There are few institutions as close to the public鈥檚 heart as the NHS, which ensures that there is intense scrutiny of any and every proposed reform.
In recent years, much of this scrutiny has focused on the extent to which the health service is being 鈥減rivatised鈥 by the expanded role of private contractors.
The chief executive of NHS England, Simon Stevens, was asked about this in an interview on BBC Radio 4鈥檚 Today programme last week 鈥 a particularly relevant line of questioning given that Stevens spent the past 10 years working for a US private health firm.
His reply was that while most care would continue to be provided by the NHS, we should 鈥渢hink like a patient and act like a taxpayer鈥 when deciding who is best to deliver services.
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In this space, new players have been encouraged to 鈥榙isrupt鈥. But private companies will want to grow their business as聽rapidly as the rules allow
This notion of putting patients at the heart of the NHS, with private providers driving quality and efficiency, has parallels with the government鈥檚 thinking on higher education.
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The aim of the 2011 higher education White Paper was to save the taxpayer money (by moving the bulk of university funding 鈥渙ff balance sheet鈥 from teaching grant to tuition fees underwritten by government) and to improve things for students by granting them consumer sovereignty and introducing market forces into the equation. However, the paper was not followed up with appropriate legislation to underpin it.
By most people鈥檚 assessment, the great consumer experiment has yet to deliver the promised sea change in the quality of education (which in most cases was pretty good in the first place), and has started the countdown on a financial time-bomb given the likely default rate of those state-backed loans.
But if these were the two main pillars of the reforms, a key component of the foundation on which they were built was an expanded, disruptive, role for 鈥渁lternative鈥 providers, who were supposed to trigger a 鈥渞ising tide that would lift all boats鈥.
David Willetts, the former universities minister, set out his thinking in a speech in 2011: 鈥淚 have worked on many different areas of the public sector over the past 30 years. The biggest lesson I have learned is that the most powerful driver of reform is to let new providers into the system. They do things differently in ways none can predict.鈥
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This last statement, at least, has proved accurate. In our cover feature, we examine in detail the way in which one alternative provider has responded to the government鈥檚 overtures, with rapid growth in the number of students with state-backed loans taking Higher National Diplomas, and the way in which the oversight of a new and emerging part of the higher education sector is working.
This is a case study of one college that is operating in a space deliberately created by the government, in which new players have been encouraged to 鈥渄isrupt鈥. There is no suggestion that it has broken any rules 鈥 it has done what private companies do and grown its business as rapidly as the rules allow.
In another Radio 4 interview last week, a GP of 25 years was asked for her view of private healthcare contractors. 鈥淚鈥檝e got nothing against alternative providers, as long as they add value to the NHS,鈥 she said. The same obvious logic applies in higher education. So the question is: can you feel that tide lapping at your toes?
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