Dilemmas of investment and attaining the dream of success
There is an adage that says you can make a small fortune out of football, provided you start with a large fortune. The recent announcement concerning Glasgow Football Club tells us many things about what is frequently referred to as 'the beautiful game'; not the least of which is that it is a sure fire way to lose money.
In this blog I want to make some comparisons between football, the future of the Economic Union and reform of the National Health Service. The connection, I suggest, is the dilemma that will inevitably occur between the desire to invest in the dream of success and the reality that a supply of funds is never limitless. Much as we want the best, we sometimes have to either compromise or, worse, stop spending and give up.
So in the case of football, success is simple. You secure the services of the best, and usually most expensive, players and, hey presto, you cannot fail. Try telling that to the Glasgow supporters. If a team as big as this can go into administration then so can any other. No football club has an automatic right to exist and, I fear, more will fail.
The Economic Union is qualitatively different to football. But, as a very recent blog explained, the objective was the creation of a collection of diverse countries collaborating in the pursuit of consistent economic objectives. With sufficient investment from the rich (largely northern countries such as Germany), poorer countries (mainly Mediterranean - Spain, Portugal and Greece) would achieve success.
Similar to investors in football clubs, those providing funds for the failing 'PIIGS' economies (Portugal, Italy, Ireland, Greece and Spain) are asking, 'What is the point?' A consensus is emerging that if the dream of a United States of Europe is to survive it would be better off without the likes of Greece.
Which brings us to the NHS? Under New Labour a tremendous amount of money was invested to create a 'world class' system of health provision. When times were good we could rack up increased debt due to this investment because, compared to GDP, which was growing, the ratio didn't appear to be a problem.
Since the global financial crisis, our economy has faltered. Our GDP is, at best, stagnant and could easily become negative. If we cannot create more growth through, for example, exports all that any Chancellor George can do is to cut expenditure on the public services such as the NHS; just like the Greeks are being asked to do - again!
So, like football clubs and bankrupt economies such as Greece, we may have to accept that idea that the NHS may no longer exist in the way that they were originally intended. Reform through rationalisation and inclusion of private providers is argued to be the only way to ensure that they survive.
The desire to reform the NHS is not new. New Labour tried and, in large part, failed. Given the size and complexity of the organisation this is not surprising. It size is staggering; it employs over 1.43 million people and has a budget in excess of £100 billion.
However, because of significant increases in the costs of providing free care to an ageing population it the HHS needs even more money to pursue the dream of eradicating illness in order to make us a much healthier nation.
The trouble is that we don't have the money and, instead it is expected to make savings of £20 billion by 2015 and increase productivity by 4% each year; something that it has never achieved. If it doesn't it will follow Glasgow FC and Greece and become so bankrupt that its continued existence is questioned.
So what to do? The trouble with the NHS is that the dream is still worth pursuing but that the strategy is incoherent. The NHS bill appears to be a hotch-potch of ill-considered plans to achieve efficiencies that may be, at best, illusory. For instance, take the reform of the railways in the 1990s.
Private providers do not automatically solve your problems and we are still trying to improve a system that, to be fair, seems to have worked in the nationalised British Rail days by a 'make do and mend' culture and dedication of employees who had a passion for the organisation.
The prevailing zeitgeist is austerity. However, if in the process of achieving survival we lose expertise and undermine professionalism then that potentially creates something worse and not necessarily any less expensive. It also may leave a legacy that subsequent generations will not thank us for.
The football players at Glasgow may be assets of the club to be sold to pay debts but they will not face poverty; unlike many Greeks. If the changes being made to the NHS mean we can continue to enjoy a level of service that means everyone is entitled to the service we have become accustomed to, especially those most in need (the poor), then that is laudable.
But once you start disentangling a system as complex as the NHS, you do so at your peril. Football clubs may come and go but no one will die as a result. Greece will survive though I have no doubt it will be tough for many of its people. The key question is what our NHS will look like in the future, and how much we as a nation are prepared to invest in it?