Now there will be no fixed tariff, so private companies can undercut and cherry-pick easy work. That risks destabilising NHS services.
What can be done more cheaply by someone outside the NHS will and should be done by someone more cheaply, outside the NHS. That which cannot be done so (like, say, A&E) will not be done so.
In this manner we manage to get more health care for the money we are willing to spend on health care.
It is possible to get a tad more complex in this argument: that there are a lot of cross subsidies for example. Unbundling the NHS will make clear and apparent these cross subsidies. But then again, that\’s the point. We should always be working to make such subsidies explicit, not leaving them implicit in the design of a system.
For implicit subsidies have a tendency to become very damaging because, being implicit, they are not examined.
As an example I would give you the NHS national pay rates. These are, by definition, national, and mean that NHS pay in areas of low local wages is quite high compared to those local wages. Not too much of a problem, those Angels deserve good pay. But in areas of high local pay it means that those national wages are too low to attract the desired staff.
And yes, this does kill people:
These effects are not trivial: the results suggest that a
10% increase in the gap between the wages paid to NHS
nurses and those paid to women working in the private
sector locally raises the fatality rate among people
admitted with a heart attack by about 5%.
Only by unbundling the NHS will we be able to see these problems.
Unless, of course, you want to start arguing that equality of pay across the country is such an important issue that people should righteously die from a heart attack just because they live in an area of high pay?