competing with competition

20 01 2011

The NHS is being pushed further and further down the competition route. The theory is, quite possibly, convincing. Organisations work better when they are competing with each other because competition improves efficiency and makes things cheaper. Which is actually the point. This sort of free-market capitalism seems to me to be dreamt up by a certain type of man. And a few women. But mostly men, I reckon. People who live in a world where everyone wants to win; being cheaper and more efficient is the most important thing; and actual people are sidelined in favour of theoretical economics.

Theoretical economics doesn’t take account for the presence of humans, who are not always fair, who do not all like a level playing field; we might even so far as to say people will often cheat and lie and put themselves, rather than than the greater good, first. Where having winners makes other people losers. And so the weakest suffer, the strongest prosper, and I suddenly feel like I’m writing a Psalm from 1,500 years ago. Has nothing changed?

Having said that, I am a fan of people. And I am a fan of remembering that there is no such thing as an ‘economy’, just humans in communities who make transactions. In the NHS, as with other state services, I am a fan of putting people first. Sometimes that makes things more efficient; sometimes less efficient. Ok, often less efficient. Like taking away train carriages to reduce costs may make things more efficient, but doesn’t help the people crammed in the remaining ones like sardines. Taking away doctors from doctoring so that they can manage bidding competitions means that they are not doctoring, or are managing and doctoring, which is surely less efficient as doctors need to be awake when  treating patients. And have trained for x years (at our expense) to be doctors, not managers.

I don’t want hospitals to be in competition with each other any more than I want train stations to be. When my son had an accident I didn’t check the league tables to see which hospital was the best; I went to my nearest (St Helier). I want my nearest hospital to be as good as it can be, because the staff are motivated and the hospital is resourced. I don’t want to be treated by the company that put in the cheapest bid and employs the cheapest staff. Of course there is nothing wrong with competition in itself – it can be motivating and inspiring and encourage good behaviours. But in the NHS context I cannot see how it will improve things, with private companies circling to cherry-pick the easiest patients and the NHS left to do the long-term difficult care.If humans could be trusted, the free-market could work. But humans need boundaries, because unless we are all filled with the love of God and allow that to direct and influence our every move we have a tendency to be selfish, to look out for ourselves, to turn a blind eye to those beneath us in the pile. Or not to notice there is a pile at all. Just look at the banking crisis, where people are rewarded for failing simply because they are allowed to, and let the poor suffer the consequences. Free market is great when you are the one that writes the rules.

There is an alternative to competition, there is an alternative to turning every public service into a free-market. Because although we are all equal, it is always the rich who are more equal than others.

Excellent,I think you are right about why so many of us evangelicals are frightened of emphasising the positives about our faith. And I am sure the use of the word ‘in-breading’ where perhaps ‘in-breaking’ would be more conventional was simply a subtle reference to yeast in the dough. Rather than a mis-spelling of ‘in-breeding’, which is not a very evangelical thing at all.



4 responses

20 01 2011

Capitalism is not working at the moment and it needs to be fixed. However when we look at the alternative – public ownership I can’t see something which is better. Because greed and inefficiency aren’t just the province of capitalists, they seem to be even more rife in the province of socialists, its just different people who get rich and the same people who suffer.

The Bible doesn’t tell us that we need a socialist or a capitalist or a capitalist government it tells us that we want good and wise rulers of integrity, who care about the poor and needy, however we pick them or whatever dogma appears to drive them.

The question the Church needs to address, and speak out on is what needs to be done to fix things. Where are the Christians stepping forward to join the debate, not along party political lines but to speak up for the needy and to propose practical ways to move forward.

20 01 2011

Hi c2drl, i agree with you that we (generally) do not support one type of political leadership over another (so long as it is left-leaning tolerant gospel-inspired liberalism with a healthy dose of eutopianism and a smattering of gospel prerogatives), we support wise leadership with integrity and a care for the weakest in society. Which I think the church consistently speaks out on, though is usually ignored! See Faithworks, see Ekklesia, see Oasis, see Stop the Traffik…

21 01 2011

Kevin, I agree that there are some who speak out and I would add Theos to your list. But look again, these are not the Church but organisations set up with that one purpose. In a way that highlights my point – we have taken politics abd government off the agenda of the whole Church and abrogated it to a few organisations that are not accountable to the Church. Surely these things should be at the heart of the life of the local and national Church Sunday by Sunday, day by day in our prayers. It has the feel of being something for the odd people who think about it, not a core strand of our faith.

But then of course the Church has much more important things to worry about, like women bishops, whether the flower arrangers need a CRB check and what sort of music to sing, or not.

21 01 2011

I disagree – I think that politics is firmly on the agenda of many churches, you just need to look at the Archbishop of Canterbury’s website to see the number of speeches he makes about such things. Not that he is the benchmark, but he is an example. I don’t think it is the responsibility of weekly church to deal with politics and government per se, and I know that if I did that in my context I would have no-one left because no-one really engages with that sort of thing. But what we are called to do in the local church is resource those who are prepared to get involved, and to support organisations that have the time and resources to do the same, which usually we do not. In our local contexts we deal with issues that are political – youth crime, anti-social behaviour, the elderly, council housing, health-care – but not in an overtly political way, because that is not our primary purpose.

So I take your cynicism about the church getting side-tracked with a pinch of salt – yes it does, and yes the media would rather report something trivial than when someone says something serious about something that matters. But I won’t accept that the church is not involved; and I also won’t accept that the ‘para-church’ organisations are not part of the ‘church’ anyway. They are, and they are (in general) accountable to the church, that is, followers of Jesus. When we point a finger we always find 3 fingers pointing back at us…

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