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We might be in danger of receiving threats this week.. Nevertheless we'd like to discuss the power of the NHS (what’s new we hear you cry).

It is of course a hugely loved institution in this country. Witness the Thursday hand-clapping and the posters in villages praising staff during the pandemic.

However, its sheer scale of operation leads to problems.

Witness the issue of compulsory vaccination raised last week. Independent observers tend to agree that the real reason the government backed down on mandatory vaccination was that the NHS said it would fall over if the policy was implemented.

Recruitment remains the biggest problem area in health and social care, and again the NHS has an outsized and malign influence on the marketplace.

Other providers simply cannot compete with an organisation that has 12.4 million staff and a budget of over £100 billion.

There is a compelling argument also that the quality of delivery in the NHS is poor. As an economist, you would be surprised if a monopoly provider of healthcare, with no real competition, delivery quality.

There tends to be a general misunderstanding of privatisation.

Whenever it is mentioned the majority of the public shouts no, thinking that privatisation will mean that they will no longer get healthcare free at the point of delivery.

But what if that key principle remained – but you had a choice of provider.

So we continued to pay for the NHS through general taxation, but there would be a number of primary and secondary healthcare providers, competing to provide the best quality at the cheapest price.

What then?

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