That is not because Labour ministers were useless or that a different group of people would have done the job fine. It is rather a structural problem with the British state. Its machinery was designed for a 20th-century world that no longer exists. Today's citizens are used to fast, efficient, wireless services that give them a high degree of personal choice; the lumbering bureaucracy of the state cannot catch up. Nor will aping the private sector, pretending government can be run like Domino's Pizza or DHL, work - because health, education and public safety are not like garlic bread or packages. They are much more complex to deliver.
There, in that one paragraph, we see both the clear realisation of exactly what's wrong, along with a deluded failure to grasp what's wrong. Fascinating.
Yes, the problem is the incompetence of the state. But no, it's not a new problem, and it has nothing to do with people being used to the speediness and flexibility of twenty-first-century technology. When the lumbering bureaucracy of the state caused Russians to starve in their millions back in the Twentieth Century, they weren't less pissed off about dying than they would have been had they owned laptops. And no, that same lumbering bureaucracy that makes a total arse-up of the simple tasks is not the best tool for providing the most complex services we have.
Providing education and public safety is not even all that complex — unless you try to have one centralised organisation provide the same education and public safety to every person in the country. Educating one child just takes a handful of teachers and a pile of books. It's educating a million at once in exactly the same way without ever seeing any of them that's so bloody difficult.
Health, though... yes, health is pretty damn complex. But does that really mean that private companies simply can't provide it? Can they really not manage anything trickier than pizza? Well, you're reading this right now thanks to private companies. Hundreds of different companies somehow coordinated their activities to produce all the hardware and software that I've used to create this blog and you're using to access it. Chances are that the screen your computer's using is made by yet another firm out of components made by yet others, and then there are the private telecoms networks that enable me to write this in Northern Ireland, save the data somewhere in the US, and publish it internationally, with a delay of mere seconds between those three processes. I can even blog from my phone if I like, seamlessly coordinating the services of yet more firms. And how about food? Think for a minute about what's involved in bringing a nice meal to your table in a restaurant. Even just the pepper and salt: one grows in trees, the other needs to be extracted from seawater or mined. Yet, somehow, private farmers, private hauliers, private chefs, private waiters, private importers, private curers and smokers, and private fishermen manage to pull it off, millions of times a day. Does anyone really think that all this would work better if it were run by the state?
In the US, health provision is handled by private firms. For pretty much every potentially fatal disease, they have a higher survival rate than we have in the UK. Sure, there's an argument to be had about the ethics of their funding mechanisms, but that's a separate issue. If it is true that health is so complex that only the state can manage it, how comes having the state manage it causes so many more people to die?
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