“What counts is what works” – common sense or dogma?

27 May 2015

Opposition politicians have continued to generate wonderful pro-reform statements at the beginning of this Parliament. Yesterday Chuka Umunna argued that the Opposition should deliver, “a new approach to public services: integrating health, mental health and social care services, starting at ‘what works’ and putting the principles of prevention and innovation at the heart of the welfare state”. “Starting at ‘what works’” is his way of saying that what should matter in the delivery of public services is the quality of provision, not whether the provider is private, public or third sector. Before the Election the Opposition took a stance against private delivery of NHS healthcare, and both main Parties stood (and stand) against private delivery of taxpayer-funded schooling.

Jonathan Freedland’s Guardian column last week warned the Opposition against taking on particular policy positions just because they were put forward by the electorally successful Blair Government. He said that “private sector provision in the NHS” was an example of that kind of dogma, and the Party needed to be more thoughtful than that.

He is clearly right that any political party needs to be thoughtful. Opportunities to update policy across the board are actually relatively rare and precious for political parties. They need to be seized. But in this case the dogma would be to oppose private sector provision. Nearly every piece of NHS equipment is provided by a private company. Some areas of the NHS, such as elements of mental health, are mostly provided by the private sector.  Given the experience of other countries, it is natural for the NHS to be more open.

Support for public sector reform may have political resonances, but that doesn’t stop it being right in its own terms.

Andrew Haldenby, Director, Reform

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