The Magic “M” Word
3 months ago I floated the idea (not entirely seriously, I might add) that in the even of a hung parliament the only other party the LibDems should consider going into coalition with is the Cooperative Party. My main aim was to spark a discussion about how mutual solutions should be used to make welfare and services more efficient.
A couple of things have happened. In one corner we have Devils’ Kitchen giving speeches on friendly societies and in another we have Tessa Jowell talking about Cooperative Schools. Furthermore, Philip Blonds think tank ResPublica launched in November and aside from being one of David Cameron’s favourites I have it on excellent authority that they are being courted by Nick Clegg.
So why are LPUK, New Labour, the Tories and the LibDems all singing from the same hymn sheet? All roads lead to the “M” word “mutualism”.
Well, New Labour have done the libertarian cause a great many favours. Their brand of authoritarian social democracy has not only bankrupted the country but they have simply shown that more money does not equal better public services. Throwing money randomly in all directions has not improved the quality or the efficiency of services. In fact, it has had the opposite effect. It does matter how that money is spent.
In “The Ownership State”, Philip Blond shows how NHS productivity has gone down despite record investment:
Dishing out public services according to a centralised paradigm is failing. The fact that politicians from every angle of the spectrum are discussing new ways to structure how we deliver service is testament that this is the beginning of the end.
Ranked no. 56 in the UK
Ranked no.6 in the UK
December 21st, 2009 at 11:58 am
You would expect measured NHS productivity to fall as inputs increase because of the way in which it is measured. In general, output is a “completed clinician episode” - i.e. it doesn’t matter if you live or die. So if the doc spends more time with you, and you live, measured productivity has fallen. Equally, if care improves, by say not discharging patients before they are ready to be discharged, measured productivity will fall.
Is productivity higher in other systems? That would be interesting to know.
December 21st, 2009 at 1:25 pm
Is productivity higher in other systems? That would be interesting to know.
Yes, it would be very useful. The problem is, of course, that measuring productivity of healthcare is rather difficult.
But the NHS seems to be middling in the European context when it comes to service to patients - 14th out of 33 countries in the latest Euro Health Consumer Index. The top country is the Netherlands (for the second year running), which jumped to the top part of the table after reforming healthcare in a market-friendly direction (though with insurance being compulsory, with a risk pool and public subsidy). See http://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands
The second country was Denmark, which operates a “single payer” system, funded by local taxation (to my knowledge) and strongly devolved compared with the NHS.
I think the Dutch reforms deserve serious consideration, especially if tweaked so that the commissioning of healthcare is managed by mutuals like friendly societies. To me this is a logical extension of the existing Lib Dem policy of devolving spending decisions to locally-elected boards.
December 21st, 2009 at 11:54 pm
It is strange the the Cooperative Party is pretty much a wing of the Labour Party, which happens to be the party which did most to destroy the cooperative and voluntary aid movement with the welfare state.
Libertarians have long advocated voluntary and mutual organisation, especially those on the ‘left’ but increasingly those on the ‘right’ who realise that both community and the opportunity for individual excellence is founded upon such institutions.
For the LibDems, in theory the cooperative movement should fit in firmly with the stated ideals of the party, but ideals and policy often diverge massively.
December 22nd, 2009 at 1:11 pm
It is strange the the Cooperative Party is pretty much a wing of the Labour Party…
Indeed. Apparently the Cooperative Party was founded out of anger at the Liberal (then Coalition) government during WW1, whose wartime economic and rationing policies hurt the co-operative movement. Then they decided to effectively join the Labour Party about the same time as the Fabians became dominant there. Talk about going from the frying pan into the fire!
That said, I don’t think all welfare can be effectively delivered just by mutual self-help; there is a strong case for tax funding of healthcare and education. But the funds should be spent as far as possible by mutuals accountable to their members (i.e. taxpayers control the spending of taxpayers’ money), and individuals should have as much choice as is feasible in how it is spent.
December 22nd, 2009 at 4:58 pm
I am perfectly happy that Nick Clegg takes an interest in this think tank, but you may not be.
Did you read the following in the introduction?
———————————
“Market versus statist thinking is a crude
false dichotomy, based on an ideologically
gloomy vision of human nature which
has led both sectors into today’s cul-desac
– a nightmare treadmill where every
problem thrown up by a dysfunctional
system can only be addressed by
prescribing larger doses of the treatment
that got us into the mess in the first
place.
The management model that has
come to dominate all the airwaves,
from the A-grade journals that shape
the academic research agenda to the
management consultants and eminent
advisers who influence government
policy, and (unbeknown to many of
them) the practical managers who have
absorbed it because it is ‘in the air’,
is the neo-liberalism of the Chicago
School economists whose line of descent
goes back to the radical individualism
of Smith (of the Wealth of Nations
rather than Moral Sentiments), Hume,
Locke and Bentham. Before he died,
Milton Friedman consoled himself for
(he judged) Chicago’s relatively small
influence on economic practice with the
knowledge that: “Judged by ideas, we
have been on the winning side”. He was
right. Almost all the social sciences –
sociology, law and social psychology as
well as economics – have been colonised
by Chicago economics. This is especially
true of management, which in its efforts
to be recognised as a real science has
been as consumed by economics envy as
economics has by that of hard physics, to
its enormous detriment.”
December 22nd, 2009 at 5:05 pm
Yes, I read the whole document and it’s excellent. Some of Phillip Blond’s views are eccentric but I have a great deal of time for him. What he is suggesting is that the state shouldn’t have the monopoly of the provision of welfare and that’s a good thing.
December 22nd, 2009 at 6:35 pm
There’s an interesting blog post on ResPublica and the free market here: http://conservativehome.blogs.com/platform/2009/12/philip-booth.html
Even if you think Mr Blond is too anti-market (I’m reserving judgement until I’ve actually read some of the think-tank’s ideas in more detail), you can still support some of his good ideas.
February 5th, 2010 at 6:11 pm
Mutualism, with its anarchist roots, is potentially a very radical policy for mainstream politics. It’ll be really interesting to see how far the politicians are willing to take the idea. Unfortunately I suspect once they are in power that the temptation to privatise things instead of mutualising them will be too powerful for the Tories. I’m sure a lot of the Tory supporters are counting on a raft of privatisations.