Whenever a particular idea appears to have captured the centre ground of politics it is time to look at it with a beady eye. This applies now to what is sometimes called the "choice agenda". The idea is that core welfare state services, above all health and education, should remain state financed, but that the users should have a greater choice, for instance, among schools and hospitals. At a minimum they should be able to select among state providers; but in the more daring version, private enterprise providers would be able to compete too, as long as the services remained free at the point of entry.
The British Labour politicians who call themselves Blairite have made this programme their flagship and suspect Gordon Brown, the prime minister, of not being sufficiently keen on it. The same set of notions is just as popular among the self-styled progressive wing of the Conservative party, whose members could hardly wait for Tony Blair to retire so that they could claim the programme as their own.
Although sometimes better than nothing, the type of choice envisaged is extremely limited as long as no top-up payments by patients or parents are allowed. Money should not become a fetish, but is nevertheless an extremely useful human invention and a main instrument by which choice can be exercised. To forbid some people from paying more to obtain a different quality of service is a sign of a belief not in equality but in uniformity. It is apparently acceptable for a citizen to lay out cash for a holiday in Las Vegas but not for a private room in a National Health Service (NHS) hospital.
The whole discussion reminds me of the
The fallacy of the 'choice agenda'
Samuel Brittan | Published: July 21, 2008 00:00:00 | Updated: February 01, 2018 00:00:00
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