Tuesday, 21 August 2012

And always keep a-hold of Nurse, for fear of finding something worse

The suggestion that the NHS brand could be sold overseas is being opportunistically tied to Danny Boyle's Olympics love-fest and the Team GB feelgood factor, but this does not stand up to a moment's scrutiny. Britain is adept at marketing invented heritage abroad, from upper class fashion to Scotch whisky, but the fundamental principle celebrated at the Lea Valley hoe-down is not one that can be monetised let alone exported, namely: free at the point of use. That is the core brand value, after all. Take that away and it's not clear what the NHS brand stands for, beyond a nostalgic longing for carbolic soap, tapioca pudding and Hattie Jaques.

For some, the brand idea is merely another opportunity to call for reform, which we all know ultimately means privatisation. Others claim that the NHS is already in business abroad, through Moorfields and Great Ormond Street clinics in the Middle East, so marketing the NHS brand through some form of franchising is not that radical a departure. In reality, these offshoots are selling the labour of consultants and other specialists (who operate as independent contractors), which can already be accessed privately in the UK. What they're not doing is spending public funds or exporting paid-for resources such as trained nurses or medical equipment.

One parallel that no one seems keen to point to is BBC Worldwide, the commercial arm that generates revenue by selling programmes abroad. In the catechism of the right this is an abomination that gives the subsidised BBC an unfair advantage over purely commercial broadcasters. But selling intellectual property that was developed using public funds is no different to exporting expertise and techniques developed within the NHS. Assuming "NHS International" is a franchise with local "hardware", then this "software" is what you would get for your money, presumably along with higher standards through quality control from HQ. The irony that this latter aspect is usually presented as the achilles heel of the NHS will no doubt be lost on those critics who now see merit in selling the brand.

The real point of the parallel between the NHS and the BBC is that the profits generated by the latter's Worldwide operation are seen as a justification for a cut in the licence fee, rather than as a bonus that the corporation should be entitled to use for investment. The suspicion is that NHS trusts that generate profits from overseas franchises or other tie-ups will be obliged to plough those monies back into general expenditure, thereby helping to keep overall health spending down, rather than to upgrade or expand domestic services for the benefit of UK citizens.

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