Saturday, 23 April 2011

The market, university education and the NHS.

This week it was announced on one of the evening news bulletins that most universities will be charging the maximum allowed by the Party for university tuition fees of £ 9,000 per year. According to the figures in this piece 75% of universities will be charging the maximum.

This is interesting as one minister said that the higher figure would only be charged in “exceptional circumstances”. Another one thought that about £ 7,000 would be the norm with maybe only the Oxbridge universities would be the exceptions.

It is always nice to see politicians come unstuck with their policies and certainly there was outrage in a bit of southern Northernshire when shortly after Oxbridge announced they would be charging the maximum for a mediocre education a former polytechnic now promoted to a university announced that it too would be charging the maximum for something far superior.

This is not too dissimilar to what is going on in the health service which is being reformed by the same politicians who have overseen the university fee changes. They too have set a maximum fee for medical treatment but in this case there is less leeway for there is only one price so patients will not have to haggle over cost for healthcare will be “free”.

Instead the only “market” choice in healthcare for the “consumer”, an alien word to those us that still treat patients, will be the place of treatment and its quality.

Now if the price is the same, as it will be for most universities and healthcare providers, then the “choice” of place of learning/healthcare might be a factor in “consumer” choice.

For most people who want a serious education you would want the best university for your chosen subject or child so Oxbridge would probably be high on ones wish list certainly way above a former Northernshire polytechnic. This will not always be the case (in education) for some universities/polytechnics provide very specialised specific courses which others do not.

Now admission to a given university is usually via an admission procedure and based on academic criteria and interview and of course will not be based on ability to pay. You can apply to any university as long as you can afford the tuition fees and to live.

You will not be able to “apply” to a hospital in the same way that you as an individual would apply to a university but in both cases the cost of your “care” has been fixed by the Party.

So if “choice” of location is going to be consortia decided, overseen by the NHS Commissioning Board et al, and the price is fixed then the only real thing the NHS customer is going to get to choose via NHS “Choice” is “quality”.

So if say you do a history degree at Oxbridge for £ 9,000 will the quality of the education/healthcare provider you get there be the same as a history degree at a former Northernshire polytechnic/healthcare provider that also charges almost £ 9,000?

In other words will the fixing of price in education/healthcare lead to similar outcomes between say Oxbridge and the former Northenshire polytechnic? If it was your child who was going to have to find the £ 9,000 per year of fees as an investment where would you rather they get their education?

Ask now the same of your healthcare.

If the price is fixed, your NHS “Choice” consortia limited and your only choice is “quality” then where do you get the best healthcare and can you, or will you, be able to do so?

The market has worked well in education with the consumer paying more so will a similar fixed price market improve access, quality and drive down costs as per education?

Given that prices for education and healthcare are fixed then if education and healthcare are meant to make a profit how can a fixed price market generate a profit whilst maintaining quality?

Something will have to give. Price (fixed), location (fixed) and quality (variable).

Can you guess what will change for the better?

Praise be to the Party for pushing on with reforms whilst listening. It seems that in education the market has not listened to the politicians. Will it do the same in healthcare?

After all education has become “more” available and “affordable” to more people as a result of these reforms, hasn’t it?


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