At the time, people naturally asked: 'Will the reforms work?' There could be no convincing answer since these changes were untried and untested. A triumph of political will over professional opposition, they were driven by faith rather than experience. Timing in policy change is everything, and the Government was not prepared to miss its chance by messing around with experiments. 'Just do it' was the order to Whitehall.
Several years on, people are still asking the same question, but no clear answer is yet possible. The changes have only been half implemented and remain in a state of confusion. A study published this week and funded by the Economic and Social Research Council offers equivocal conclusions. It detects signs of improved efficiency in education and health, but these may be at the expense of the worst-off. 'Cream- skimming' of the brightest and the healthiest by schools and doctors may, it fears, be discriminating against disadvantaged children and high-risk patients.
The conclusions sound reasonable and are not fatal to either reform. It is possible to make deprived children and chronically ill patients more financially attractive. In any case, the study is flawed by the paucity of the evidence backing up its conclusions. This is forgivable since the Government remains mightily reluctant to open its reforms to the rigours of empirical research. For example, it is impossible to know whether improvements in the NHS should be attributed to injections of extra cash or the new market. Thus argument rages about why waiting lists rise and fall.
Furthermore, the expected outcomes of the reforms remain vague and subject to scant official research. This contrasts with tight regulation of privatised gas, water, electricity and telephones. Watchdogs monitor prices, quality and access to these services. Yet the education and NHS reforms are still not defended by convincing evidence or tested against strict criteria. Now that the changes are no longer threatened with reversal the Government should take courage and subject them to proper scrutiny.Reuse content