can run competing trains on different lines – west coast and east coast  to Scotland for example – and you can use a regulator to ensure train pathway allocations over fixed track for competing services in many places. You can let competing water companies gain access to common pipes, as oil and gas suppliers share pipes for some of their deliveries.
Competition puts the customer in charge. It drives innovation and productivity improvements and forces companies to deliver high quality services. Monopoly does not create the same benign pressures and leads to everyone blaming the government that owns them for poor performance and poor quality.Instead of calling for further nationalisation of water or rail those who want better service and more provision should  call for more competition.
August 4, 2023
Good morning.
Monopoly:
Can you give examples where this is in practice ?
I tend to draw the line at water ownership, not for political or ideological reasons, but on grounds of health. We can go without food for quite a number of days but, try going without water and you will soon become very ill. We also need to look at sanitation and water treatment, all very vital to health. We need security of supply and be safe in the knowledge that the water we drink and use is as safe as possible.
So I do not agree, and have never agreed with our kind host on this issue. The State must own all the water infrastructure but may allow private companies to run and maintain it, but that really is as far as it should go.
Reply There is limited competition already, with large users allowed to draw water from sources not controlled by the main provider in Scotland, and the inset agreements for cross border provision between regional monopolies.
August 4, 2023
Well you can have systems with competition even in water but regulators usually conspire with the regulated to rob bill payers and/or tax payers.
Witness the FCA under Bailey and the 40% for all personal overdrafts racket/cartel.
Of course any competition is largely killed by (taxed to death up front) then free at the point of use (usually delays and rationing) as with the NHS, state schools, universities, the BBC⊠also hugely rigged markets in energy, banking, housing, transport, healthcare, education, broadcasting, water⊠How can you compete with the NHS much if you customers are forced to pay for the NHS, then even 12% IPT tax on all medical (and other) insurance.
August 4, 2023
Over 50 s told to work because Uni party have wrecked the economy after being in govt for 14 years!! Illegal immigrants four star hotels free health etc while over 50 s, who paid tax all their lives, told to be a delivery driver. Y govt minister, to pay more taxes for govt reckless wasteful spending!! Sunak and all uni party idiot ministers, Stop spending!
How about cut the state, use the 91,000 to go to private sector, stop low paid u skilful mass immigration and grow the economy. Start by sacking Sunak and Hunt, followed by Bailey! Undo all Blaire legislative or policy changes, anything introduced by Blaire change. Get rid of All EU laws, regs and directives. UK voted leave not technical leave but hamstrung by EU to be less competitive! Public vote Reform uni party are not for changing. 14 years and three elections and two coups prove it.
August 4, 2023
Economy is caught in a trap say Chancellor Jeremy Hunt (PPE again).
A trap set by whom Jeremy? Might it be ex- Chancellor Rishi Sunak (PPE) and Andrew Bailey (history) mainly by QE, pointless lockdowns, vast over taxation, road blocking, net zero, the vast net harm vaccines especially for the young, massive government waste (eat out to help out, test and trace, millions of duff worthless degrees, HS2, Covid loans, furlough, the appalling inefficiency of the police, NHS and almost all the dire public servicesâŠ
August 4, 2023
Couldn’t agree more
August 4, 2023
In recent years competition between energy suppliers allowed chancers into the market.
â Since July 2021, 29 energy suppliers have failed, affecting around 4 million households. Customers have been left to pay the ÂŁ2.7 billion cost of supplier failures. This means an extra ÂŁ94 per household, a cost that will very likely increase.13 Nov 2022â
Regulators never work. They are staffed by second raters and deadbeats. Government can lean on them to suppress embarrassing outcomes ( as in defence contracts and bribery).
Railway competition is totally artificial. It is just a franchise to run a service for as long as it suits the franchisee or the government. Huge subsidy is required to attract franchises. There is no incentive for improvement.
August 4, 2023
Indeed regulators very rarely do their jobs properly, very often conspiring against the interests of the consumers and the tax payers they should be protecting.
August 4, 2023
LL :
Agreed.
And no-one is ever sacked for poor performance.
August 6, 2023
Yes FCA is a national disgrace
August 4, 2023
reply to reply
Water infrastructure is both very large and expensive to run and maintain. This requires considerable investment, investment that can only be recouped over a long period of time. If you do not guarantee these people a certain level of return over a long period they will not invest.
Large reservoirs, sewage treatment plants and so on require planning permission and large land area, all of which given our governments current desire to concrete all over the place, restricts such investment.
These would be investors are working against government whereas government can only work against itself.
August 4, 2023
Spellman made clear in 2010 EU directive on environment would not allow new reservoirs!! EU wanted to stop leaks and let rivers flood! Somerset knew this all too well.
August 4, 2023
Didn’t the Tories come to power in 2010
August 4, 2023
Mark
Agree Water is a basic essential of life, and too important to put into private hands, it requires National management, planning of supply, with a comprehensive distribution network.
The only exception would be the possible construction and management of desalination plants, where water can be “Manufactured”
August 4, 2023
We wouldn’t need to worry about reservoirs etc. if there was a national grid. This country has enough water, but usually not where it is needed. They would do it for oil if needed, but not for a more basic need like water. They make huge profits, but it mostly goes abroad, not invested here very much and of course their stock falls from the sky at zero cost. Just needs a cleanup and pumping to customers. Billions have been milked from us over the last 30 years. They still rely on Victorian pipes and sewers, that’s how much they invest. Thank God for the Victorians, if left to modern government and business, we would all be drilling for it in our back gardens and using bucket and chuck it for sewage. It was much cheaper before privatisation, and who can say the quality and quantity is now superior? Of course there is no competition – SJR is clutching at straws when he says there is with a very weak argument. Where else can I get my water as a domestic customer?
August 4, 2023
Water needs to be mutualised, where the company is owned by the customers and employees.
Neither privatisation nor nationalisation models work properly.
The trouble with this system is that it violates the dogmas of both the Labour and Conservative parties.
August 4, 2023
This is something I agree with. As, Peter Wood points out below, private investors are only in it to make money, and as quickly as possible. A Nationalised industry can be heavily unionised and politicised leading to party politics much like we see with the NHS.
A business owned by its workforce is probably a better option as the owner have a vested interest in the business over and above than just making a profit, and they are not part of the State and so have little or no political interference.
