Public Service (Choice or Illusion)



Is there such thing as public services? Are the mechanisms of civil society now no more than commercial transactions?

Let’s start with terminology.  We are no longer patients, we are clients or stakeholders. And in the name of ever better “customer service” most medical practices and hospital trusts invite those “utilizing the services” to join a consultative committee.  Okay, on one level this allows some say in what services are wanted (but is that the same as what services are needed?). Should the “customer is always right” dictate our health, or more importantly the health of others?

Students are now customers as well.  The autumn round of school open evenings is here.  No, not to showcase the local school to next year’s batch of kids, but to sell the school to competitive scrutiny by “first time buyers.” Choice is good.  No question here.  Every learner deserves quality education.  But this isn’t “make the system good” stuff, but rather “opt for mine, its better” stuff.  Even teacher hiring now has “stakeholder” or student voice, when job candidates are interviewed by panels of 13 year olds. Maybe this is right and good.  It does again raise the question of our ability to distinguish between what we like, and what we need, however.

Are we (and this is only a question) taking consumerism to far? If I don’t like brand A, I will take brand B. Is the subjective starting to eclipse the objective?

The commercial aspect of “service” is showing in other ways, as well. Car parking fees at hospitals are standard in England. It was once argued that this stopped non-hospital users from using the parking facilities as a cheap option to visit a city, thus depriving those in need from access (something I was told at Addenbrookes, 20 years ago).  Now even rural hospitals with no easy access to anywhere else charge.  Budgets are such as to require payment by both patients (or should I say stakeholders) and staff to make ends meet.

I am a fan of the NHS. “Free at the point of use” is noble and fair. Well, free at the point of use, if you can prove residency for a year and can fill in the appropriate form, is not the same thing.

And in a world of the internet do we need libraries? That was rhetorical.

Money is the issue.  Not morality, not fairness, but commercial pressure. So we are back to the idea of customers.  This is not a political post, but a philosophical and ethical one.  Are we going to abandon public service entirely? Is it all going to be mere contractual agreements?

I am one who holds out hope for altruism. For giving every student a good education, any ill person care, for even public policing rather than contracted security.  Can we as a society really afford to be “sanctified customers?” If you say yes, then can we all be satisfied in a system that must be bought? Easy answer for a have, but what about for have nots?

Is the present rhetoric of choice and of “participation with our services” just a smokescreen to distract us from their demise? That in the end we will get what we pay for, and no more.


{this post in no way diminishes the dedication, selflessness, and zeal of those who work within the public services. Nurses, teachers, social workers, and so many more dedicate their lives to helping others. It is rather meant as a soul searching of the system in which they labour, and of the ideologies which control them.}


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s