It’s already happened: The NHS Goes Private

Lansley chose 19 July, the day Rupert and James Murdoch had the media transfixed with their testimony to the Culture Select Committee, to let slip that from next April a billion pounds’ worth of NHS services, including wheelchair services for children and ‘talking therapies’ for people suffering from mild depression, anxiety or behavioural awkwardnesses like obsessive compulsive disorder, will be opened up to competitive bids from the private sector. The doctor and Daily Telegraph blogger Max Pemberton described it as ‘the day they signed the death warrant for the NHS’. Throughout the latest debate on the Health Service’s future, the Conservatives have praised it as an abstract concept, pledging to uphold ‘an NHS that is free at the point of use and available to everyone based on need, not the ability to pay’. But it is quite possible to praise something even as you legislate it out of existence. Changes do not need to be advertised as embodying a cumulative destructive purpose for that purpose to be achieved. The fall of the Roman Empire was never announced, yet its fate was sealed once its rulers, no doubt for reasons of efficiency, introduced a choice of competing barbarians to defend its borders.

In the Sorting Office

Every week Dutch households and businesses are visited by postmen and postwomen from four different companies. There are the ‘orange’ postmen of the privatised Dutch mail company, trading as TNT Post but about to change their name to PostNL; the ‘blue’ postmen of Sandd, a private Dutch firm; the ‘yellow’ postmen of Selekt, owned by Deutsche Post/DHL; and the ‘half-orange’ postmen of Netwerk VSP, set up by TNT to compete cannibalistically against itself by using casual labour that is cheaper than its own (unionised) workforce. TNT delivers six days a week, Sandd and Selekt two, and VSP one. From the point of view of an ardent free-marketeer, this sounds like healthy competition. Curiously, however, none of the competitors is prospering. TNT is being forced by the hedge funds and other transnational shareholders who control its destiny to split up, even as it tries to beautify its bottom line by replacing reasonably paid jobs with badly paid ones. Deutsche Post is pulling out of the Netherlands and selling Selekt to Sandd – a company that has never made a profit.

Sandd, set up by a group of ex-TNT managers, pioneered the distinctive Dutch style of private mail delivery. ‘Sandd’ stands for ‘Sort and deliver’. In Britain, as in many other countries with big postal networks, private companies can now collect and sort mail, but delivery, the so-called ‘final mile’ of a letter’s journey, is still effectively a Royal Mail monopoly. Mail is delivered from distribution centres to local delivery offices, where salaried Royal Mail postal workers sort it into individual rounds and deliver it by van, bike and on foot. Under the Sandd system, crates of mail are delivered to casual workers’ houses. These workers sort the mail, on whatever flat surface they can find, then deliver it on set days at a time of their choosing. Besides slashing the mail companies’ overheads, the system has the advantage, from the management’s point of view, that there is little danger of the postmen and postwomen meeting each other to swap grievances or talk about joining a union.

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