In this seemingly endless and heartless age of austerity, the cost of things is measured in dollars and pounds. Services that we used to think of as being of benefit for the public or common good are suddenly too expensive, and soon they are repackaged as things to buy. We get choice – we get to be consumers – we get, in theory, to exercise that choice in a market.
But really, the market is not very good at some things. And when you try to apply it to these things – things like health care, and community well-being – it is very easy to see the difference between tradeable commodity and public good. Here are some banal stories about noting the difference.
This morning my partner called the local council gym to find out if he could go and try out the facilities on a one-time basis before committing to a rather expensive £41 monthly fee. The gym’s managment has recently been turned over to a private company. Their website promised a free induction, but the person on the phone explained that if you weren’t on benefit, the induction fee was £41. The same price to try the gym as for an entire month of unlimited use? Not really very accessible. At the national minimum wage, 41 pounds represents just under 8 hours of work. A full day’s work – just to try the gym? A single visit costs £6, but you can’t visit the gym without the induction. And as a working person, you can’t get the induction for less than £41.
Not surprisingly, my partner told the person on the phone “with these rates, you have just lost a client” and went to go use the fitness equipment in the local park – free of charge. I can understand gym companies wanting to make as large a profit as possible. But this was the council gym. Surely our borough, where the average family income is £17,000, should provide access to health-enhancing fitness as widely as possible. Surely working people deserve a break as well? But this would seemingly interfere with a company’s profit motive.
Maybe fitness is a choice – and one that some people are willing to pay to cultivate. But we can all get sick. This week the House of Lords is debating the Health and Social Care Bill, which introduces broad reforms to Britain’s National Health Service. Some of these reforms include removing he duty of the Secretary of State to provide or secure the provision of health services which has been a common and critical feature of all previous NHS legislation since 1946. This provision is what makes health care publicly accountable. Without this provision it’s difficult for the Secretary of State to intervene and make sure that the public’s health needs are truly being served. Not only that, but these reforms appeared out of nowhere, not being in either the Conservative or Liberal Democrat manifestos. So much for public accountability and governance.
I’ve been spending more time than usual recently in doctor’s offices and hospitals. Of course I can see problems with the NHS, but at its core it is a true public service – one which provides the same (normally good, often excellent) standard of care to everyone. So this afternoon I went to join a few thousand other people to demonstrate on Westminster Bridge (between Parliament and my local hospital) to protest these reforms and to encourage the Lords to give them the vigorous debate that they haven’t received. The debates start Tuesday and continue through Wednesday. If you’ve had enough of hearing that the market will provide things (like accountability and fairness) that it can’t, please write to a Lord and ask them to please participate in the debate.
Or one day we might all be paying more than £41 just to get a chance to see a doctor.