TCS Daily

The Tired Civil Servant

By Johan Wennstrom - June 30, 2006 12:00 AM

The UK Conservative leader David Cameron's recent comments praising Britain's public sector rightly underline the fact that many doctors, nurses and teachers work very hard at demanding jobs. But Cameron failed to address why so many public sector employees work so hard yet fail to gain credit or reward for their efforts: they are trapped within a structure that hinders good performance and strangles initiative.

Cameron's claim that many private sector companies would have much to learn from the public sector will come as a surprise to everyone who has contracted MRSA from the wards of a National Health Service hospital or whose children are struggling through a state school.

But it is the system, not the people within it, which should be criticized for lacking the innovation, service-mindedness and efficiency of private business.

The public sector, not least when it comes to the police or the armed forces, has an important role to play in every modern society. However, it is obvious that certain functions, such as hospitals or schools, do poorly when managed by public authorities.

For example, Britain's nationalized health care system has, because of its immense bureaucracy, made it hard for people to access primary care. And overstretched staffs struggle to give patients the proper medical attention. As a result, general practitioners are advised to refer fewer patients to specialists and restrict patients' access to a second opinion. There is more: although public spending on British healthcare has increased enormously during recent years, productivity has fallen by 20 percent since 1997, says the Organization for Economic Cooperation and Development.

Other countries that rely heavily on the public sector for health care services, for example Sweden and Canada, face similar problems - most shocking are deaths among patients waiting a year or more for an operation.

Britain's state schools are an equally dismal story. A report from the Centre for Policy Studies discussed the "worryingly low" quality of state education in Britain, and stated that 40 percent of children enter secondary schools without the proper reading skills. Additionally, a survey of teachers found that simpler exam questions were necessary to raise pass rates among secondary students.

None of this is surprising. The NHS is the largest employer in the whole of Europe, and, as one would expect, such a huge bureaucracy requires an army of managers to organize, so that valuable resources are spent on administration rather than medicine. Moreover, a nationalized system inhibits the kinds of innovation and competition crucial to progress in the private system; hospitals and trusts cannot experiment with new forms of treatment and organization because they must operate within the strict rules laid down by the Department of Health.

Rather than celebrating a non-functioning system, Cameron should call for reform. It is primarily about putting the consumer in charge, as in the private sector, where you may do away with the products and services you are not happy with.

Public services must be based on the needs and wishes of consumers, which are among others hospital patients and parents of schoolchildren. Individual patient rights, as well as parental purchasing power in education, should be introduced. And lifting parts of the healthcare system out of the public sector would raise its quality, which is evident in America.

The message from the Conservative Party should be this: when it comes to what the public sector does for us, there can never be too much value for money. Cameron has unfortunately indicated the opposite.

As Tony Blair obviously has not fulfilled his election promise of establishing world class public services, Britain needs an opposition leader who is not complacent about healthcare and education and can deliver on these issues. Cameron should strive to expose a tired, old public sector to market forces and letting them be the judge of the quality of its services. That is the only way civil servants will not have to work more than what is necessary.

The author is a Research Fellow at the Institute of Economic Affairs and Fellow with the Swedish public policy group Captus.


1 Comment

those poor beaurocrats
Let's not forget that politicians have to say stuff like that even though everybody knows they are hypocrites. Of course we know that the rulers of the UK send their kids to private schools, and go to private clinics, or Switzerland for health care. It's kind of like Al Gore stating publically that he loves government schools even though he sends his own kids to private ones. Or it's like that time when Kerry pretended to eat lunch at Burger King I think it was, when in reality he had an arranged 'proper' luncheon at the posh yacht club nearby.

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