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Fake news is cheap but real newspaper journalism costs a lot of money. It is expensive to fill up the gaps between the adverts.
The decline in readership doesn't help. In regional newspapers it's a whopping 19%. Nationally, the fall was 10% in one year between 2022/3. Advertising expenditure on newspapers collapsed from over £9.9 billion in 2005 to below £2 billion in 2022.
The Telegraph, the Sun and the Times no longer publish circulation figures. Make what you will of that.
Even though they are in decline, newspapers still provide the script for other broadcasters.
Pretty-well all TV stations review the papers and few of the breakfast shows could fill the airtime without stories from the morning papers.
Newspaper’s defence is the paywall. The New York Times in 2011, they started it. Now, more than two-thirds of leading newspapers across the EU and US are operating some kind of online paywall.
Does it work? For niche audiences, like the Times and FT, probably enough to keep them going… supplemented by their excellent Times Radio which is gaining traction.
As for the rest? Probably not … but that, is for another day.
Last Friday night’s SKY newspapers-review, featured an item in the £walled Times that made me sit up and listen. It said,in terms; our great leader is poised to reintroduce ‘market’ and ‘competition’ into the NHS…
… I confess, I shouted at the Telly… ‘that would be a very silly thing to do...’, or words to that effect.
We’ve done it before and it didn’t work,
Wezzer, ma-boy…
... the Tories introduced the internal market, in the 1990s. Partly an attempt to improve cost-efficiency and quality and partly, to head off EU Procurement Directives.
In October 1999, Labour's Jumping-Jack-Flash, Alan Milburn arrived and embarked on 1,400 days of bonkersness.
Entirely unnecessarily and at eye-watering cost, some Trusts were enticed to become FTs, after Milburn had seen the Hospital Universitario Fundación Alcorcón in Spain.
Built by the Spanish NHS but managed by a private company.
Jumpin'-Jack envisaged them as a new form of not-for-profit provider, half-in and half-out of the NHS.
At the same time he pushed the NHS into marketisation, on steroids. It failed and over time, successive governments came to their senses and dumped the Milburn-Madness.
Gordon Brown prevented Milburn's plans to make FTs financially autonomous and attempts to expand them fizzled out.
Some say the pressures on Trusts to balance the books and become FTs led to the Mid-Staffs debacle.
Now Jumpn'-Jack's back and has forgotten about George Santayana;
‘… those who cannot remember the past are condemned to repeat it…’
Unabashed, I’d guess he’ll have another go...
... at pushing hospitals into some sort of social-private-enterprise and according to the Times, have another go at markets and competition…
… which, with a nod to George, may I remind you, failed and was dumped because of:
1. High Transaction Costs
The creation of contracts, negotiations, and administration between purchasers and providers ramped up bureaucracy, with huge costs. Money that could have been used for patient care.
2. Fragmentation
Competition led to a focus on individual services rather than integrated care, making coordination between different parts of the NHS impossible.
Patients with complex needs suffered because providers operated in silos rather than as part of a seamless system.
3. Limited Real Competition and Choice
Many NHS services are natural monopolies and in many areas, there were few or no alternative providers.
4. Perverse Incentives
Hospitals and providers were incentivised to prioritise financially lucrative treatments, or high volume work, over those that were most needed.
‘Gaming’ the system became common.
5. Quality
Unlike traditional markets, where consumers can easily compare products, patients, even faced with data, have no means of making informed choices about healthcare quality and longitudinal outcomes.
Plus there are difficulties with and a reluctance to travel.
6. Conflicts with NHS Ethos
The NHS was founded on principles of cooperation, universal coverage, and equity.
Now, he's back and in my view, Jumpin' Jack is 25yrs out of date and is as much of a nightmare today as he was when the world thought the Vauxhall Vectra was their dream car.
People running the NHS do not need the distraction of Milburn’s market madness, or upheaval.
People using the NHS need local services that are high quality, accessible, safe and clean.
Wezzzz... do you think you could manage that?
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