August 4, 2023
Dear Mark B, mutuals or semi-mutuals such as the Co-op, Nationwide Buidng Society and John Lewis can be good at running service businesses but are not suited to industries such as water, sewage or North Sea oil and gas that require heavy capital investment in infra structure.
Prior to privatisation of the (investment-starved) state water and sewage authorities there were about a dozen heritage Statutory Water Companies that supplied drinking water only and were never nationalised.
They were financed by preference shares and debentures and had a right to levy water rates to cover costs and return on capital, but returned any surplus over that through lower bills.
Though attractive in some ways they were not used as a model for privatisation because they had no incentive to cut costs of service or, particularly, infrastructure projects. That proved crucial at a time when the industry faced an unprecedented capital programme to make up for decades of neglect in th public sector.
August 5, 2023
Scotland still has water and sewerage u dear their control and the bill is not an add like here, but still part of the community charge!! Quality is better than ours we are told!
In 1997 BlIre created Environment Agency. We had no cut to community charge for the work the EA released them from. Now we pay for the EA and add ons for the work they were meant to deliver on!! Ie flood defence. Why has the EA not had it budget top sliced and given to LAs who have taken back their work!! Useless Tory ministers! How many times do we pay for adult social care!! Tories were going g to sort this out. Instead they gave us more taxes for the same issue without any change! Party of high tax, big govt and wasteful spending.
August 4, 2023
Indeed. The TFL model where private companies compete for contracts to provide delivery of services, maintenance etc., is entirely appropriate for water. The national rail network would be better served by changing to such a model as well. People travelling around the TFL network are using the services of multiple private companies but don’t have to deal with the complexities of being exposed to having to deal with all of them separately and individually.
Having stood on the platform at Stoke-on-Trent station and listened to the complexity of announcements about which tickets were valid and not valid for each of the services to Manchester (there are 3 different companies who run trains between those two locations), it doesn’t make things better for us as consumers, it makes it more complex, more difficult, and more likely to fall foul of fines.
As a rail user, I just want to be able to purchase a ticket to get from A to B and use the next train to get there. I don’t want to have to deal with tickets from multiple different companies, work out which one I want to buy from, be stuck on the platform waiting for a train while other trains going to the same destination go through, but I can’t use them because I’ve got a ticket from the wrong company.
August 4, 2023
Does Manchester draw water from Scotland?
August 4, 2023
No, but Liverpool is supplied from Lake Vrnwy in Wales.
August 4, 2023
Thames Water is a case study for Business Studies students of how a ‘natural monopoly’ should not be transferred to private ownership. Quite simply, the “fast buck” objectives of the private sector are not compatible with a multi-century capital investment project.
August 4, 2023
Agreed.
August 4, 2023
PW :
The regulator was not doing its job.
August 5, 2023
Yes Sir John there are natural monopolies though artificial competition may be shoe-horned in . For instance I have used my own well water and in-garden sewage treatment for decades.
As a general proposition, the higher infrastructure costs are as a percentage of total costs the nearer a business is to natural monopoly.- eg the Humber Bridge, Dartford Tunnel and Eurotunnel.
In almost all the cases you cite, the infrastructure was built by companies so that could sell their product. This infrastructure would not otherwise exist. Gas pipes, local power networks and rail lines were hived off from the companies that built them at or after privatisation to create competition that did not naturally exist. I am surprised, given several of your telling posts, that you think Network Rail a model solution.
Unlike electricity, drinking water from different sources is not homogenous . Nor, as we have learnt after recent storms, is sewage discharge.
Mains water and sewage treatment is therefore natural monopoly. And a regulated private monopoly almost always serves customers better than a state monopoly. Just look how so many local authorities are abusing their monopoly ownership of roads – granted, as I recall, by a Conservative government.
August 7, 2023
Good morning.
Sir John
Further from above I would like to take the opportunity to direct you to the Conservative Woman website and an article recently published there on water in Kent. You do not have to publish it but I would be grateful if you could take the time to read it.
Many thanks
https://www.conservativewoman.co.uk/something-stinks-on-broadstairs-beach/
August 4, 2023
Competition competes, resulting in the best succeeding and the worst falling out of existence: Unless useless government prefers the worst and props it up. This one often does.
August 4, 2023
Thirteen years of Conservative rule have given us a broken railway system, pot holes in all our roads, sewage in our rivers and prices going through the roof. Do forgive me, but I think this country is not in need of Conservative MPs pontificating on how to govern this country. You have had your chance.
August 4, 2023
@ Lemming – Indeed, although recognize that Sir John is atypical of Conservative MPs and had he been listened to by those in government over those years we would all be appreciably better off now.
What is demoralizing is that the prospects for the next thirteen years are much the same as we have seen over the last.
August 4, 2023
Correct â doing the same exercise expecting a different outcome is madness
August 4, 2023
Potholes are local council other than Highways and you don’t see many potholes left for long on Motorways. Check out Labour councils on their pothole repairs. I think it will soon become clear all are failing. It seems our councillors think they’re speculative investors instead of doing what they should do with our council taxes.
August 4, 2023
Doesn’t funding for net-zero cycle lanes trump funding for pot hole repairs
August 5, 2023
Yes, youâre probably right glen. The problem is they never send the lane cleaner along cycle lane so when they get overgrown, dirty and debris on them the cyclists cycle on the bypass and block the cars anyway!
Our local highways has got a lot worse since the change of control. Everyone is moaning about it, the wilding is a mess all along our high street, it just looks like a load of 4ft dying weeds.
August 4, 2023
How about introducing competition in heath and education? Measure how well schools and hospitals deal with their customers and award bonuses to the staff in top spots. I was PTA chair of Weaverham School, who spent the least money on admin services. WE also ran an Appeal Trust scheme, where parents contributed to extra spending, like astro tennis courts. The school staff should have been rewarded.
August 4, 2023
Yes, Health and Education could benefit from competition, since it is the individual that receives the service, then the individual should have a choice from a variety of suppliers, where the barrier to entry is not extreme.
Why not look at the NHS as an insurance facility only, allowing the health industry to set up and provide facilities and services that the population wants, can select, and pay for by claiming from the NHS insurer? Hospital facilities could specialise and streamline and behave like a corporation, attracting the best talent and thriving or falling based on health outcomes/reputation. Profitability, as seen in the Mayo Clinic, could be limited. Make the NHS Trusts compete!
Education on similar lines.
