Wednesday 27 April 2011

A lesson from school

When i was at school, I took business studies for one year. In the first class the teacher asked 'What are companies for?'

The student said 'to provide a service'. Wrong.

The next said 'to give people jobs'. Also wrong.

I said 'to make money'. Kerching! The right answer.

Companies exist to make money. If they don't make money, they stop trading. Companies everywhere start screaming when they forced to make concessions to ensure proper health and safety, quality control, because it costs them money. They do things as cheaply as they can possibly get away with in order to make the biggest profits. If profits start to slip, they look at ways to boost it. We've all heard of builders who charge for shoddy work, of manufacturers who produce goods made with substandard materials, of sweatshops who pay slave wages.
None of this is because it's right, it's because it's how they maximise their profits.
Supermarkets charge knock down prices to entice customers into their stores, so they won't go elsewhere.
How many high street shops lost their butchers, bakers, greengrocers, hardware shops, once a big supermarket moved in?

This market is what the coalition is proposing for the NHS. Competition will make it more efficient they say. Bring in the private companies - 'companies' being the pertinent word here - and let them take on NHS services.

Private healthcare companies are companies just like any other. They exist to make money. They look for ways to make as much money as possible, in their case from your healthcare.
If a service doesn't make them money, they will stop providing it. If it costs more than it will bring in, it won't be provided. If your care will cost more than they can make from providing it, they will look for ways to bring those costs down.
If they can bring in a loss leader to take customers away from the NHS they will. Because eventually that loss leader will start making them money.

The government will not admit this. It insists that competition will make the NHS more effective. We all know that's not true. Competition in healthcare does the exact opposite. It drives down quality. It gives services based on cost, not need. It won't matter if you need something, if you can't afford it, you don't get it.

The government refuses to acknowledge any of this. Either they are arrogant enough to think we don't know this or won't recognise it until it's too late, or they are hopelessly naive.

I don't know which is worse.

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