Democratic Regulation – of private providers of public services

It is widely recognised, and mostly accepted, that ‘utilities’ provide a public service and not just private services, so it is legitimate to regulate them in ways that ensure the public interest. This is partly because there are always elements of natural monopoly in the way in which these services – power, water, fixed line telephony and cable, public transport, etc – can be delivered. It makes economic sense to only have one set of lines, pipes and cables going into one property, neighbourhood, etc. The other public interest dimension of these services is that they are regarded as essential – rights almost – for survival in a modern society. hence there is usually an obligation for ‘universal service’ which includes provision of service to uneconomic areas (e.g. remote rural locations) and strict conditions on suspension of supply, usually only in extremis. Continue reading

Working for Patients?

Back in the early 1990s I was living in London and my then GP was Dr John Dunwoody, ex husband of formidable Labour MP Gwyneth Dunwoody and himself a former Labour MP. John ran a singleton practice on the edge of Clapham Common.

I was visiting John as a patient just after the first wave of ‘market’ reforms of the NHS introduced by the then Conservative government. I was reminded of this last week when both David Cameron and Nick Clegg made speeches in which they extolled the virtues of ‘working for patients’ – they didn’t use the exact phrase, but that was the key sentiment. Continue reading