the times | Monday May 2 2022 25
Comment
Buy prints or signed copies of Times cartoons from our Print Gallery at timescartoons.co.uk or call 020 7711 7826Care scandal exposes carelessness of the state
Privatisation can bring benefits but only if government retains the right to demand change through stringent oversight
than admit their whizzy Fujitsu
contractors were at fault.
The core problem is that
privatisation and outsourcing need to
go hand in hand with stringent,
expensive and authoritative
oversight. The regulatory bodies
must be intelligently staffed and
funded, and always have the ear of
government. The National Audit
Office has repeatedly called for more
professionalism in these bodies. Nor
are sanctions any good once you let
someone get too rich to fail: Ofwat
issued £21 million in penalties for
environmental damage to water
companies a couple of years ago, and
the companies barely blinked. After
the scandals of elderly Covid deaths
and terrible children’s homes, the
Care Quality Commission flails in a
swamp of muddling data and
dubiously optimistic reporting.
Either it gets easy for a “good chap”
mentality to bring regulators so close
to providers that they don’t rake
around enough in the rubbish. Or
else, as with NHS England and the
Priory cases, repeated demands for
improvement just aren’t met.
So that breezy political threat to
sell off important public jobs is not
worthy of a grown-up prime
minister. When citizens, especially at
their most vulnerable, have no
choice about a public service it is a
serious matter to entrust that service
to the profit motive.children’s homes, prisons, or indeed
vital needs like army recruitment (in
which Capita has missed targets ten
years running). To rush ahead means
believing business will always be
magically efficient compared to its
own civil servants and their
managers; or presuming the taxpayer
won’t mind being made into a source
of private profit.
Of course sometimes it works well,
at least for a while. Water quality did
improve in the early years, thoughbills also shot up by half. BT was
definitely nippier than the old Post
Office telephones. Privatised power
utilities gave consumers competitive
options, though once the system
came under stress some collapsed.
But even without unusual stress
some services are just too complex to
hand over and, like the railways, just
end up being saved by the taxpayer.
Sometimes the vainglory of
commercial independence and
increased top salaries can make a
“freed” organisation plummet into
disaster, as when Post Office leaders
preferred for years to believe that
hundreds of loyal postmasters had
suddenly turned criminal, ratherand on to beaches, citizens’ money
kept flowing the other way into top
salaries, bonuses and shareholder
dividends. The prime minister might
pause also to think about the parallel
in the record of prisons run for
profit: 47 per cent more violence has
been recorded in private ones.
So those chest-beating threats to
privatise “the arse off” still more
essential services ignores areas in
which the said backside is already
sagging. Adventurous business is
good, capitalism is not all evil, but in
areas when the taxpaying consumer
has no choice — passports, driving
licences, drinking water, prisons,
health, social care — handing over
practical responsibility to business
investors is a solemn matter.
Entrepreneurs naturally have a
strong secondary motive: not just to
fund dividends but usually to set
ultra-high executive salaries because
a decadent business mantra says that
without inflated pay leaders won’t do
their jobs. Meanwhile lowlier
employees may be deeply
responsible and delighted to be
meeting public needs but they are
units in a profitable business, not
“servants of the Crown”. A phrase,
believe it or not, which was
important to former generations.
Thus a government, or local
authority, should always hesitate
before entrusting to commerce a
core public service like water,A
depressing picture was
painted by this
newspaper’s investigation
into the Priory group’s
repeated failures, and how
official criticisms and demands for
rapid improvement got nowhere
much. It tells of suicidal patients able
to abscond or left in rooms with
known ligature points. In 11 cases
over a decade, coroners have pointed
to failures in care; right now three
bereaved families are suing the
company. Yet the Priory group, most
often reported as looking after some
celebrity in crisis at a price, actually
gets £400 million a year from the
NHS. It is wholly owned by a
profitable Dutch private equity group.
NHS England has said it “will not
tolerate service failures”, but year
after year it seems to have to. As too
often in cases where government
entrusts core services to commercial
companies, it finds itself almost
toothless when they don’t do well.
Privatisation and outsourcing are
often touted to us as signs of
energetic improvement, but it is time
to go back and question this attitude,
and especially to consider the
usefulness of regulators.
There are still those who believe in
privatising as a quick silver bullet,
preferable to managing or funding a
service directly. We have just heard
the prime minister, Godfather-style,
uttering that menacing threat to
“privatise the arse off” the DVLA
and the Passport Office. No doubt it
made him feel tough, an invincible
Thatcher with a brick in his handbag.
Yet while saying it he failed to notice
not only the harrowing problems of
the Priory’s private service to NHS
patients but plenty of others. Take
the case of the Passport Office: its
present chaotic delays are actually
mostly down to a private Frenchcompany which runs its telephone
service and an equally private
American delivery firm which
delivers the documents.
Or remember the scandals and
heartbreaking disruption in care
homes when, in some distant tax
haven, economies and closures were
ordered. Or the fact that while water
companies were letting a third more
untreated sewage flow into riversWater quality did
improve early on but
bills shot up by half
Regulatory bodies
must be intelligently
staffed and funded
Libby
Purves@lib_thinks