In today's Telegraph the PM sets out his intentions around opening up public services to competition. The starting assumption is to be competition not centralisation and it will be up to those who seek a monopoly to explain themselves, not those trying to create a market. Personal budgets will be extended and, where possible, services will be local and professionals 'empowered'.
Before I say where Cameron hasn't got it quite right, let me be clear that he's mostly correct. Whatever the Guardianistas say about co-ordination, planning, corporate takeovers and postcode lotteries, there can, I am afraid, be no way to raise productivity, innovation and meaningful choice than to introduce the market into monopolies. Thirty years ago people were saying the same thing about telecoms and other nationalised industries. The truth that cannot be hidden is that you can't expect monopolies - public or private - to serve the customer or client. They serve themselves. Period.
So what has he got wrong. Two things. Firstly he talks about empowering professionals. What I think he means here is allowing them to run free of targets, excessive paperwork and nonsensical interference. However, what a lot of people know is that you only empower clients of public services by taking professionals' power away. Put another way, it's only any good giving people personal budgets if they, not the professionals, decide how to use them. A trifling point perhaps, but having seen many good people's lives unintentionally ruined by 'professionals' in health and social care, I am not sure talk of giving them more power actually makes sense.
Secondly, Cameron needs to be very clear indeed that he intends not to replace one form of exploitative monopoly - the public sector - with another - the large corporate sector. The capital available to large corporate players in health and social care compared to that available to social enterprises, charities, local organisations and so on is massive. In a competitive situation it will be easy - as we are seeing in Welfare to Work - for the scale private sector to bag everything, kill or subordinate the competition and then turn the handle on a helpless and increasingly dependent Government commissioning body.
Only first-class market-making, protection for SMEs, capitalisation of the smaller sectors and social clauses and tough regulation will make it possible for other sectors to compete with the large beasts. Of course, partnering between private and other sectors must be encouraged. But this has be just that - partnering, not subordinating.
Otherwise, we'll just be swopping one type of expensive crap for another.