The Compassionate Society

One of the toughest challenges in advancing libertarian ideas is to rid people of the notion that the choice is between the imperfections and inequalities of the market and seamless government intervention with negligible costs. It is like the joke about you and a friend being chased by a polar bear: you only need to out-run your friend. In the same way, it suffices to undermine the myth of beneficent government by advancing the case that intervention, whilst nominally beneficial for some specified group in the short term, is accompanied by distorted private incentives, political lobbying and bureaucratic mismanagement. The writings of Bastiat and Hazlitt are the most lucid examples of the first point, while the work of the Public Choice school challenges the assumption that actors in government are altruistic and efficient.

In recent years, one of the most effective popular media for communicating this idea has been the BBC sitcoms, Yes, Minister and Yes, Prime Minister. This Friday, the society will be hosting Jonathan Lynn (Facebook details here), the series co-writer, and each day this week, the blog will feature one of the best clips satirising government.

Today: healthcare provision.


Lynn discusses the scenario in a Q&A on his website:

The basic idea of each episode came in a variety of ways... Sometimes completely out of our own imaginations. An example of the latter would be the episode on the National Health Service in which we invented a hospital with five hundred administrative staff but no doctors, nurses or patients. This hospital won the Florence Nightingale Award for the most hygienic hospital in the country. After inventing this absurdity, we discovered there were six such hospitals (or very large empty wings of hospitals) exactly as we had described them in our episode, notably one in Cambridgeshire in which there was only one patient: the Matron (head of nursing staff) who had fallen over some scaffolding and broken her leg.

Helen Evans, director of Nurses for Reform and author of 'Sixty Years On: Who Cares for the NHS?,' draws attention to a finding that suggests the NHS bureaucracy doesn't harbour the romantic illusions of its advocates:

As Sir Humphrey says later in the same episode, in response to Hacker's outrage at the waste in public funds designated to make sick people better:

No, no, no, no, Minister: it is make everybody better - better for having shown the extent of their care and compassion. You see, Minister, when money is allocated to the health or social services, Parliament and the country feel cleansed, purified - absolved. It is a sacrifice. And when a sacrifice is made, no one asks the priest what happened to the ritual offering after the ceremony... We don't measure our success by results, but by activity, and the activity is considerable - and productive. Those five hundred people are seriously overworked...