August 4, 2023
Trouble is with the NHS, if it was run purely for profit, you would have to forego A&E, intensive care, emergency ambulances for a start. We have private hospitals etc. which do none of those things because they can’t make money out of it. Do you think they wouldn’t do it if they could make a killing? They mostly just want routine elective procedures, with their mistakes ending up in the NHS. I wouldn’t trust insurance companies either, they only like collecting premiums, not paying out. For instance, at my advanced age, as it gets nearer to paying out, my life insurance policies get more expensive and the payout less and less. One of these days I will have to consider if it is worthwhile paying out the ever increasing premiums or cashing in. Get old, with a big problem and the insurance won’t pay out, I’m quite sure of that.
August 4, 2023
A lot more privatisation could be introduced into health. That could include self-mutilation (I’m not required to pay for someone to have a tattoo or their ears pierced, so why should I chip in when a man wants surgery to look like a woman?), and the consequences of lifestyle diseases. Perhaps if everyone had to pay for their old age care they would take more care of their bodies when young. Why do I have to support elderly in care homes, when they have squandered all their money on drink, drugs, gambling and tobacco? Now that everyone has to have a pension scheme by law, let them use their 25% tax free allowance to buy care home insurance – and get rid of IPT.
August 4, 2023
You can be requires to pay taxes for other peopleâs tattoos to be removed though and for otherâs pointless plastic surgery ops.
August 4, 2023
” Why do I have to support elderly in care homes, when they have squandered all their money on drink, drugs, gambling and tobacco? ”
In fairness Dave I gave up smoking years ago – it’s the Whiskey and Wild, Wild Women I’m struggling with…
August 4, 2023
Tony
I simply cannot understand why, when people want to use a private service, and remove themselves from the State cost of education and health care, they are then financially penalised for doing so.
Given we already have extensive waiting lists for health care, and very often a choice of local schools, surely it would make sense to encourage people to use non government funded organisations, as long as they exceed the guidelines on performance.
Clearly the government is failing on both of these basic provisions, so reducing the demand on the system is surely a no brainer, and should be encouraged !.
August 4, 2023
I agree Tony.
August 4, 2023
On the subject of health and education, where Sir John admits that there are very limited private sectors available to those who can afford to both subside the sub-standard State offering AND pay for a superior private service:
These are obvious examples of a wealthy elite (you might be forgiven for identifying the wealthy Establishment) looking after its own interests. They can afford to pay for the limited but superior private healthcare; they can afford to send their children to superior private educational establishments. And they’ve effectively made sure that they aren’t infiltrated by the “peasants.”
The playing field could be levelled by a voucher system which has been muttered about occasionally, but never seriously considered. The voucher-holder would then have the ability to select the school (or hospital) which they believe suits their/their children’s circumstances.
Instead the Establishment deliberately restricts choice for everyone except the seriously wealthy and the Old Boys’ System is protected.
August 4, 2023
Indeed with health care this has even got far worse, you used to get tax and NI relief on private company and other medical insurance premiums (under Thatcher) and now you also have to pay 12% IPT on top. If the foolish socialists like Gove and Starmer get their way we will have 20% vat on private school fees too.
So then you pay four times over. Once in taxes, then more taxes on the extra you need to earn to pay the medical insurance or school fees, then the fees or insurance premium and then 12% IPT tax (or VAT if Starmer get in) on top. A totally rigged anti-competitive market.
August 4, 2023
That is a political matter, nothing to do with the NHS. Don’t keep voting for those who impose it all if you don’t like it. Next year may be our last chance to change things with a new party. After that, I’m afraid it will be all over. No-one is going to keep trying to form new parties and being knocked back by a corrupt voting system forever. A new party, previously, 4 million votes, one MP, old parties with very low support hundreds of MP’s and become government.
August 4, 2023
Why shouldnât the rich spend their money as they wish and leave publicly funded ( by ALL tax payers) resources free for those with less earning capacity? Allow more private establishments not fewer.
I always think that the levelling up argument is an admission that the NHS and state education are rubbish.
Which of course after years of book cooking and socialist policyâŠthey are!
We only have limited numbers of âprivateâ now because many private schools and clinics, nursing homes etc were âdone away withâ through state regulation.
August 4, 2023
I’m quite happy with the rich spending their money as they wish. What I’m not happy about is a system which is deliberately rigged to ensure that they get exclusive access to private sector health and education – and which also ensures that the State Sector available to the rest of the less wealthy population doesn’t improve because it’s a “take what you’re given and be grateful” system. A voucher system which allowed patients/parents to “shop around” for the best State provision and which could be topped up with their own money to access the private sector would improve overall provision.
August 4, 2023
Simple.
Cut regulations and go back to a system where there were plenty of affordable ( even for the middling sort of person) private healthcare and education. Rather than dumbing everything down to a totally worthless level.
Comprehensive education, designed to destroy grammars is a good example of this. The NHS is another.
It is the politics of envy red in tooth and claw and nobody benefits in the end.
August 4, 2023
The private sector in Health was snatched away by the State during âthe pandemicâ. Nothing is safe from the state.
August 4, 2023
It seems even Tony Blair is slowly & belatedly realising that Net Zero is economic, electoral and scientific lunacy.
David Frost today:- The eco-cultistsâ war against the car is built on fantasy and delusion.
No, people donât drive because public transport is poor, and cycling is a rich manâs faddish luxury
So Mr Mel Stride how many oldies have to do a takeaway Deliveroo shift each day to pay enough taxes to HMRC for one boat migrantâs hotel, legal and other bills (for just a day)? I estimate about 20 of them. This winter will these 20 oldies be able to afford to put their heating on and eat when they get back home after their night shift? Not something the illegal migrants they are paying for will have to worry about I suppose.
August 4, 2023
So Khan has increased payments from his scrappage scheme. But why on earth pay people to scrap perfectly good vehicles. Manufacturing the new cars causes more CO2 and more pollution anyway especially if they choose electric cars or vans. EVs are more emissions but just elsewhere vehicles.
Even if there is any different in emissions per mile for the new vehicle it is usually totally trivial, this especially for people who do not drive very much anyway.
August 4, 2023
LL :
Correct.
And how much of London’s above ground air particulates come from the extraction of the air from the Underground tunnels?
August 4, 2023
Errr, none? I know down there it smells a bit funny but the tube trains are all electric. No particulates?
