Public/Private
Ownership
The current debate in the
UK about the apparent partial privatisation of the NHS through the
back door prompted me to think about attitudes to private and public
ownership in the UK and France. The point is that infrastructure in
France seems very largely to work well; in the UK, it seems
frequently to work badly. Why?
Their is a definite
contrast between the UK and France in this respect. The French seem
to have a very clear view of arrangements between private and public
ownership. Almost all infrastructure in France is owned and run by
the state. Road infrastructure is owned by the state but maintenance
is let out to private organisations. Railways are state owned and
run. So are electricity (effectively) and gas; a risible 25% of
electricity is theoretically liberalised as a sop to EU directives.
Telephony is minimally liberalised at the moment but could become
more so. The French like it this way and, whatever Brussels decrees,
are determined to keep the status quo.
In the UK, I would argue
that liberalisation of telephony has been an outstanding success;
rates tend to be between a third and a half cheaper than in France.
But it is difficult to point to any others. Electricity and gas are
arguable, although electricity in France is still cheaper than that
in the UK (piped gas is generally available only in sizeable
conurbations). Roads and railways in the UK are certainly inferior
to those in France.
The health service is
interesting, as I have touched on before. In France it is totally
privately run, with chargeable rates set by the state; and the
service is generally excellent. It is the effect of the state
setting chargeable rates that interests me. If you want to see an
eminent surgeon or other specialist, he/she will charge more and you
will have to pay the difference; but perfectly competent specialists
seem to charge much lower rates than do those in the UK. A recent
conversation with an ex-hospital consultant friend in England
revealed that he had the alternative of waiting some 10 weeks for an
appointment or going private, with a £150 fee for a consultation.
The cancer specialist I see, gratis, can normally make an appointment
within ten days and I know that his charge to the state is around
£50. The point is that since the large majority of people can pay
only what the state reimburses most medical staff set their fees
accordingly. This could, and no doubt will, change in the future but
seems a better arrangement than that pertaining in the UK. It seems
likely to me that, in France, there will be a growing divergence
between what the state will reimburse and actual medical charges,
resulting in the patient having to contribute more; but the state
reimbursement rates put a useful brake on price rises. The UK
expectation of a totally free service means that access to the
service, and the quality of that service, has to supply that brake.
Behind all this is the
effectiveness of private/public arrangements. Numerous, disastrous
so-called PFI initiatives in the UK indicate that the Civil Service
has no idea how to negotiate with private enterprise. In France,
state bodies are notorious for their hard-nosed negotiations.
Therein, perhaps, lies a key difference between approaches to this
question in the two countries. Possibly equally key are how and why
the two sides get together. In France, there seem to be generally
agreed and established roles for each; in the UK, cooperation often
seems speculative, arbitrary and designed primarily to cut visible
state expenditure (in theory if not in practice). It may be this
speculative and arbitrary aspect that militates against the Civil
Service's ability to negotiate. Whatever the reasons, the
private/public split seems to be better managed in France than in the
UK.
Citizenship and
Democracy
This Sunday, as I usually
do, I had lunch with Steve and Jo and the conversation got around to
democracy, citizenship and communities'(see below): big topics,
though we've already between us put the world to rights so often I
sometimes wonder that it can till be in the mess it in. However,
these are topics that simply won't go away and are good
conversational fodder to enhance an extended lunch.
We all believe that
western democracy, imperfect though it undoubtedly is (made even more
so in the case of the UK by the proposed crass press legislation), is
a cornerstone of western European society. Which turned my mind to
the citizenship commitments proposed for new immigrants and a
conviction that a commitment to democracy should be included
specifically. That means not simply a commitment to obey the law,
which is pretty obvious but too general, but a commitment to uphold
democracy. Forget the nonsense about God, the Queen and British
history, which are really no more than incidentals in this context,
and focus on democracy and language. I don't believe anyone can
function usefully in a country without at least a minimal mastery of
its language; and overt support for a principle at the very base of
its constitution (written or not) is also required. I understand
that this assertion can provoke a number of quibbles but believe, if
implemented, it would solve far more problems than it creates.
Communities
I've commented before on
the great sense of community which I value here. Comments from
various friends living elsewhere make me realise jut how valuable
this is and also where it does not seem to apply. Large towns always
seem capable of it, even if they do not achieve it in all areas, and
so do villages, albeit needing some kind of subsidy in many cases.
Where it almost never seems to apply is in suburbs or housing
estates. Which makes me believe that these are not natural
environments in which human beings can thrive. But they exist and
countles people live in them.
So what's to be done?
Clearly, some kind of catalyst in the form of a community officer is
indicated and I know they exist but have little idea of what they do.
Clearly also some kind of physical community centre is required,
which often does not overtly exist (but underused schools do). Then
it is a question of will and cost. I see bits of this picture in
areas of the UK that I know but also huge untapped potential. The
problems, I suspect, are that the results would not be easily
quantifiable or show on sacred government targets and that local
government budget is far too centralised in the UK. Against that,
the gain in quality of life could be huge with a similarly
considerable economic pay-off (reduction of crime, enhanced social
care, etc). To me, it seems a small risk for a potantially large
gain. It simply (????) needs someone to break the current mould of
legislative goals and priorities within which it doesn't fit.