John Spiers: We must face the facts over cash and choice
CHOICE in public services is now a key offer from all three main parties. Gordon Brown's billions, thrown at education and healthcare, have not adequately improved services and have lowered productivity. There have been too few incentives to do enough to enable Janet and John to learn to read, or their families to get good health care.
The voters are frustrated, angry, and disappointed. "Choice" is seen by politicians as the antidote, but they are too timid. Choice can only be effective if we give people back their own money or give the poor tax-credits so that they too can spend on health and on education, just like the middle-class consumer.
For choice to be an instrument rather than an aspiration we need real levers and incentives which work. The key to choice is patient (and parent) control over mobile money.
Take healthcare. First, the individual must have control over a personal tax-based individual healthcare fund. These would be spent by taking the fund to one of a number of competing, co-operative, mutual purchasers of care. It cannot be spent on lottery tickets. These organisations could be called Patient