August 5, 2023
MW :
The Guardian :
“App reveals most polluted London Underground routes to travel on”
https://www.theguardian.com/environment/2023/jan/21/phone-monitor-helps-london-tube-passengers-avoid-polluted-routes
August 4, 2023
Of course, those people offering such inane advice have no worry, with their parliamentary and ministerial salaries, payouts when they get the sack by voters and of course pensions we could only dream of. Out of touch with reality goes nowhere near describing such idiocy.
August 4, 2023
John
No one party has done more to collectivise and politicise our society than your party in government and the reason is simple, appeasement of a more powerful political enemy.
Unions and Labour and their progressive outriders now control vast swathes of the public sector (a pure politicised monopoly) and run them like fiefdoms whose employees are chosen according to race, gender and sexuality ie purge white, hetero male.
The private sector shackled by ESG Socialism act like Stasi insiders ie Natwest and other banks using access to financial services to force compliance
The grip of the left has never been as great as it it today. An admittance of this and an admission that John’s party is partly to blame for this would be most welcome so that those who can reverse this trend ie Tory party, can start doing so
John, we know what your party’s become and we know why it has become what it is today. You yourself are utterly captured and that cannot be very pleasant. The Left now dictate the parameters of debate and Tory MPs adhere to it and sacrifice the civil space in the process
August 4, 2023
DOM, ++++++++. Even the best are neutered by party discipline
August 4, 2023
DOM, ++++++++. Even the best are neutered by party discipline.
August 4, 2023
+ 1
It is the Not-a-Conservative-Party’s treachery (over the EU) and utter cowardice in dealing with left-wing extremists which has created the mess this country is now in.
August 4, 2023
It’s only a matter of time before the Falklands is handed over to Argentina. The Equalities and Diversity officer will soon be in place and then all they need is a couple of Argentinians to take up residence.
As with all large organisations and corporations – they are now ruled by Diversity and Equality officers fresh from the most militant university courses.
August 4, 2023
The point of the mastectomy cartoon on the Costa vans was not to display virtue to the public but to signal to the employees and bosses of Costa that the Left are in charge.
Tow the Leftist line or you will be sacked.
This is how they’ve captured the capitalist West.
August 4, 2023
LBT :
Correct.
And to the customers, who won’t be served, and possibly forcibly evicted, if they do not tow the line.
August 4, 2023
@DOM +1 sums up the ability of the HoC to take on the job it is paid to do.
August 4, 2023
Dom :
Unfortunately you are correct.
August 4, 2023
Food is essential to our lives but nobody in their right mind would want the government to run supermarkets.
August 4, 2023
Same should be said of the NHS. It’s so poor that NOBODY copies it.
August 4, 2023
Nor to run much else beyond perhaps defence and law and order, but they are rather useless at those too in the UK. Aircraft carriers that do not work and no aircraft. Also, for example, shoplifting is up 30%+ due to a total failure to bother to attend, prosecute and deter. Similar for many other crimes too.
August 4, 2023
I think the govt. is having a pretty good try considering how it disabled the small shop competition during the scamdemic and introduced virtual rationing.
To what extent is govt. run by supermarket magnetsâŠsitting on various boards etc?
Plus I daresay we still implement much EU legislation regarding food.
We have actually lost control of our own nutrition.
My Mother in Law always said that we eat what it suits the govt. ( and their supermarket pals)to promote.
Surplus of corn syrup? Bung it in everything and claim low fat eating is the way to go.
World prices in sugar soar so bars become smaller and less sweet â For our own goodâ.
August 4, 2023
Or farms!
August 4, 2023
Wait until the WEF sets up its proposed 4 food hubs and controls the World food supply. You will be queuing up weekly outside your local bug-gery for your 200g ration of mealworms and paying for the privilege.
August 4, 2023
Surely lack of competition has increased the cost of private health care and education?
The NHS has its fingers in too many pies yet claims lack of money.
Education has become indoctrination by less qualified persons.
âGoing privateâ, as many used to, takes pressure off state-run horrors and gives poorer people a better chance.
Marxism is never kind.
August 4, 2023
âNot kindâ? It is pure evil and a disaster for almost everyone but some crooked politicians!
August 4, 2023
Agreed. It is indeed the very essence of evil.
I used the word âkindâ because many people are seduced by socialist promises of care (kindness) like the âcradle to graveâ stuff.
However, as we know, it is actually all about control and the power thus derived.
August 4, 2023
Sorry, but how could that work? For practical reasons there can only be one national grid. If Company A has a coal fired power station they might be able to produce electricity at a profit for X pence per kw/hr. Company B with a nuclear power station might need X + 5 pence per kw/hr to be profitable. Who would buy from Company B? But Company B cannot produce enough
electricity for everyone. It makes no sense.
The same is true for water. And sewage treatment. And gas. And telecoms. We might have notional different âsuppliersâ but they are not always âproducersâ. Open reach owns and operates the phone/broadband network.
There might be competition in, say, the extraction of oil and itâs conversion to petrol and itâs distribution to a pump near you. Funny how the price difference between petrol stations near to each other is only ever a couple of pence per litre.
reply There has been competition between different generators for many years, with the added complexity now of giving priority to renewables when bidding to supply
August 4, 2023
MW :
Sir John is correct regarding electricity.
Different forms of electricity generation perform different jobs.
Are renewables, wind and solar power, supplied by single company?
And who supplies the electricity when the wind isn’t blowing and the sun isn’t shining?
Or, do you believe, like the DESNZ, that when this happens when they have decarbonised our electricity in 2035 we just have to accept DSR (demand side response = rolling blackouts)?
August 5, 2023
Reply to reply. So, why canât I buy my electricity from whoever the cheapest supplier is? Because, by definition, everyone would want their electricity supplied by that supplier and they could not supply everyone. If they could, theyâd have a monopoly!
August 5, 2023
MW :
Firstly, electricity prices are not constant. See the National Grid website which shows wholesale prices :
https://grid.iamkate.com/
As I write, renewables are providing only 20% of demand according to this National Grid website.
The 28 GW of installed wind power is providing just 3.13 GW and 14 GW of installed solar power is providing just 1.47 GW.
Gas is providing 11 GW or 46% of demand and it would be a lot more if we weren’t importing electricity (7.3 GW) which certainly cannot be counted upon as “secure”.
So, today, would you like your electricity to come from a renewables supplier or a gas supplier or a mixture of both?
August 4, 2023
âIt is easy to have competing producers of electricityâ Not when the providers all work to OfGen maximum charge – that’s a Contradiction.
A bit like Universities all charging students top price regardless of the quality of the University or the Degree.
