Heavy Stuff

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.