I’ve decided I’m in favour of NHS privatisation.

Politics, Society

I’ve decided I’m in favour of NHS privatisation.

Why? It seems we can’t shake the myth that public sector can not make bold or useful changes. Meantime there are lots of great, socially minded enterprises out there which are delivering a fantastic service and just solving the problem.

I’ve just been in one of them (Circle Partnerships) having a knee operation. It was a brilliant experience. From the warm smiles and efficient welcomes, to waving goodbye as I walked out with  a fixed knee 8 hours later.  The staff were pleasant and friendly, took time to talk and were clearly happy. The building was purpose built, part hotel – part hospital, and felt a little like a scene from the future – I’m not quite sure why – maybe because it was functional AND aesthetic.

In the afternoon whilst I was recovering and stretching my legs I talked with as many staff as I could find: nurses, doctors, physios, receptionists. “What’s the best part of this job for you?” and “What makes it better than the equivalent in the public sector?” The answers were essentially the same from everyone: “I can do a better job here.”

Key points which came up again and again:

  • They have a voice in how it works: Circle Partnerships is run by it’s staff. They all decide how things go, and they’re all invested in the outcomes – receiving dividends in good years.
  • Staff-to-patient ratio: is about half that of the NHS. Which means they can know their patients and support them accordingly. “In the NHS I felt terrible because I was always in a rush to get to the next person, and I went home at night not being able to remember people. That’s a horrible feeling.”
  • Teamwork: because there’s more time to do their own job well, they can work together as a team more effectively, too. Who’s going to help someone else if their workload is already full? Lending a hand here and there prevents logjams.
  • Not that much more money: the people I spoke with are paid up to a few thousand pounds more. Not an amount to change lifestyles, but enough to change lives.

This is inspirational stuff. The narrative about the patient benefitting from the free market and ‘greater choice’ has always struck me as peculiar – no one would choose to go to a crap hospital after all. But if we make it about the doctors and nurses having autonomy then it’s more obvious that it could work well, since it combines the 3 key human motivators: Mastery, Autonomy, and Purpose.

What to change?

So for me to be in favour of NHS privatisation,  every contract winner must:

  • be a cooperative / Bcorp / charity
  • report on their triple bottom line / GPI
  • set limits to its growth
  • be funded by ethical finance / make only ethical investments
  • not avoid or evade tax

We would get excellent models of how it should be done, kickstarted by public funding, leading the way into a new and progressive economy.

Also, here’s a paradox for every MP to answer: In order to be in favour of privatisation you have to agree that the public sector is bad at taking decisions about things. Including decisions about privatisation.

Ed Dowding

Ed Dowding

Founder, strategist, writer, gadfly, TED talker, world-record holder, and (foolishly) reality-TV farmer. DOES: Innovation, Product, Advocacy THINKS: Regenerative Systems, Institution design, 300 year horizons

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