August 4, 2023
I recently required to jump on the train from Wokingham to Waterloo, not an unusual route. As I am no longer a regular user I need a one off return ticket, then buying into all the hype about ticket offices closing down I headed on-line to make a purchase. The theory then all fell apart, Wokingham â Waterloo was to take 2 or 3 changes, some going via reading, others via Guildford â none direct. Yet there are no problems on the direct line? Then of course booking on-line required a ÂŁ1.50 booking charge.
In the end I walked into the Station bought a ticket, situation resolved.
South West trains is the only service on that route -customer choice?
âYou can run competing trains on different lines â west coast and east coast  to Scotland for exampleâ That’s not competition, one route will take you were you want to go in Scotland the other to a different part of Scotland, you are then faced with additional journeys to get to your destination
August 5, 2023
Ian B – how much did your ticket cost?
August 4, 2023
Sir John
I am slightly at odds with your thinking on the NHS. A Universal compulsory Insurance has been shown to work infinitely better than the Worlds Largest monolith of an employer at delivering customer service. The money then does chase the service, something that is impossible with say water or even the railways.
NHS is such a massive, excessively massive service, the parts that are good and excellent are downgraded by the areas that are shoddy, political and Woke.
August 4, 2023
Competition works best when we choose products or services on a retail basis, deciding what to buy instantly instead of having to tender for them. Think buying a new bathroom, compared with finding someone to fit it.
As the first option, public services should be organised based on providing retail choices for consumers.
If this is not possible, public procurement comes into play. Here the U.K. needs to do better, especially compared with our neighbours on the continent (despite having the same procurement rules). The reasons for our poor performance are:
a) We set up our industry structures on a monopoly basis. Monopolies work for governments as they get quick short-term results, but unfortunately, they do not work out long-term for consumers. They are great for bureaucrats, and company shareholders also love them as they deliver a steady income stream.
b) The tendering terms and conditions are over-specified and over-prescriptive, leaving little space for supplier innovation.
c) Weak government commercial teams need to be more hard-edged with their suppliers. They are often more interested in boasting about the number of jobs they have created or having good supplier relationships instead of getting a good deal for the taxpayer.
So, yes, competition is essential, but so is getting the best type of competition and getting it to work effectively.
August 4, 2023
Sir John wrote: ‘customer choice is crucial to higher standards, more innovation and lower prices’
Which is what’s lacking in education.âWhen there’s a big Government supplier, as in health and education, private offerings have to find a niche rather than be able to compete head on and this prevents economies of scale forcing them to the expensive end of the market.
Education lacks innovation.âThe state is still pushing the Prussian model of learning the same wide range of topics in ever greater detail year after year.âAlternatives have long been suggested.âA 1947 speech to educationalists by novelist Dorothy L. Sayers, by day an Oxford medievalist, explained the system which saw fourteen-year-olds start university: ‘The lost tools of learning’, https://gbt.org/text/sayers.html It recognises a child goes through stages and the education should match, e.g. learning nursery rhymes and songs, or trying to find a flaw in authority and answering back.
Home schooling is growing in the USA where the department for state education says 50% haven’t got the reading age of 12 by the time they leave school.âDominic Frisby took a son out of an English school and got ‘home’ tutors over the Internet to finish the schooling and gain entry to university.âHopefully the Internet will help undermine state-school attendance by providing better education, more cheaply, to individuals or small home-schooling groups.
âWith fundamental educational reform being both difficult and requiring years to show end results in a better educated population entering adulthood, it is politically much more expedient for elected officials to demonstrate immediate âconcernâ for education by voting to spend increasing amounts of the taxpayersâ money on it, even if that leads only to more expensive incompetence in more showy buildings.â â Thomas Sowell, Basic Economics: a common-sense guide to the economy, 5th edition.â(An excellent book.)
August 4, 2023
Competition is often an illusion. The domestic banking in the UK is a cabal. It is ripe for real competition which is blocked I suspect by a cosy arrangement between banks, government and the BoE. The way in which customers are excommunicated strongly points to comprehensive collusion in which through their inaction the FCA play their part.
Health and education are paid for twice by users of the private sector. Users should be able to offset the cost against tax. However I strongly believe that both should largely state run and “Free” at the point of need and use. How they decide to contract various aspects of their service should be down to them. Free meaning out of tax which is only free to those who pay no tax.
I think we should have national grids for water, electricity, gas, and liquid fuel. The suppliers should contract with the manufacturers and the grid to get the commodity to the end user. At present it is none existent for water, inadequate for future planned demand for electricity, seemingly working for gas, and liquid fuel for aviation. However the financial lottery between extraction/creation, largely in incompetent pseudo religious government hands, leads to UK users paying world leading prices.
In transport the competition should be between road, rail, air and be market led, not government fiddled with or subsidised to satisfy vested interests. At present road is grotesquely over taxed and unddd provided, rail is under used over manned and over subsidised, air is very effective intercity but currently short on facilities and politically unpopular.
Everything above suggests that government isn’t much use at doing anything, so better reduce its involvement drastically and leave it to the market everwhere possible.
August 4, 2023
As I understand it the state heavily subsidises the training of doctors who then can work in the private sector in UK or emigrate. This is not a fair funding system.
August 4, 2023
âcustomer choice is crucial to higher standards, more innovation and lower prices.â
Where that cannot be achieved, efficiently and effectively there needs to be another model. Water comes to mind but is not the exception.
The UKâs water infrastructure is largely as a result of taxpayer funding to create it, the private entities now running them now own the infrastructure â not the taxpayer. We have a couple of water companies that have focused on paying dividend and not growing facilities to meet the demand of the UKâs population explosion. It will be the taxpayer still on the hook, not those that can walk away.
It may have been more logical for the private water companies just being licenced/contracted to run the service, with the fear of revocation held over them, without them attaining infrastructure ownership. But it still doesnât get customer choice into the system. I donât really have the answer but as it stands the way they are run for the consumer fails.
We have in the UK very weak regulators, particularly when it comes to protecting the consumer. They appear to protect the industry, foster monopolies while not being responsible or accountable themselves.
August 4, 2023
If large essential utility’s like water and transportation are owned by PLC ‘s or in otyerwise private ownership for instance then laws should be made to ban the practice of paying out dividends. Profitx should be put back into the business and Ownership should be on a buy and sell of shares basis only – let’s test this idea that ownership of essentials is a very noble and patriotic way of doing things and that competion works.
