Market Forces or Government Knows Best?

The government wants to close local hospitals and put them into “centres of excellence”. “Centres Of Excellence” is a title, not a description. They want to do this because it makes for “better treatment” by concentrating the expertise. There is some evidence for this in major/catastrophic ill health such as, cancer, stroke, heart attack etc but far more evidence that early treatment prevents long term complications and speedy recovery. To this end ambulance staff have become paramedics, able to diagnose and administer doctor like treatments. This provides the early intervention while the patient is transported to the hospital. I don’t have the knowledge to know if one counteracts the other, but it seems clear that if you are going to close local hospitals you need to increase ambulances and paramedics to compensate. Anyone seeing this? Ultimately the argument is about efficiency verses community.

Market forces would say that locals are against hospital closures, but government knows best!  

On the other hand shopping is (and has been for some time) gradually moving away from high streets. To purpose built shopping centres and out of town supermarkets and outlet villages/parks, and more recently to online shopping. Why the shift? Convenience. Traditional high streets do not have the choice, are often more expensive and crowded on Saturdays. They are difficult to get to, with one way systems, expensive and labyrinth parking. As high street shops close, so foot fall drops leading to other shops failing. The high street becomes shabby and pubs, cinemas, restaurants start to lose out as the high street stops being a destination. Yet the government (and local government) want to keep the high street open. Suddenly community is more important than efficiency. Why? Money, business rates, VAT and other taxes. You know you are taxed and when you earn and spend money. This is about the spending. Some of this spending tax is direct (VAT) other is indirect, so an element of the price you pay goes to cover the retailer’s rates, tax on their rent payments, the tax and national insurance it pays it staff, the tax on the building, content, and public liability insurance, the tax on the fuel to deliver to and heat/light the shop. The revenues from parking charges, parking fines etc. Buy online from someone like Amazon, Play et al and you don’t pay UK VAT you pay Belgium. Jersey  or other VAT. Its lower and the end price reflect this. Even getting your supermarket shopping delivered saves on fuel, car maintenance, time and stops you passing other shops and that impulse buy. 

The Governments plan is give new shops the first 6 months off from paying business rates. That a great idea, at least for the first six months they won't be losing as much while the high street and shop is empty. Nice pedestrianised areas, just missing pedestrians. Think laterally. free land trains that are also road sweepers, so people can get from car park and up and down the high street easily with bags full of shopping. Come on something imaginative! 

Market forces (people voting with their feet and purses) says close the high street (as they are), but the government knows best!