Northern Ireland: Public Sector Failure – Private Sector Opportunity

There is plenty of opportunity in Northern Ireland. True to their word, the executive is encouraging more private enterprise in NI. The failures of the executive has facilitated an environment in which private enterprise can thrive. Infrastructure is underdeveloped. Eniskillen, Omagh and Derry are major areas of NI yet the infrastructure and transport links are poor outside of the main Belfast – Newry corridor. Moreover, healthcare services are shambolic. People are languishing for years on waiting lists while GP appointments can be difficult to come by. There is a clear need that is not being met by the state. So, in the absence of a capable executive could private enterprise take advantage of this opportunity? More importantly, should privatisation of health be considered?

Commodifying a Human Right

The majority of us will need healthcare. As a child or an adult. People are the fabric of any society so it is fundamental that a state can provide treatment in the service of a capable society. Such an important aspect of life should not be treated as a commodity. However, reality is forcing a situation upon the 1.8 million residents that requires more pragmatic thinking.

Despite the negative connotation that accompanies the word “privatisation” it is not necessarily a bad thing. Free markets are great for dealing with existing needs and what is the greatest need facing Northern Ireland right now? The problem will be controlling the costs people face. The supply and demand mechanism that determines prices can be subject to manipulation. Either factors can be suppressed or inflated artificially through a variety of methods. However it is largely recognised that competition is an efficient method to control valuation and quality of service. As a result, this would require a Stormont executive to ensure an open and competitive environment for medical enterprise to operate in.

Relying on an executive to legislate for a competitive market seems slightly naïve considering the cronyism and corruption of past executives. A monopoly will most likely arise assuming an unregulated or poorly regulated market. Monopolies have a detrimental effect on valuation as the controlling monopoly would be in a position to set prices. Northern Ireland residents would face ridiculous situations as U.S residents often find themselves in nowadays if this were to happen in a market responsible for healthcare. A cancer scare would ensure medical debt beyond our means. Quality of service will likely be reduced too. People would be forced to pay a higher price for a worse service. Stormont would then have to act to break up the medical monopoly.

Unfortunately, managing a public health service appears to be too much responsibility for the DUP and Sinn Fein. Despite this there is an alternative to fully privatising health services.

An alternative to privatisation?

Privatisation need not be all or nothing. The public service could be retained and provide common services and leave specialist treatment to the private sector. In this case, cancer services would be the sole responsibility of the NHS while treatment for Huntington’s disease may be left to the private sector. This would ensure that common necessities are catered for but it would be costly for those unlucky enough to suffer from rare diseases. Alternatively rarer diseases could be covered by the NHS while more common illness are covered by private practice. Maybe this would be a more cost effective option. Although these are just suggestions they demonstrate that privatisation is not either or.

An executive that is petrified to make tough decisions condemns society to crumble in the face of an evolving environment. By delaying the consolidation of health services when the budget was cut the executive invited the current situation to unfold. So if commodifying health is a step too far we could continue in the current cycle. Change most likely won’t come until the electorate demands better of our representatives. Effectively, there must be a continued shift away from the orange or green mentality.


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