August 4, 2023
Current ULEZ London income is ÂŁ224M. If TFL gave ÂŁ5000 scrappage allowance per none compliant vehicle it would replace 44800 vehicles. I have no idea how many none compliant vehicles owned by fringe London dwellers have to travel into the new or existing ULEZ zone, but if they could prove they have to they could take prescedence over day trippers from outside.
August 4, 2023
âThese include the obvious ones of health and education, where it is a generally agreed fundamental that the state should pay for the care and education.â
There is a big difference in how they are funded, to how the user attains the service and who gets to run the service. Can there be real competition? Should be the only question
Money has to be created, so Governments reach for the Taxpayer â Why. That is why the Government is negotiating on the wages and not the Trusts. How about a National Health Insurance(NHI) compulsorily paid, it may be splitting hairs but at least it identifies the reason for the payment.
Privatisation is about putting the Consumer in Charge not the Government.
This Conservative Government keeps running around looking for jobs, jobs they canât cope with or do.
August 4, 2023
It would be nice to have some competition on the house of lords ….maybe if they where all elected by fair competition of their ability and consumer choice
August 4, 2023
Whilst I accept the case for taxpayer funded education and healthcare, I do not accept the case for government provision. If the state provided everyone with the money to fund health insurance everyone could then shop around for the best deal. Similarly with education. We would get better and cheaper provision of both and nobody would be priced out.
August 4, 2023
The customer is not in charge or we would have more control over people who run trains, water, etc. Government must have a part in the control process by acts or conditions on companies or they run wild just for profit. Moral responsibility must come into play with people who seem to have had no moral/principles in their basic training today. Foreign owners live by different rules to ours which is another problem which needs addressing.
August 4, 2023
Another day of zero people in boats ‘without permission’ according to the administration.
https://www.gov.uk/government/publications/migrants-detected-crossing-the-english-channel-in-small-boats/migrants-detected-crossing-the-english-channel-in-small-boats-last-7-days
So where are they being let in? Through Ireland and across the Irish Sea or into Northern Ireland and ditto, or by air into what was Britain? Or have they been reclassified as ‘having permission’?
August 4, 2023
Donât forget, ferries, lorries, car boots etc âŠSunak pledged to stop the boats âŠ.and to be clear he said that heâd stop the small boats, he didnât say anything about illegal immigrants
August 4, 2023
glen cullen :
And the PM didn’t define what he meant by a “small boat”. Perhaps the 50+ arriving on a single boat is no longer described as “small”?
August 4, 2023
Dear Sir John,
I think you view is based on ideology rather than what is possible and strategically necessary for security from outside (non-UK) control and influence.
Without Water, Gas and Electricity there is no Education or Health.
The NHS is not free we pay for it in our Taxes. Nothing is free.
People say the Government is not spending enough on this or that.
The Government has no money only the taxes we pay or the debit the Government chalks up on our, and future generations behalf to pay off.
There is no reason why people working for Government should not be subjected to the same terms and conditions as those in the private sector. Why do MP get a rise when others do not ?
August 4, 2023
Competition is a basic ingredient of democracy – customer choice is always vital . Years ago Sir William Armstrong when was Head of the Civil Service recognised the need to change how the Civil Service was run and he introduced a system of Manager exchange with the Private Sector in order to change things – this approach was also followed by his successor . The exchange condition existed for many years and was still active up to the time I retired ( 1988 ).
August 4, 2023
We are not a very balanced Country. Councils like to put a majority of social housing and affordable housing in one town in their County, allowing other towns to take a much smaller %; this then imbalances public service provision as well-heeled areas can pay top-ups into state schools and hospitals appear to be better run in areas with lower social deprivation.
Why not do the stats, and start to balance up? No town with more than 20% social and affordable housing provision; how many would fail that one? I hadn’t realised hospital catering was private. I would love to compare them with a truly private external large-scale catering operation, say a big hotel that gives everyone meals within their room charge. Perhaps each hospital should have a private catering kitchen where the public can pay extra and choose their meals from a short three-menu set choice; hospital visitors could also go to eat there, a portion of the money then saved would improve hospital meals for everyone else.
August 4, 2023
Give parents a voucher for schools & over time only the better schools will survive & attract pupils. Then children may be taught properly & have none of the nonsense about white privilege or Critical Race Theory taught. That would inject some competition into schools & give parents a lot more control.
But how to do that in the Civil Service? Why has the number of CS gone up in the last 12 months? The only way to improve standards & inject some competition is to reduce the numbers drastically, & sack poor performers. For example, whoever is in charge of the PM’s security should be sacked, but they won’t be.
When Andrew Bailey is sacked, I might believe the Government wants to improve things, but I am not holding my breath.
August 4, 2023
KfL :
Agreed.
August 4, 2023
Close the NHS and re-model it upon the Swiss or French model. Make access available only to those with a National Insurance number.
August 4, 2023
MWB :
The Swiss model we need to copy is their ability to allow referendums on big decisions.
We’re in desperate need for a referendum on our unilateral drive to the economy destroying Net Zero.
Read the UK Fires “Absolute Zero” government funded report for a description of life in 2050.
August 4, 2023
Sir John,
State monopoly and lack of competition has resulted in the financial black hole that is HS2.
August 4, 2023
Hasn’t this government cancelled HS2 yet
August 4, 2023
I am in profound disagreement with your premise. Having every British props on health and education paid for is not the same as providing it.
State provision has degraded education to the point that Iâm afraid our young people will be unable to hold their place in the world.
The State has allocated ÂŁ87 billion (yes BILLION) for clinical negligence. Is this not evidence that it is incapable of delivering quality healthcare?
August 4, 2023
I think there is a case for national ownership of water infrastructure. You and many others point out how bad the water board was in the past – fine, shouldn’t do it that way again.
Private companies and (very often foreign) private investors will always seek to extract maximum profit at any cost, even the cost of poisoning habitats and harming the health and well being of the population, for which they care nothing.
As has been amply demonstrated, they will ruthlessly exploit the weakness and stupidity of any government that allows them to do it. My contention is that such weakness and stupidity will always be found in any government in this country, especially these days.
Personally speaking, if the water infrastructure were nationally owned, I would still expect to be paying every month.
