Dear Ms. Roberts

I\’ve usually got nothing but contempt for your ideas but here you\’ve at last said something sensible:

Second, the grip of the consultants and GPs has to be loosened. The NHS has 1.2 million staff. Thousands upon thousands have good and often simple ideas about how to improve the service; help patients and cut costs – but too often those ideas go nowhere.

In the NHS, too often, there isn\’t the space, the time, the management structure to encourage and develop ideas that might also involve a certain amount of risk. If an idea comes up from the lower ranks, too often – in a target-driven culture – it goes straight in the waste disposal unit.


A great deal of what\’s done in the health service is driven by hierarchy and tradition: that\’s the way it\’s always been. Good ideas for change can come from staff, from patients, from individuals who have never had a day\’s illness in their lives. All it needs is a fresh pair of eyes and a healthy disregard for custom. That\’s what politicians need to be talking about – how to put the health back into the NHS.

What you are in effect advocating is a market driven system in health care. Remember, markets do not have to be driven by money, even if that is the form we normally think of them having.

Try something, do it on a small scale, see if it works. Adopt those ideas that work and reject those that don\’t.

Yes, we do expect that people who are at least interested in, if not completely driven by, the pursuit of their own financial self interest do this more than those who do not. But note that the true phrase used is \”enlightened self interest\” and none of us free market types are so crude as to think that cash income is the only motivation for that enlightened self interest. Respect, honour, the desire to help patients, these all count to.

And a proper market based system would aid in both allowing and promoting the very innovations you desire.

So why not call it what it is? You want a market based health care system. Why the shyness about using the word \”market\”?

3 thoughts on “Dear Ms. Roberts”

  1. b .. b .. but if you left healthcare to the wild savage market spirits then greedy capitalist slave drivers would only provide healthcare to the super rich, while making obscene profits and handing themselves enormous bonuses and the poor would only have a life expectancy of 30 years!!

    And don’t go making comparisons to the free markets in food and consumer electronics .. becuase that’s…err…uhhh…somehow different!

    (Yup, think I got all the clichés in there.)

  2. Investor’s Business Daily is quoting Mark Steyn and I would like to know if this is true.

    “Britain is well along the road toward totally controlling health care. Steyn says, “Under Britain’s National Health Service, for example, smokers in Manchester have been denied treatment for heart disease, and the obese in Suffolk are refused hip and knee replacements. Patricia Hewitt, the British Health Secretary, says it’s appropriate to decline treatment on the basis of ‘lifestyle choices.’ ”

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