The chimera of choice: how both Labour and the Tories are deluding the public

Worries about Blair's approach is a bond that links Brown and Prescott in an alliance of growing significance
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The Independent Online

For decades public services in Britain were some of the worst in Europe. Politicians from across the spectrum agree that in the past schools and hospitals suffered from severe under-investment and poor management. Yet suddenly we are leaping from a long drawn out era of public squalor to a sunny land where patients and parents will be spoilt for choice. Soon it seems we will be able to see Dr Smith or Dr Jones on a Saturday afternoon and attend, if we so wish, the best hospital in Newcastle for our subsequent operation. The past must have happened a long time ago.

For decades public services in Britain were some of the worst in Europe. Politicians from across the spectrum agree that in the past schools and hospitals suffered from severe under-investment and poor management. Yet suddenly we are leaping from a long drawn out era of public squalor to a sunny land where patients and parents will be spoilt for choice. Soon it seems we will be able to see Dr Smith or Dr Jones on a Saturday afternoon and attend, if we so wish, the best hospital in Newcastle for our subsequent operation. The past must have happened a long time ago.

Politicians are decent people on the whole, much more in touch with the worries of the voters than most of the media suggests. Yet I can think of no other issue that will convey a sense that they live on a different planet than their claims about choice in the public services. Some of them are deluding themselves or seeking to deceive the voters by claiming that, with a click of their fingers, Britain will move from a land of waiting lists and elusive GPs to one where a surplus of sparkling hospitals and eager doctors compete for our custom.

For a long time we have had a choice of solicitors if we have the cash to pay for them. In most parts of the country there is now a choice of private gyms, a new one seems to open each day of the week. It is possible to choose where you want to sit on a rowing machine and when you do so. An aspiring athlete can find a rowing machine day or night and at weekends too. It is not possible to see a GP at the weekend in quite the same way. Probably there are far more rowing machines in Britain than there are GPs, at least if you are willing to pay in order to develop the body of an athlete.

In 1997 Tony Blair and Gordon Brown inherited public services that were hardly breathing. The level of under-investment in Britain, compared with most other EU countries, was huge. Relative cuts in public spending did not begin with Margaret Thatcher in 1979. The Labour government that preceded her has acquired a reputation for reckless spending, but it cut expenditure ruthlessly, well before the IMF ordered it to do so. It was only halfway through the current government's first term that Tony Blair and Gordon Brown began to reverse the long downward trend in public spending. One of their most significant achievements has been to raise investment in schools and hospitals to a level comparable with other countries in Europe without damaging the economy.

Now the government is in danger of running ahead of itself. It takes years to train the doctors, nurses, and teachers. The building of new hospitals and schools takes even longer. Other countries have been spending at this level for decades. Yet Britain is already being hailed as the land of choice for the users of public services.

Even in this Fantasy Land there is a limit to the number of choices a patient or a parent would be able to make. As Gordon Brown has pointed out the provision of health care is not a typical market. In most cases no one knows when they are going to fall ill, or are experts in the types of treatment available and the costs involved. In a market many patients could not afford an expensive operation, or make use of the new technology.

When parents make choices on education they limit the possibilities for other schools and those who attend them. I live in a borough where there are choices galore, selective state schools, private schools, self -governing schools, local authority schools and specialist schools. Attending an open evening at the selective state schools is the equivalent of going to an FA Cup Final. The surrounding roads have to be policed such is the ferociously intense determination of the many thousands who turn up. Those who fail to get their kids into those schools go private or see whether the new specialist schools "specialise" in creaming off other talented kids. The other schools are called comprehensive, but are really old secondary moderns. They are stuck with the less motivated kids, or at least the parents who have not had the means or the interest to exercise their apparent choice.

It should be said that the voter has a choice of choices as the exchanges at Prime Minster's Question Time demonstrated yesterday. Tony Blair acknowledged that choice was only possible in hospitals as capacity expanded. He managed to win the argument decisively by recognising its limits. Michael Howard claimed to offer a choice throughout the whole NHS without addressing the problems of capacity. In his speech earlier this week Mr Howard cited the example of the Netherlands as a model. Indeed there is a greater range of choice for patients in the Netherlands, but partly as a result of much higher public spending for decades. In the end there is no getting away from it. Voters cannot have European-style public services and aspire to US levels of taxation.

There is an illuminating lesson for both parties in the disastrous privatisation of the railways. The reform was destructive partly because changes were implemented before the scale of under-investment was addressed. The problems arising from a shortage of cash were transferred from the government to a diverse group of companies and regulators who made the problems even worse. The state of transport in Britain has a wider lesson. It is the most decrepit of all the public services, a daily inconvenience and a national embarrassment. Yet we have plenty of choice. It is possible to travel from London to Manchester by car, train, plane or coach. Most of the time it would be cheaper and quicker to fly to Mars. There is not much point of having a choice if all the available options are dire.

On several levels this is becoming a big issue. Worry about Tony Blair's approach to public services is one of the bonds that links Gordon Brown and John Prescott in an alliance of growing significance. Some other ministers twitch uneasily. One tells me that ministers were allowed to speak for only three minutes each at a cabinet meeting that discussed the future of public services - so much for the recent misjudged speculation about a return of cabinet government.

Mr Blair is right to seek new ways in which to empower the users of public services, so that patients, pupils and commuters are more than people who make life awkward for some complacent providers of these services. Users of public services seek quality, efficiency and information. All three would be a novelty and enough for now. I do not detect a great clamour for "choice", at least not until the government builds on the substantial progress that it has made in recent years, expanding services that were in a state of crisis.

At a time when they desperately need increased support the leaderships of the Labour and Conservative parties are wooing the voters with something that the voters do not want.

s.richards@independent.co.uk

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