August 4, 2023
If you scrap your 10 years+ old car with zero carbon footprint the government will give you ÂŁ2,000 but then youâll have to replace it with a ULEZ compliant a new (probably imported) car with a huge build footprint which costs about ÂŁ35,000 âŠ.utter madness
Net-Zero by defination is anti-competition
August 4, 2023
All petrol cars bought new after 01/2006 are Euro4 and therefore ULEZ compliant. All diesel cars bought new after 09/2015 are Euro6 and therefore ULEZ compliant. All motorcycles bought new after 06/2005 are Euro3 and therefore ULEZ compliant. Which means there might be quite a bit of ULEZ compliant vehicles to choose from in the second-hand market.
You wouldnât knowthat reading glenâs comments as he doesnât seem to check anything before writing another of his @#ÂŁ&* comments.
August 5, 2023
Yes they are complaint from 2015 and lots of these newer diesel vehicles when they get just over 100,000 miles go off the road with significant problems starting with adblue warnings that require expensive fixes because of the cat converter, the denox or the dpf, ÂŁ3000 weâve just had to pay to get a vehicle back on the road two weeks later its broke down again, three others are off the road with a problem no-one knows how to fix, the main dealers are just washing their hands of it and saying they canât even see the vehicles till September, the smaller garages donât have the computer fix that they require without a ÂŁ5000 fix. The manufactures arenât bothered about solving the problem. So take care buying eight year old euro diesel vehicles.
August 4, 2023
âAll main parties agree healthcare and schooling should be available free to anyone who needs themâ
And there lies the problem. You are providing these services to anyone from the rest of the World who rocks up in our country. The NHS is also paying for the health care of hundreds of thousands, maybe millions of people who donât even live in this country. Always wanting to be the nice guys toward foreign countries is bleeding us dry. Now you are encouraging those living abroad to buy UK state pensions. Donât you understand that pension harvesting will allow foreigners to accrue massive state pensions from multiple countries that we the UK taxpayers will be part funding? Or donât you care about us?
August 5, 2023
That seems self evident to me. Politicians only care about themselves – their wages, expenses and pension – and foreigners. They donât give a flying **** about us. We just pay, pay and pay.
August 4, 2023
Doesnât the government via its testing of annual emission test at MOT, determine the emissions criteria and threshold for every car in the UK âŠ.so why the need for ULEZ ???
August 4, 2023
Are you that thick? How do you know that the âaverage emission carsâ are distributed evenly over the whole country?
August 5, 2023
Can’t you please go to another forum; more suitable of your unconstructive comments
August 5, 2023
Try thinking before writing, you will improve the quality of your comments and get less âunconstructive commeñtsâ from me. Simples.
August 5, 2023
You really are petty
August 5, 2023
Hefner, your persona has changed a lot in the last couple of days, do you think youâre on twitter? I normally find you very polite.
August 5, 2023
Sorry, but some comments are so stupid they make my blood boil.
August 5, 2023
I prefer the more measured approach that you usually have even when everyone causes your blood to boil. Just remember this isnât X, I donât always agree with you but I prefer a measured, intellectual response over a base insult. You donât want people to start to skip over your contribution do you as they did with Martin from Cardiff, Nottingham Lad Himself or whatever their new Monika becomes.
August 4, 2023
Zero competition means rarely getting the best service at the lowest prices. With absolutely no disrespect to its front line services, the NHS is a monopoly with no competition. What private sector medical company can compete with the NHS on price? In its current form, who would want to?
The NHS budget for this year is ÂŁ160B so I wonder just how much of it is spent on say, administrators and those non-jobs?
I also wonder what the private health sector could do with that amount to run our National Health system. We already know how good it is for us consumers to compare our local supermarkets to ensure we always get the best value for our money, so why can the Government not introduce a new system within the NHS to produce a form of competition and thus a better service than we currently have.
The disastrous locks downs coupled with the nonsensical freezing of all hospital beds during the pandemic, wrought havoc within the health sector and there seems no solution to cutting the waiting times for too many operations. Apart from bringing in the Private Sector. That is underway I believe but don’t stop there, lets have a serious review of the NHS, conducted by qualified private sector experts to establish how our once “envy of the world” can move into modern times and again please the British citizens providing the service they pay for.
August 4, 2023
Grant Shapps needs a kick up the backside. His SMR competition, effectively delaying Rolls Royce in developing the tecnology is worse than that. In effect he is allowing foreign competitors from the USA and Japan into the UK market at the expense of UK jobs and a massive potential export trade for the UK economy. Insanity, but par for the course in consocialist Britain.
August 4, 2023
agricola :
Agreed, which is why we’re in desperate need of a Parliament that’s pro Britain.
Not one existing Parliamentary party fits the bill.
August 4, 2023
I live in France. I enjoy a health service which combines the services of private suppliers with the state run hospital system. Private clinics supply menu priced services tot he state, thereby optimising the beds available and offering a fast service through qualified doctors who either work direct for the State or the private clinics. All services private or public are at agreed prices. All the big ticket items like scanners and xray machinery are supplied by private contracors and their uses are billed to the State. Thus the French health budget is smaller than the UK. The machinery is upgraded regularly with more modern equipment as per the private state agreement. In my view this combination of private/state supply is the way to go for the UK.
August 5, 2023
Careful! Youâll get your bank account closed coming out with reactionary stuff like that. Never, ever say anything bad about âourâ wonderful NHS.
August 4, 2023
I am so grateful for the Tories for bringing into existence in the utility sector businesses that should not exist. I contracted with my chosen supplier for energy supplies and find that as a result of ‘competition’ in the sector, my chosen supplier was taken over by a supplier which has been growing by acquisition despite being rated second worst supplier in the country and having been fined twice for their predatory practices. I was not able to reconcile my first bill received from them after the takeover nor was I alone in this. The company is privately owned. How much corporation tax and income tax is paid by these private companies and their owners?
Why were the public energy grids privatised? Why create private monopolies which then have to be regulated by unambitious and generally useless people?
Why not focus on ensuring that industries that are innovative because they face international competition to produce better products are not allowed to become lambs to the slaughter when it comes to foreign predation such that our engineering sector is almost completely denuded of British companies?
August 4, 2023
Wilko closed 400 stores yesterday and Clintons closed 38 stores today âŠ.Tories plan to decarbonise the highstreet âŠall hail net-zero
August 4, 2023
And Sunakâs permits that caused his house to be wrapped in plastic ( surely it could have been stopped?) are pretty worthless. Woke banks wonât lend for drilling etc and insurers will not insure.
Stop Oil need not worry.
AND have you noticed the push towards âpicking up your parcelsâ to âhelp your carbon footprintâ?
By the time people wake up to all the shop closures it will be too late.
There will be neither delivery nor shops to travel to.
As you say, Net Zero and 15 min prisons beckon.
August 4, 2023
You know the army holds shooting competitions between regiments, running competitions between regiments, and so on. There is no reason similar stuff could not be done elsewhere in the public sector. So, even where individual citizens cannot be given buying power in the relationship with providers, there is no reason competition cannot be used to encourage higher standards.
August 4, 2023
I see there is a kerfuffle over a Bloomberg allegation that Drax avoided paying ÂŁ639m to consumers by not running its CFD funded biomass plant. Unfortunately, Bloomberg got its analysis completely wrong.
The real story is that the bad design of the Drax CFD meant that the capacity was only available last winter during the period of extreme system stress. It was not available to help displace expensive gas imports.
If Drax had tried to do what Bloomberg suggests they would first have had to find retailers prepared to hedge at prices higher than ÂŁ405/MWh for the winter in order to fund the “payout”, which would merely have compensated for the extra spending on the hedge. However, the CFD is only indexed for inflation, not woodchip prices – and these were likely at lossmaking levels against the CFD strike price, so Drax would have chosen not to run even if it had made the sales. They would have bought in from other suppliers to cover their forward sales – purchases that were in fact made by the retailers at much lower prices, averaging about ÂŁ130/MWh over the winter. Drax would have booked a large trading profit, and the retailers would have had no compensation for their high price hedge purchases, meaning higher bills for consumers.
If Drax had been selling on a market basis then there would have been times when they would have run when gas was expensive (e.g. in December when the weather was cold), undercutting gas. At other times, gas would have been cheaper, and the outcome would have been exactly as it was.
August 4, 2023
Health and education are but emphatically should not be ‘special cases’. Even if customers do not pay directly for these ‘services’ they pay and pay an outrageous amount via their taxes for these.
Yes, competition puts the customer in charge even if the customer is the state (on behalf of taxpayers’ tax). There needs to be competition between schools and hospitals. For instance nursery education (and indeed University education) is largely funded by the state but operated privately – so why shouldn’t the same apply to primary education and secondary schools and indeed hospitals? Decades ago an acquaintance of mine established a private nursery for children and ran it for half the cost per child as the Council nurseries. Indeed the Council run nurseries were so expensive to run that that they no longer exist in Bury – nor at last do residential homes for the elderly that were much more expensive and inefficient than private residential homes.
In about 1970 I remember Reginald Maudling, then Deputy Leader of the Conservative Party said in a radio programme he thought the balance between the private sector and the public sector was about right. It wasn’t then and it still isn’t now – there is still a long way to go in privatisation, in particular in going into areas that are and may continue to be taxpayer funded.
August 4, 2023
What’s matter with Andrew Bailey pussyfooting around about the banks not passing on better interest rates for savers – why doesn’t he just spit it out – probably doesn’t like to offend his pals in the banks I suppose – might harm his chances for his next big job
August 6, 2023
With respect Sir John, you miss the point on health services. The issue is not state vs private provision. The problem with the almost 100% state provision (including private GP practices with are funded by the state) plus ‘free at the point of delivery’ is that it it reduces all individual patients to single standardised generic item not deserving and not having any choice. As I have commented previously, in the Autsralian system providers get paid when patients choose their services. That means patients control the flow of funds within the system , no matter whether those finds are sourced from government, insurance or their own pockets. IN addition the Australian integrates priovate and public provision. For example I hab=ve just had an operation to reconstruct my shoulder. It was my decision to go to a private surgeon in a private hospital. I chose him with advice from my GP because he is the best for this operation. The bill for the surgeon, the hospital and aneasthetist are paid by contributions from my insurance company, the state and me. Post op pharmaceuticals were paid for partly by me, and partly by my insurer and the price was determined mainly by government purchasing contracts. I could have chosen an entirely public provision and my experience of public hospitals has been exemplary but this surgeon does not operate in public hospitals. i wanted him because he is the best.
I have had other procedures for which I have chosen a public hospital but again I could choose whether the bill was paid by my insurer or by the government (taxpayer). The point is that it is my decision every time who gets paid for waht. No postcode constraints, no restrictions on choice.
That means there is not only competition but a true market comprising patients only, not third parties or intermediaries.
that is how competitionj can work in an intergrated public and private system. The NHS however could not accept such a system without profoiund cultural change. Contracting government organisations provide suppliers is still public provision because the private company does not manage the service provision.
Patients of the NHS will never ever be allowed to control funding so long as the service is free at the point of delivery. So the necessary reform will not happen until that mantra is given up.
And no heathcare does not cost very much more per capita in Australia than it does in the UK. But the outcomes are way, way better and the staff working in heath are much, much happier. It is hard to envisage Westminster and Whitehall ever looking for alternatives beyond the USA and Europe. But there are alternatives better than all of those in the bigger wider world.
August 9, 2023
Competition is a wide term. What is healthy competition? Anything goes? Lies ,cheating, fraud, deception covered by law to achieve certain goals and get what they want,duplicity,impersonation,fake news? So I and so forth….
August 10, 2023
The Shadow Mental Health minister today has told us 1 in 8 people are waiting for NHS treatment, more than ever before. Coincidentally I have eight people I’m working with today, none of them are waiting for NHS treatment, furthermore none of them have family waiting for NHS treatment so where in England exactly are the main problems? What treatments are they waiting for? Why doesn’t Barker ever answer back.
They say a decade of underfunding, pull the other one, we’ve never spent so much. Which trusts are causing this, what treatments are people waiting for? Allin-Khan says: “Patients are waiting in pain and discomfort for months or even years. Rishi Sunak has no plan to turn this around, The last Labour government delivered the shortest waiting lists and highest patient satisfaction in history. The next Labour government will provide the staff and reform the NHS needs, so it is there for us when we need it once again.”
August 11, 2023
I refer many people to secondary services weekly and. I have to tell the patients that they should expect a wait even to get a date for their first appointment.
We are a small GP practice and most get seen very quickly but the reasons many want a GP consultation are farcical.I had a patient thursday who wanted a same day appointment for a broken nail and there are so many others blocking the system in the same way.
Many coming from the abroads have no concept at all of wellness and below parr health.They can’t go to a local supermarket for over the counter medicine because firstly they can’t read and secondly a runny nose is seen to be influenza and perhaps not a simple cold or allergy.They don’t understand.